Challenge

Commercial Payors only reimburse hospitals for services when they send the explanation of payment data (835s) from adjudicated claims; accordingly, there is a 2-7 week delay from a claim being adjudicated until payment is made to a Medical Provider.

Solution

Because NMFS has the ability to interrogate the adjudicated claims databases of major Commercial Payors daily, NMFS will know how much a hospital client will be paid for services weeks before they know … hence

• NMFS may advance funds to hospitals with a certainty of the amount Commercial Payor will pay
• NMFS does not require a client hospital to enter into a borrowing agreement, nor does NMFS place any liens on hospital assets
• NMFS payments received by a hospital are not booked as cash and a liability; but rather, as cash and an offset to accounts receivable
• Because NMFS is advancing the precise amount the Commercial Payor, via the adjudication process, will be paying, there is no reconciliation requirement … which traditional factoring companies do require
• NMFS does not interfere with any debt covenants a hospital may have with existing lenders, including accounts receivable financing companies, nor does it increase the NMFS hospital client’s debt
• NMFS does not charge interest on the rapid payment advances. Rather, NMFS’s fee (as with VISA/MasterCard/American Express) is in the form of a reduction in payment of the medical claims for which rapid payment was made
• Implementing NMFS reduces days of accounts receivable with no need to augment administrative processes managed by RCM staff