Industries / Medical and dental practices
Medical and dental practices: capital between the payer and the payroll.
Physician owned practices, dental groups, specialty clinics and infusion sites. How the payer cycle reads in the statements, where practices get stacked, the facilities that fit, and what a sale process looks like when the owner is ready to exit.
What the read looks for
4 things an underwriter reads in this trade before the application.
The bank statements are read first in every trade. In this 1, these are the 4 patterns the read is looking for, and the 4 things to have explained before you send the file.
The payer cycle
Insurance receivables arrive in lumps 30 to 90 days behind the visit, while payroll, rent and supplies leave every 2 weeks. An underwriter reads the gap between the 2 as the working capital need, and a practice that shows the pattern clearly is easier to fund than 1 that hides it.
Payroll as the largest debit
Clinical staff are the biggest line and the least flexible. The read asks whether deposits cover payroll every cycle without the account going negative, and how the practice bridged the cycles when they did not.
Equipment and buildout
Imaging, chairs, infusion suites and tenant improvements show up as equipment notes and lease obligations. They are also collateral, and they are how a lender sizes an expansion facility.
The owner's draw
An owner who takes distributions and also personally guarantees the practice debt is read on both files, the practice's and the owner's own. The credit briefs explain why both matter.
The common position stack
Expansion and a slow payer build the stack.
How the stack usually builds in this trade, and the way out of it.
A practice opens a second operatory or adds a provider, the payer credentialing runs long, and a short advance covers 2 payroll cycles. A second advance follows for the equipment deposit. The remittances then pull from the very receipts the practice was growing into. The clean exit is a facility sized on the receivables and the equipment that retires the positions at closing and returns the practice to 1 monthly payment.
Facilities that fit
3 structures that match the trade.
Structures, not offers. Every facility is arranged through third party lenders and is subject to their underwriting and approval. Which 1 fits is decided by the file, not by the page.
Term loans
Fixed monthly payments for equipment, buildout or provider expansion, sized on collections.
Read more FacilityPosition buyout
Advance positions retired in full at closing, replaced by 1 monthly payment.
Read more FacilityBusiness sale brokerage
A run sale process to strategics and sponsors when the owner is ready to exit, with the founder's continuity plan built into the story.
Read moreQuestions from the trade
Answered straight.
Who buys a practice, and what do they read first?
National networks, platform companies backed by private equity, hospital systems and other practices. The first question every 1 asks is clinical continuity: who runs the practice the day after closing. The second is adjusted EBITDA, not the tax return. A sale process that answers both before the first call gets read; 1 that does not gets a polite pass.
Our receivables are mostly insurance. Can they be collateral?
Yes. Healthcare receivables are a recognized collateral class, and lenders size on collections history by payer. A practice that can show 12 months of collections by payer is ready for a facility; 1 that can only show bank deposits gets a smaller read.
Do you work with practices outside the lower 48?
Yes. Citadel Ridge serves operating businesses nationwide, including Alaska and Hawaii, and the process runs remotely from intake through funding.
Start with the file
A straight read within 2 business days.
Send the basics through the intake form: what the file supports, what is missing, and the next step if there is one. If we are not the right desk for it, we say so.