Retina practices front $1,500 to $2,200 per anti-VEGF dose and wait 30 to 90 days to get paid. A banking structure that maps to the drug spend cycle cuts the carrying cost.
Retina practices buy anti-VEGF inventory at $1,500 to $2,200 per dose, then wait 30 to 90 days for reimbursement. Most fund the gap with a working capital line of credit. Smarter banking does not eliminate the gap, but it reduces what funding it costs.
A retina practice running anti-VEGF injections is operating one of the highest-volume drug spend businesses in outpatient medicine. A single Eylea, Avastin, or Lucentis dose can cost the practice $1,500 to $2,200, paid up front to the wholesaler. Reimbursement typically comes 30 to 60 days later, sometimes longer. Margins are slim. Volume covers it. But the cash gap between buying the drug and getting paid for it is real, structurally close to Mohs surgery's 90-day cash gap (opens in a new tab), just funded with drugs instead of surgical time. Most practices manage that gap with a working capital line of credit.
A typical retina practice buys anti-VEGF inventory weekly or biweekly. A practice doing 200 injections a month spends $300,000 to $440,000 a month on drug acquisition. Reimbursement timing varies by payer:
Working AR for a busy retina practice routinely sits at $500K to $2M in receivables tied to drug-billed claims. That AR has to be funded. Most practices fund it with a working capital line of credit.
The structure most retina-heavy practices land on:
Drug spend has its own ledger from acquisition to reimbursement, the same virtual-account structure behind banking built for multi-service-line healthcare practices (opens in a new tab). Your CFO or revenue cycle lead can answer "are we current on our drug billing?" at any point in the day, not just after a quarterly reconciliation.
Idle cash earning 1.75% APY across a typical retina practice's $1M to $3M operating reserve generates $17,500 to $52,500 a year. That does not eliminate your line of credit, but it offsets a meaningful share of the carrying cost. FDIC coverage runs up to $10M per entity through the IntraFi sweep network, so the reserve sits insured even on the days a large reimbursement batch lands.
ACH is $0 in both directions, so paying the wholesaler weekly does not introduce per-transaction fees. Wires are a flat $15 if a wholesaler requires one for a same-day order.
Per-stream virtual accounts give you the data to answer questions retina practices struggle with:
These questions are usually answered through manual reconciliation between the practice management system and bank deposits, the same fragmentation that shows up when exam, surgical, and optical revenue share one account (opens in a new tab). A virtual-account structure shortens the answer to a dashboard view.
A solo retina specialist with one part-time injection day might not need this structure. A multi-provider retina group running 500 or more injections a month, especially one carrying a working capital line of credit, will usually recover the migration cost in the first quarter through cleaner cash visibility, recovered yield, and better working capital management, much like the case for routing ambulatory surgery center revenue separately (opens in a new tab) on the surgical side of a retina practice.
The transition follows the same cadence as any other multi-payer migration: open the new account, provision virtual accounts, update payer EFT enrollments, run parallel for one cycle, close the old account. Six to eight weeks end-to-end.