Why do banks turn down medical practices for loans?

This is the one industry on the list where approval is not usually the obstacle. Practices have strong personal credit, professional qualifications and durable demand, and a bank will often lend.

The obstacle is the calendar. A bank term loan takes weeks of underwriting, and reimbursement gaps do not announce themselves weeks in advance — a payer changes a coding rule or slows a batch and the shortfall is next month.

Practices also carry heavy equipment finance and leasehold debt already, and existing obligations reduce what a bank will add on top.

The receivable is the whole story. Money is genuinely earned; it is simply in transit. Funders underwrite the deposit history that proves the payers eventually pay.

Speed is what is actually being bought here. Days rather than weeks is the difference between covering a payroll and not, and it is worth paying for in a way a long-term expansion is not.

Equipment belongs on its own financing. Imaging, chairs and lasers secure their own loans at rates that working capital cannot match.

Working capital sized to your deposit history bridges the months between treating patients and being reimbursed, which is the real gap in most practices.

Chairs, imaging and other clinical equipment cost less as equipment financing, because the equipment secures it. A practice can often still get a bank loan; the alternative is chosen for timing, because a bank's timeline rarely matches a payroll date.

Six months of business bank statements showing payer deposits.

Your payer mix, roughly. A practice weighted to slow payers is a different risk from one settling weekly.

Any existing equipment finance, which underwriting will see anyway.