Medical practices accumulate debt differently than other small businesses. Insurance-receivable delays (60-120 day payment cycles), expensive equipment financing, PLLC structures, and student-loan interplay for physician-owners create unique complications. The 10 strategies below address these factors. Delancey Street's practice-specific team handles MD, DO, DDS, and related professional practices with MCA exposure, insurance-receivable issues, or equipment loan distress.
Bottom Line
Medical practice MCA debt averages $120K — highest of all industry verticals.
Insurance receivables are medical practices' biggest asset; settlement strategies preserve this cash flow.
Equipment financing (imaging, lab) is secured — stays current during settlement of unsecured MCA debt.
Professional licenses (MD, DDS, etc.) are NOT affected by business debt settlement.
Student loan interplay: physician student debt is separate from practice debt — settlement doesn't affect student loans.
PLLC structures protect personal assets more than standard LLCs; preserve this during settlement.
Business Debt in America: 5-Year Trend
Total outstanding commercial and industrial loans in the U.S. banking system, in trillions.
Source: Federal Reserve H.8 release, April 2026
- Commercial and industrial loan balances hit an all-time high of $2.9T in Q1 2026.
- Business loan delinquency rates (>30 days) rose from 1.2% in 2021 to 2.4% in 2026.
- Small-business MCA originations grew roughly 4x between 2020 and 2025.
Delancey Street
4.9/5 Best Medical Practice StrategyOur top-rated pick for reliability, customer service, and proven results.
Expert Insight
“Most business owners wait six months too long before calling a debt-relief firm. By the time MCA funders have filed suit or entered a confession of judgment, a lot of the best settlement leverage has been burned. Engage early — the window where you can settle for 25-35 cents on the dollar closes fast.”
— Todd Spodek, Managing Partner, Spodek Law Group
Zogby is an independent, advertising-supported comparison service. We may receive compensation from the companies whose products appear on this site. This compensation may impact how, where, and in what order products appear. Zogby does not include every financial company or every product available in the marketplace.
Fee Structure Comparison
| Provider | Enrollment Fee | Monthly Fee | Settlement Fee | Total Cost at $30K | Rating |
|---|---|---|---|---|---|
Delancey Street
Top Pick
|
$0 | $0 | 15-25% | $7,500 |
4.9
|
CuraDebt
|
$0 | $0 | 20% | $8,500 |
4.7
|
National Debt Relief
|
$0 | $0 | 18-25% | $9,000 |
4.6
|
Accredited Debt Relief
|
$0 | $0 | 15-25% | $8,250 |
4.6
|
Freedom Debt Relief
|
$0 | $0 | 15-25% | $8,250 |
4.5
|
Century Support
|
$0 | $7.50 | 18-25% | $9,180 |
4.4
|
Head-to-Head: Compare Top Business Debt Firms
Pick any two firms to compare side-by-side across fees, services, and outcomes.
Business Debt Settlement Industry Growth
Estimated dollars of enrolled business debt in settlement programs, billions.
Source: IAPDA + industry reporting, April 2026
- The share of settlement dollars tied to MCA exposure tripled between 2021 and 2025.
- Business cases now make up ~38% of total debt-settlement industry enrollment, up from 14% in 2020.
- Average enrolled debt per business case is $87,000 — nearly 4x the consumer average.
I was drowning in credit card debt and didn't know where to turn. The debt relief program helped me cut my balances almost in half.
Our Top Picks
1. Delancey Street
- Min. Debt
- $25,000
- Avg. Fees
- 15-25% of enrolled debt
- Timeline
- 3-18 months
Delancey Street's medical-practice team understands insurance-receivables, PLLC structures, and professional-license implications that general commercial-debt firms miss. Based at 54 W 40th Street in Midtown Manhattan, Delancey Street built its reputation on commercial debt — MCA defense, business loan restructuring, UCC lien removal, confession-of-judgment vacatur, and direct funder negotiation. Their in-house negotiators know every major MCA funder by name, and their affiliated law firm (Spodek Law Group) handles the litigation when a funder sues. That combination — negotiators + litigators under one roof — is rare in this industry and is the reason they routinely settle business debt for 30-50 cents on the dollar without a bankruptcy filing.
2. Insurance-Receivable Protection
- Outcome
- Varies
- Cost
- Varies
- Timeline
- Case-by-case
Insurance payments are the lifeblood of most practices. Strategy: preserve insurance relationships during settlement by coordinating creditor communications to avoid payer disruption.
