400 practices, no successor
You built it over 24 years. Your daughter is a physician and does not want it. The practices are already asking what comes next.
Does this sound familiar?
Two situations we know
The software vendors are pushing
Practice software offers self-billing. Your service can do more, but you lack the capital for automation.
Your day-to-day, as we know it
This is what happens in your business before anyone talks about succession
Reimbursement disputes with private insurers
The patient forwards the rejection letter from their insurer. Your team then writes the statement on the analog code, even though the invoice was correct.
Missing consent
The practice sends records without a signed release from confidentiality. You may not bill and have to chase the practice.
Justifications above 2.3x
Every item above the threshold needs a patient-specific justification. Text templates from the practice often do not match the findings.
Dunning runs and returned direct debits
Installment plans fail, direct debits bounce, addresses are out of date. Shortly before year-end, the statute of limitations adds pressure.
How we measure your company
The metrics we look at in the first call
We look at the numbers you use to run your business yourself. The right column shows our acquisition criterion.
| Metric | What it tells us | Our benchmark |
|---|---|---|
| Annual fee volume | How much invoice volume runs through your systems and how stable it has been over three years. | We look for steady development over several years. |
| Number of clients and largest client | How dependent you are on individual practices or chief physicians. | Good from 200 clients, none above 15% of revenue. |
| Time to payment | How well invoicing, dunning and reimbursement queries work together. | We are interested in the development over several years. |
| Share of invoices with patient queries | How well justifications and analog ratings are right before sending. | We look at the trend and the reasons. |
| Factoring and default risk | Whether receivables sit on your own balance sheet or with a refinancing partner. | No factoring on the own balance sheet and at least 15 employees. |
What actually changes after the acquisition
Step by step
We automate the desk work. Professional decisions and customer contact stay with your people.
TodayReview records from the practice, check codes and multipliers against GOÄ rules
With GTPChecks for exclusions, maximum values and missing justifications run automatically. The billing specialist decides on borderline cases and analog codes.
TodayWrite statements to private insurers and the state allowance office
With GTPA draft referencing the findings and the invoice item is ready. The specialist checks, adds to it and signs.
TodayAnswer patient calls about invoices and installment plans
With GTPA system answers standard questions about amount, deadline and reimbursement around the clock. Sensitive cases go straight to your team.
TodayManage dunning runs and follow up on returned direct debits
With GTPAddress checks, dunning levels and deadlines run automatically. A person still decides on debt collection or goodwill.
Your systems stay in use:CGM MEDISTARCGM ALBISCGM TURBOMEDmedatixx
AI potential in the segment
How much desk work can really be automated here
This is GTP's assessment. We show it upfront so you can see what we will work with after the acquisition.
Suggest billing codes automatically
A language model reads the treatment documentation and suggests GOÄ codes. The specialist confirms them.
Answer insurer queries
Text generation drafts replies to reimbursement queries. The case handler checks and sends them.
Capture records without manual entry
Text recognition transfers service data from practice software and paper records into the billing.
What limits the technology here
Health data falls under Art. 9 GDPR and professional secrecy under Section 203 StGB, so every model needs EU hosting and a contractual framework.
What this means for you
Your billing specialists keep checking and deciding. The technology takes over the typing and the follow-up.
Sources Bitkom Research, AI use in practices and hospitals (2025) · KBV, notes and recommendations on confidentiality and data protection in medical practices (2024)
What we want to see
The documents we need
After the first call and the non-disclosure agreement, these five documents are enough for a solid offer.
