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How It Works

From claim submission to cash in your account.

A complete walkthrough of the Copay process, from the moment your billing team submits a claim through final payor reconciliation.

Product Overview
1
Submit claims as normal
Day 1
Your billing team submits through your existing EHR and clearinghouse. Nothing changes.
CPT 90837
CPT 90791
Aetna
2
Funds in your account
Next Business Day
Purchase amount deposited
$164.80
No draw request · No approval process · Automatic
3
Payor reimburses Copay
Day 30–90
AetnaReconciled
UnitedHealthcareReconciled
CignaReconciled
The Process

Four stages. Zero changes to your workflow.

1
Day 1 — Claim Submission

Your team submits claims the same way they always have.

Your billing team continues using your existing EHR, practice management system, billing platform, and clearinghouse to submit claims to payors. Nothing changes to your workflow.

Submitted claims are eligible for purchase based on payor type and procedure and claim level eligibility. Ineligible claims are flagged and excluded before any purchase is calculated.:
2
Day 2 — Funding

Funds are deposited into your practice bank account by the next business day.

For each eligible claim identified on Day 1, Copay calculates the advance amount based on the Expected Net Reimbursement for that specific claim, less the applicable discount fee. The net advance is transmitted via ACH to your designated practice bank account. No draw request required. No approval email to wait for. Embedded funding that runs automatically with your existing billing process.

How the advance is calculated: Each claim is priced individually using actual reimbursement performance data for your payor, procedure, and specialty combination. The purchase reflects the real expected payment for that specific claim.
3
Day 30–90 — Payor Reimbursement

Your payor pays on their normal schedule. Copay handles the rest.

Your payor pays on their usual timeline. Nothing changes on their end, and nothing changes for your billing team. Copay reconciles each purchased claim as remittances are released, your practice has already been paid before the remittance occurs.

What reconciliation looks like: As remittances are released by each payor, Copay automatically matches them against purchased claims. Your billing team receives remittance advice as normal.
4
Ongoing — Reconciliation

Copay reconciles every claim. You see everything in your dashboard.

The process runs automatically every billing cycle without a draw request, approval step, or manual trigger. As your practice grows more providers, more patients, more volume your available facility grows with it. No renegotiation, no new application. Copay is built to scale with you so you can focus on building your practice, not managing your cash flow.

Scales automatically: Your facility capacity increases as your claim volume increases. Adding providers, more patients, or opening a new location expands your available funding without any action on your part.
Integration

Works with what you already use.

Copay connects to your existing billing infrastructure. No new software, no new logins, no training required for your billing team.

EHR / PM Systems

Practice Management Integration

Copay connects to leading EHR and practice management systems. Your billing team continues submitting claims through the same platform they use today.

Clearinghouses

Clearinghouse Compatibility

Claims submitted through clearinghouses are fully supported. Copay reads claim data at the clearinghouse layer without interrupting your existing submission workflow.

Setup

Implementation in Days

Once approved, integration is typically completed within one to two weeks. Copay's implementation team handles the technical setup. Your staff involvement is minimal.

What Happens to Denials

Non-recourse means what it says.

Eligible purchased claims that are denied, reduced, or not paid by the payor result in no financial obligation for your practice.

You keep the advance

The cash advanced on a denied eligible claim is yours to keep. Copay does not reverse, reduce, or clawback the payment.

No action required

Your billing team does not need to notify Copay of a denial or take any steps. Reconciliation is automatic.

Appeals remain yours

You may still appeal denied claims through your normal process. Any recovery on an appealed claim is handled per your purchase agreement terms.

What makes a claim eligible?

Eligibility is determined at the time of purchase based on payor type, procedure type, and your approved facility terms. Claims billed to Workers Compensation, auto, or no-fault payors are excluded. Patient responsibility balances are excluded. All other commercial payor claims are evaluated individually and either purchased or flagged as ineligible before any advance is calculated. You are never advanced on a claim Copay does not intend to purchase.

See how it works for your specialty.

Schedule a 30-minute demo and we will walk through the process with your actual payor mix.

Schedule a Demo Benefits and Features