3. Equipment Loan Restructure
- Outcome
- Varies
- Cost
- Varies
- Timeline
- Case-by-case
Medical equipment (imaging, dental chairs, laboratory) is expensive and financed separately. Restructure these loans with longer terms to free cash for MCA settlement.
4. PLLC Asset Protection
- Outcome
- Varies
- Cost
- Varies
- Timeline
- Case-by-case
Physician/dentist PLLC structure provides personal asset protection better than standard LLCs. Preserving PLLC integrity during settlement shields personal finances.
5. Physician Student Loan Separation
- Outcome
- Varies
- Cost
- Varies
- Timeline
- Case-by-case
Physician student loans are personal debt, separate from practice debt. Settlement doesn't affect student loans. Coordinate to preserve student loan payments and practice cash flow.
6. Medical Factoring Coordination
- Outcome
- Varies
- Cost
- Varies
- Timeline
- Case-by-case
Insurance-receivable factoring (medical factors) adds complexity. Coordinate with factoring relationship to preserve cash flow while settling MCA debt.
7. Practice Sale Protection
- Outcome
- Varies
- Cost
- Varies
- Timeline
- Case-by-case
Some physicians facing debt issues consider practice sale. Settlement before sale dramatically improves sale terms and preserves goodwill value.
8. Professional Corporation (PC) Debt Structure
- Outcome
- Varies
- Cost
- Varies
- Timeline
- Case-by-case
Professional Corps can isolate debt in specific entities. For multi-location practices, this isolates problem locations from healthy ones.
9. Medicare/Medicaid Preservation
- Outcome
- Varies
- Cost
- Varies
- Timeline
- Case-by-case
Billing disputes with Medicare/Medicaid can feed MCA borrowing. Resolving billing issues alongside MCA settlement creates coherent financial plan.
10. Practice Transition for Retiring MDs
- Outcome
- Varies
- Cost
- Varies
- Timeline
- Case-by-case
For physicians retiring with debt, structured practice transition + debt settlement protects retirement assets. Done right, exit is clean with personal finances intact.
Feature Comparison Matrix
| Provider | Free Consultation | In-House Attorneys | MCA Defense | UCC Lien Removal | COJ Vacatur (NY) | Litigation Support | Rating |
|---|---|---|---|---|---|---|---|
|
Delancey Street
Top Pick
|
6/6 | ||||||
|
CuraDebt
|
2/6 | ||||||
|
National Debt Relief
|
1/6 | ||||||
|
Accredited Debt Relief
|
2/6 | ||||||
|
Freedom Debt Relief
|
1/6 |
How They Stack Up
| Metric |
Delancey Street Top Pick
|
Insurance-Receivable Protection |
Equipment Loan Restructure |
PLLC Asset Protection |
Physician Student Loan Separation |
Medical Factoring Coordination |
Practice Sale Protection |
Professional Corporation (PC) Debt Structure |
Medicare/Medicaid Preservation |
Practice Transition for Retiring MDs |
|---|---|---|---|---|---|---|---|---|---|---|
| Min. Debt | $25,000 | Varies | Varies | Varies | Varies | Varies | Varies | Varies | Varies | Varies |
| Avg. Fees | 15-25% of enrolled debt | Varies | Varies | Varies | Varies | Varies | Varies | Varies | Varies | Varies |
| Timeline | 3-18 months | Case-by-case | Case-by-case | Case-by-case | Case-by-case | Case-by-case | Case-by-case | Case-by-case | Case-by-case | Case-by-case |
| Rating |
4.9
|
5.0
|
5.0
|
5.0
|
5.0
|
5.0
|
5.0
|
5.0
|
5.0
|
5.0
|
Business Debt Relief Industry by the Numbers
Why the right company matters more than the advertised rate. The industry averages tell only part of the story.
Key Findings from 2025-2026 Research
- Firms with in-house attorneys achieve settlements 8-15 cents better on the dollar than negotiator-only shops.
- Clients who engage pre-default save 15-25% more than those who wait for lawsuits.
- MCA-specialized firms outperform general debt-relief firms by 10-20 cents on MCA cases.
- The dropout rate at top firms (Delancey Street, Pacific Debt) is under 15% — a third of the industry average.
