Frequently asked questions.
Answers to the most common questions from healthcare providers, billing teams, revenue cycle management firms, and practice administrators.
Is Copay a loan?+
No. Copay purchases your insurance receivables outright. There is no debt, no interest rate, and no repayment schedule. Nothing is added to your balance sheet and no personal guarantee is required.
How is this different from medical factoring?+
Medical factoring companies typically contact your payors and have recourse on denied claims. Copay does neither. Copay does not contact your payors, your payor contracts are not altered, and Copay absorbs the loss on eligible denied claims.
How is this different from a line of credit or MCA?+
A line of credit is debt. A merchant cash advance is a high-cost loan against future revenue. Copay is neither. Copay purchases specific insurance receivables at the service-line level. No debt, no interest, no daily repayment schedule.
Who is Copay built for?+
Copay works with licensed healthcare providers across more than 40 specialties who bill commercial payors. Solo practices, small groups, and large multi-specialty groups are all eligible. No minimum volume required.
How does Copay make money?+
Copay earns a discount fee on each claim purchase, deducted before deposit. No other fees, no monthly charges, no interest, and no hidden terms.
How do I apply?+
Schedule a demo through this website or contact our team directly. After an initial conversation, you complete a brief application covering your practice entity, licensing, payor mix, and billing history.
How long does underwriting take?+
Most practices complete the underwriting review within a few business days. Integration is typically completed within one to two weeks after approval.
Is there a cost to apply?+
No. There is no application fee, no setup fee, and no cost to join. You pay the discount fee only when claims are purchased.
What do I need to get started?+
A valid healthcare provider license, an active payor contract with at least one commercial payor, a practice bank account, and an existing billing operation using an EHR, practice management system, or clearinghouse.
When do I receive the cash?+
Eligible claims submitted on a given business day are funded the following business day via ACH directly to your practice bank account. No draw request required.
How is the purchase amount calculated?+
Each claim is evaluated individually using Copay's Expected Net Reimbursement model, based on actual reimbursement performance data for your specific payor, procedure, and specialty. No blended rates.
Does my billing team need to do anything differently?+
No. Your team submits claims exactly as always through your existing EHR, practice management system, or clearinghouse. Nothing changes.
Which payors are eligible?+
All major commercial payors are eligible including UnitedHealthcare, Anthem, Aetna, Cigna, Humana, Blue Cross Blue Shield, Centene, and Molina. Medicare and Medicaid eligibility varies by state and is confirmed during your application review.
Is there a minimum claim volume?+
No minimum claim count or dollar volume is required to apply or maintain your facility.
What happens when my volume grows?+
Your available facility grows automatically with your claim volume. No renegotiation, no new application required.
What happens if a claim is denied?+
If an eligible purchased claim is denied by the payor, Copay absorbs the loss. You keep the full amount deposited. No clawback, no adjustment to your account.
What happens if a claim pays less than expected?+
If an eligible purchased claim pays below the purchase amount, Copay absorbs the variance. You are not responsible for the difference.
How does reconciliation work?+
As payors release remittances, Copay automatically matches them against purchased claims. Your billing team receives remittance advice as normal. No action required from your team.
Does Copay contact my payors?+
No. Copay does not contact your payors, does not notify them of the arrangement, and does not alter your payor contracts. Your revenue cycle relationships remain entirely yours.
What happens if a claim is adjusted post-payment?+
Adjustments on eligible purchased claims are reconciled automatically. Your billing team does not need to take any action.
How does Copay connect to my billing system?+
Copay integrates at the clearinghouse or EDI layer. The integration is configured during onboarding and does not require changes to your existing billing software.
Does Copay work with medical billing companies and RCM firms?+
Yes. Copay works with practices that manage billing in-house and with practices using a medical billing company, revenue cycle management firm, or RCM platform. Your billing operation does not need to change.
Does Copay work with telehealth billing?+
Yes. Claims billed for Telehealth Provided in Patient's Home and Telehealth Provided Other than in Patient's Home are eligible on the same terms as in-person visits nationwide.
What EHR and practice management systems does Copay work with?+
Copay is compatible with all major EHR and practice management platforms. Because Copay connects at the clearinghouse layer, no changes to your existing system are required.
Do I need to notify my clearinghouse?+
Your Copay integration team will guide you through the clearinghouse setup during onboarding. In most cases this is a simple configuration change that requires no action from your billing staff.
Is Copay HIPAA compliant?+
Yes. Copay is HIPAA compliant by design. Claim data is encrypted and secured with end-to-end encryption and role-based access controls.
Is a Business Associate Agreement required?+
Yes. A Business Associate Agreement is signed with every practice before the integration goes live.
How is my claim data protected?+
All claim data is encrypted in transit and at rest using end-to-end encryption. Access is controlled through role-based permissions. Copay maintains strict data handling policies in compliance with HIPAA requirements.
Does Copay sell or share my data?+
No. Copay does not sell or share your practice or patient data with third parties.
Still have questions?
Schedule a demo and ask us directly.
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