Urgent care is the highest-volume specialty in primary care. Two hundred to four hundred patient visits a week per clinic. Mixed payer flow: commercial, Medicare, Medicaid, occupational health, workers' comp, and self-pay. Same-day cash transactions, plus patient EOBs that arrive weeks later. The cash flow looks like retail crossed with healthcare.

Most banks aren't built for either side of that.

What an Urgent Care Center Needs

Same-day deposits. With 200+ visits a week, batch deposits should hit your operating account same day, not 1 to 2 business days later. Float matters when payroll is bi-weekly and reimbursement timing is variable.

ERA 835 reconciliation across high payer volume. A typical urgent care center processes 300+ ERA files monthly. Manual matching is a half-time billing role.

Multi-site consolidation. Most urgent care groups run 3 to 20 clinics. Each clinic should be its own visible entity in one dashboard.

Medical lockbox for occupational health checks. Companies often pay for employer-sponsored occupational visits by check. Without a lockbox, those settle slowly.

Cash management for high-velocity revenue. With $200K to $1M flowing through monthly, idle cash earning 0% APY adds up fast.

How the Major Options Compare

Big banks: scale and branches, no urgent-care-aware tooling. Common default for legacy groups.

Fintech banks: clean dashboards, free ACH, no healthcare features. Doesn't handle the payer mix.

Lemma: ERA 835 matching, same-day deposits, Medical Lockbox at $2.50 per check, multi-entity onboarding in 5 to 10 days, 1.75% APY, $10M FDIC per entity.

What to Pick by Group Size

Single clinic, $1M to $2M. Lemma covers ERA matching, lockbox, and cash management as one platform.

3 to 10 clinic group. Lemma's multi-entity model fits. Each clinic gets its own FDIC entity, the parent gets consolidated reporting.

10+ clinic group with PE backing. Lemma plus a dedicated billing partner. The bank handles deposits, reconciliation, and treasury.

The Math for a 5-Clinic Urgent Care Group

5 clinics, $8M annual collections, $700K operating cash, 1,500 ERA files monthly across multiple payers, 100 paper checks (mostly occupational health).

On a generalist bank: 80 hours/month manual ERA matching ($33K/year fully loaded), $6,000/year lockbox vendor, $3,000/year ACH fees, 0% on operating cash. Net friction: $42K/year.

On Lemma: $0 ACH, automated ERA, included lockbox, 1.75% APY on $700K ($12,250/year). Annual swing: roughly $54K.