The latest 2025 Revenue Cycle Management Survey conducted by Smarter Technologies in partnership with MedCity News just confirmed what every practice manager already knows: Over 40% of respondents said it currently takes two months or longer to receive reimbursement. Medicaid is even slower, with some cases stretching over six months. This is real money sitting in someone else’s system.
For a growing practice, 60 days is not just a delay. It is working capital that is locked up. It is rent. It is payroll. It is a nurse you cannot hire yet. It is an infusion chair your practice needs but cannot get. The care is done. The revenue is earned. The payment is late.
Why this hurts more right now
Costs have not gone down. Staffing is still tight. Payers keep changing rules and prior auth requirements, which affects how fast a claim can move through the system. Multiple 2025 reports are pointing to the same pattern. Claims eventually pay, but they pay slowly, and every extra week sits on the practice’s balance sheet instead of in the bank.
That is why even well run practices can feel cash pressure in a single month when volume goes up or when a big block of claims is sitting with a slower payer.
Where is the cash getting stuck
Most practices are not failing to bill. The problem shows up after submission.
We speak to practices every day that are doing the work. Claims go out on time. They follow payer rules. The EHR is set up the way payers want it. Then the money crawls in. It is the same story over and over.
- One commercial payer pays in about two weeks.
- Another takes 45 days.
- Medicaid takes longer than anyone wants to admit.
- A few denials hit, staff resubmits, and suddenly payroll for that month is off.
What makes it so frustrating is that the work is already done. The patient was treated. The claim was submitted. That revenue belongs to the practice. It is just sitting in someone else’s queue.
This is a very personal topic for us. Most of our team come from previous healthcare careers. Three people on our team worked together at a leading telehealth network that handled more than a million visits. Telehealth grew fast, but reimbursement did not move at the same speed. Visit volume was there. Patients were seen. Claims went out… But cash still lagged because payers were not paying as quickly as the clinical side was delivering care. Living through that at scale is some of the reasons we build Thrivory. We see the same pattern providers are dealing with today. Modern care, with a payment model 20 years behind.
So when we say this is not an abstract RCM topic, we mean it. We have watched administrators chase remits. We have watched founders track cash daily while waiting for money they already earned. We have seen teams lose hours on resubmissions and appeals instead of working on the things that make the practice more efficient. It wears people out. It is not bad management. It is a payment system that moves too slowly.
The usual fixes are just duct tape
Most practices already do the obvious things.
- Cleaner claims
- Better eligibility checks
- Staff training on denial codes
- Tighter edits in the practice management system
All of that is smart and should continue. It still does not change the fact that payers pay on their timeline. You can improve your rejection rate and still sit 45 to 60 days waiting to get paid. The 2025 surveys are showing that the delay continues to be on the payer side, not the practice.
Traditional financing is not a solution either. Lenders don’t understand healthcare. They want collateral and account control, with full recourse and sky-high fees. A client mentioned during a call that one of the lenders she spoke with wanted a $5k non-refundable due diligence fee. That is a tough pill to swallow when your real problem is that Blue Cross is at day 47.
A cleaner way to think about it
Here is the simple version. You submit a clean, recent claim. You know you will be paid. You just do not know when. That lag is your money trapped in the payer pipeline.
Thrivory was built to unlock that part of the process.
- The practice submits a new claim.
- Thrivory advances up to 80% of the expected value right away.
- When the payer reimburses, Thrivory collects repayment plus a one time low flat fee.
- If the payer does not pay, Thrivory absorbs 100% of the loss.
There is no loan. There is no interest. There are no personal guarantees. Billing and bank setup stay the same. Thrivory is purchasing the claim asset and turning it into immediate capital so the practice can use its own revenue on time. Which is what providers wanted in the first place.
Welcome to instant adjudication.