A small medical clinic is busy every day, but the owner still feels broke. Then they open their aging report and realize they have tens of thousands sitting in “denied” and “unpaid” claims.

It is Thursday night, and someone is in Target buying cardboard boxes like it is a last-minute survival mission. They spend $120, still do not have enough, and half of them collapse before packing is done.

A Shopify founder scrolls through their payment dashboard and sees a row of chargebacks labeled “Fraud” and “Item Not Received.” It looks like a few random refunds until they realize it is thousands of dollars gone, plus fees, plus lost product.