Lending Against Your Lien Book: Financing Options for the U.S. PI Medical Practices

Wherever you practice, the economics of personal injury are the same: money moves from insurers through settlements into trust accounts, fees, liens, and finally provider and client hands — and the accounting has to keep up.

PI medical practices in the U.S. face a brutal working-capital equation: payroll is due every two weeks, and your biggest asset is a lien book that pays out on someone else's litigation timeline.

Ways PI practices finance the gap

• Receivables-based lines of credit. Lenders will advance against LOP receivables — but only against credible, reduction-adjusted valuations, not gross billed charges.
• Lien portfolio sales. Selling aged liens at a discount converts paper to cash. Sometimes smart, often expensive; the breakeven depends on your real collection rate and time-value of the cash.
• Equipment financing & SBA lending. For imaging, treatment tech, and expansion — usually the cheapest capital a practice can access, and heavily dependent on the quality of your financial statements.

The valuation problem

Everything above hinges on one question: what is your lien book actually worth? A practice that tracks collection rates by referring firm and case type can answer with evidence. A practice guessing from gross receivables gets worse terms — or a loan sized to a fantasy.

Where we fit

We produce the lien-book valuations and monthly financials that make every state practices bankable, model sell-vs-hold decisions on aged liens, and structure whatever financing you choose so it's accounted for and deducted correctly.