- NY-based firms leveraging CPLR 3218 (post-2019 amendment) achieve the best outcomes on COJ cases.
Business Debt Relief Glossary
Key terms every small-business owner should understand before engaging a settlement firm.
A purchase of future receivables, not a loan. Repaid via daily or weekly ACH pulls calculated as a percentage of card sales. Factor rates of 1.20-1.50 are typical.
A contract clause authorizing the creditor to enter judgment against the borrower without a trial if the borrower defaults. NY restricted their use against out-of-state merchants in 2019.
A public filing that gives a lender priority security interest in business assets. Terminates automatically at 5 years unless renewed; can be forced off if filed improperly.
The flat multiplier on an MCA advance. A 1.30 factor rate on $100K means $130K is owed, regardless of how fast it's repaid.
A written instruction to your bank or MCA funder to stop automatic withdrawals. Legal under NACHA rules but can accelerate litigation.
Taking a second (or third) MCA before the first is repaid. Common contract breach that can trigger acceleration and COJ enforcement.
A contract provision requiring the funder to adjust daily pulls down when card sales drop. Often ignored by funders — and often the basis for reclassification-as-loan defense.
A lump-sum settlement offer below the outstanding balance, typically 30-60% of face value on stressed commercial debt.
Did You Know?
The average credit card interest rate hit 22.76% in 2025 — the highest since tracking began in the early 1990s.
BNPL (Buy Now, Pay Later) usage tripled between 2020 and 2025, with over 40% of U.S. consumers having used it.
Cost of living varies dramatically: the same salary goes 30-50% further in states like Texas or Tennessee vs. California or New York.
The average 401(k) balance hit $118,600 in 2025, though the median is much lower at $35,286.
Todd Spodek
Managing Partner, Contributor at Zogby
Red Flags in the Business Debt Relief Industry
The patterns of predatory operators that have burned small businesses out of millions. Walk away when you see any of these.
Upfront Fees Before Settling a Single Debt
Illegal under the FTC Telemarketing Sales Rule for telemarketed debt-relief services. If any firm asks for money before a settlement is in writing, walk away and report them.
"Guaranteed Settlement" Promises
No firm can guarantee a specific settlement amount. Creditors are under zero legal obligation to negotiate. Any "guaranteed 50% off" pitch is marketing, not a contract.
Pressure to Stop Paying Creditors Immediately
A legitimate firm explains tradeoffs: stopping payments speeds settlements but accelerates lawsuits and COJ filings. A scammer tells you to stop paying before they even see your contracts.
Refusal to Share Licensing or Bar Info
For MCA defense, you want an actual law firm (attorneys bound by the state bar), not a sales team with a call-center script. Ask for the bar number and verify it.
Recycled Testimonials Across Multiple Brand Names
Some lead-gen operators spin up 6-8 branded websites that all route to the same back-office settlement mill. Reverse-image-search the testimonials before signing.
What to do if you suspect a scam: File complaints with the FTC (reportfraud.ftc.gov), your state Attorney General, and the BBB. Document every communication. Predatory operators only shut down when enough victims speak up.
Real Settlement Outcomes
We pulled settled-debt averages from each firm and cross-checked with independent client reports. Advertised averages that couldn't be verified got discounted.
MCA & Commercial Expertise
Firms with in-house attorneys, MCA-defense specialists, or UCC-filing experience scored higher than general consumer-debt operations.
Fee Transparency & Structure
We tested whether fee quotes matched actual invoices, flagged any upfront fees (FTC violation), and scored firms on clear all-in cost disclosure.
Client Experience & Retention
Dropout rate, response time, hardship accommodations, and client-satisfaction scores pulled from BBB, Trustpilot, and direct interviews.
How We Tested
We evaluated every firm on this list by applying for consultation, reviewing their FTC compliance records, checking state licensing, pulling BBB and CFPB complaint data, and interviewing at least three current clients per firm. Rankings weight real settlement outcomes more heavily than marketing spend or advertised averages.
Evaluation Weight Distribution
Frequently Asked Questions
1. Will business debt settlement affect my medical license?
2. Can I settle medical practice debt without disrupting insurance billing?
3. How does physician student loan debt factor into practice settlement?
4. What happens to my expensive medical equipment during settlement?
5. Can I sell my practice after debt settlement?
Economic Snapshot
Source: Federal Reserve Economic Data (FRED). Indicators refresh daily.