- Client list with fee volume per client over three years
- Templates of the billing contracts and of the patient consent releasing confidentiality
- Open items list with aging and dunning levels
- Refinancing overview: who bears the default risk, which receivables sit on the own balance sheet
- Data protection concept with data processing agreements and access concept
What we buy
Our acquisition profile for this segment
Criteria
- 200 or more active clients, no client above 15%
- EBITDA €0.5m to €5m
- Client relationships longer than 3 years
- No factoring on the own balance sheet, partner bank acceptable
- 15 or more employees, documented processes
Value drivers
- Interfaces into practice software, data migration as a switching barrier
- Documented data protection concept, EU hosting
- Reimbursement management as an add-on service
Value reducers
- Fees below 2.5%
- Consent texts not transferable
- Owner holds all practice relationships
How you can tell we know your business
Three facts you can quote
- 01About 60% of outpatient private billing is outsourced (valantic 2025).
- 02There are 13 regional PVS and about 120 private billing offices (abrechnungsstelle.com 2026).
- 0333.7% of statutory health insurance physicians are 60 or older. Every practice handover is a switching risk (KBV 2025).
Market range, third-party source
What comparable companies trade at in the market
| Size class | EBITDA multiple |
|---|---|
| Micro-cap, revenue below €5m The relevant class for most succession cases in this segment | 4.0x to 6.0x |
| Small-cap, revenue €5m to €50m | 5.5x to 7.2x |
Category healthcare: care and service providers. Source: DUB KMU-Multiples Q2/2026. The DUB figures show asking prices and price expectations on a business marketplace. They do not include completed transactions. The range comes from an independent third party and is not an offer from GTP.
From multiple to cash
The multiple gives the enterprise value. What reaches your account depends on four items:
- Net financial debt
- Loans, leases and shareholder accounts are deducted, cash is added.
- Working capital
- We assume a normal level. An account emptied before the sale reduces the price.
- Investment backlog
- Vehicles, measuring equipment and software due in the next two years are deducted from the price.
- Payment structure
- Part of the price is paid only after signing, through a rollover or a performance-based component.
What lowers the value
If one of these points applies, the value drops:
- The owner personally holds the key customers
- Short remaining terms or contracts that can be terminated at any time
- If a large share of revenue depends on one customer, the price goes down.
- No second management level that runs the business without the owner
We calculate your value in the first call using your numbers. We go through the four items openly with you, even if the result is below your expectations.
All market data and the regulatory timeline for non-medical healthcare services
Frequently asked questions
What owners in this segment ask
May a financial investor buy?
Yes. Private billing offices are not subject to a third-party ownership ban. Professional law limits apply only to practices and MVZ.
What happens to the consents?
In a share deal they remain valid because the company stays the same. In an asset deal they would have to be obtained again. That is why we buy through a share deal.
Do you buy with factoring?
We do not buy factoring on the own balance sheet, because it requires a license under Section 1(1a) of the German Banking Act (KWG). A partner bank model is welcome.
How fast?
Response usually within 72 h, indicative offer in 2 to 4 weeks, data protection review as a separate step, closing usually in 6 to 9 months.
Non-medical healthcare services
More segments in this area
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Billing with statutory health insurers under Section 302 SGB V for therapists, medical supply stores and nursing services.
Sell a medical controlling companyCoding, MD management and revenue assurance for hospitals.
Sell a dental billing companyBEMA and GOZ billing as a service, without factoring on the own balance sheet.
Sell an ambulance billing companyBilling of transports and missions with insurers and operators.
Sell a practice back office companyHR administration, accounting and contract management for practice groups, without billing.
Sell a hygiene and QM documentation companyDocumentation and audits for practices and MVZ, as an addition to a billing core.
Why we buy this segment
In billing, the know-how sits in the heads of your specialists. AI takes over the data capture, the decision stays with your team. Whoever checks today will do so after the acquisition too.
I have automated back-office processes in large organizations. Where companies cut jobs first, they later lacked the know-how for billing.
For M&A advisors, tax advisors and succession advisors
Response on your client usually within 72 hours
Acquisition profile, teaser metrics and our commitments for all 24 segments are on a separate page. We only approach your client through you.
First step
Talk to a buyer who knows your segment
A 30-minute call is enough to know whether we fit. Afterwards you get a written assessment with reasons.
Request a confidential first call
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