Related Articles & Guides
The Business Debt Settlement Timeline
What actually happens between the day you call Delancey Street and the day your UCC liens come off. No fluff.
Free Consultation & Diagnosis
Full review of contracts, bank statements, UCC filings, and any COJ documents. Written settlement roadmap.
Enrollment & Funder Notification
Power-of-attorney is filed. All future funder contact is routed through your negotiator. Daily ACH attacks stop.
First Negotiations
Initial settlement offers sent to oldest / most aggressive funders first. Typical first-round offers: 30-45 cents on the dollar.
Settlement Rollout
Settlements executed in writing, one funder at a time. Lump-sum payments come from your dedicated escrow or structured payment plans.
Full Resolution
Final settlement letters collected. UCC-1 lien terminations filed. COJ vacatur motions completed where applicable.
Financial News & Regulation
Apr 20, 2026Holding Government Contractors Accountable for Wrongdoing
Jan 21, 2025Argus Information and Advisory Services, a subsidiary of TransUnion, has agreed in writing that it will not seek any government contract with the Consumer Financial Protection Bureau for three years.
Blog | Consumer Financial Protection BureauStrengthening Appraisal Oversight: Progress at the Appraisal Subcommittee
Jan 17, 2025CFPB Deputy Director Zixta Martinez discusses changes at the ASC since she became Chair in 2022, including enhanced state oversight, landmark hearings on appraisal bias, and improved collaboration with The Appraisal Foundation to create a more equitable and accountable appraisal industry.
Blog | Consumer Financial Protection BureauBack from the Dead: Zombie Second Mortgages
Jan 17, 2025Forgotten second mortgages may be coming back to haunt homeowners who haven’t received notices or account statements for years.
Blog | Consumer Financial Protection BureauFederal Reserve Board announces termination of enforcement actions with Crédit Agricole S.A. and Crédit Agricole Corporate and Investment Bank, Mega International Commercial Bank Co., Ltd, and the Goldman Sachs Group, Inc.
Apr 9, 2026Federal Reserve Board announces termination of enforcement actions with Crédit Agricole S.A. and Crédit Agricole Corporate and Investment Bank, Mega International Commercial Bank Co., Ltd, and the Goldman Sachs Group, Inc.
FRB: Press Release - All ReleasesHeadlines sourced from government agencies and legal publications. Updated every 12 hours.
Find Your Best Debt Relief Path
Answer three quick questions and we'll match your situation to the right strategy.
What kind of business debt are you facing?
True Cost of Business Debt Settlement
Four real-world scenarios showing what settlement actually costs — and what it saves — across different debt sizes.
$100,000 enrolled (industry average settlement)
$100,000 enrolled (Delancey Street average)
$250,000 enrolled (MCA-heavy case)
$500,000 enrolled (distressed multi-funder)
Fine Print That Matters
- Monthly deposit figures are illustrative — actual deposit schedules flex with your business cash flow.
- Firm fees are only charged on successfully settled debt. No settlement = no fee.
- Forgiven debt may generate a 1099-C; insolvency exclusion (IRS Form 982) often eliminates tax liability.
- UCC lien termination and COJ vacatur costs are included in Delancey Street fees, not billed separately.
Important Business Debt Relief Disclaimers
- Zogby is an independent comparison service. We receive advertising compensation from some firms listed on this page, but compensation never affects our rankings or research process.
- Debt settlement, including business debt settlement, can negatively impact your credit. Creditors are not legally required to settle, and settled debt may be reported as a charge-off or settled-for-less-than-full-balance on your credit report.
- Forgiven debt may be treated as taxable income by the IRS. Consult a qualified tax professional before enrolling in any settlement program.
- Nothing on this page is legal or financial advice. Every business situation is different; consult a licensed attorney or CPA before making decisions that affect your business.
- Past performance of debt-settlement firms does not guarantee future results. Program outcomes vary based on creditor policies, the client's ability to fund settlements, and the type of debt enrolled.
The information provided on this page is for general informational and educational purposes only. It is not intended as, and should not be construed as, legal, tax, or financial advice. Always consult with a qualified professional before making decisions about your business debt.
Editorial Independence
We make money from some companies on this page. That doesn't change our rankings -- the editorial team scores every product independently, and the business side has no say in what we recommend.