Good morning and welcome to the audio conference of Oncoclínicas. At this moment, all participants are connected only as listeners. At the end, we will begin the question-and-answer session. When instructions will be given, participants will be supplied. Please remember that this audio conference is being recorded, and I would now like to pass it to Dr. Bruno Ferrari, Founder and CEO of the Oncoclínicas Group. Dr. Bruno, please go ahead. Good morning to everyone and welcome again to one more results earnings call of Oncoclínicas. We're very content to announce the advances conquered during the third quarter, fruit of an intensive and extensive trabalho of organizational restructuring of the company, where we'll discuss the sale of hospital assets to lead the company to future commitments for investments, among other things.
I do not remember of any other quarter in the history of the company in which so many fronts were executed at the same time, in which we have been able to deliver so much in such a short time. This performance on Friday, we concluded the increase in the capital of private capital was totalized approximately BRL 1.4 billion, an important part of this turnaround, the strategic turnaround, and commercial turnaround, and operational turnaround of the company. The increase in capital is bringing an important deleveraging, and it leaves our balance and our capital structure. Speaking about this, I'll speak about all of these deliveries going ahead. Before that, I would like to point out the hard work of all the people who have, from our doctors, our directors, and the directors, have all remained aligned in the same goal of reconquering the profitability of the company.
Always, as I promised, the client, the patient as the center of everything. This is the center of our strategic. I would like to thank everyone. We look today at a company which is very different than that which we saw a few months ago, much lighter, much more focused, and again, with its business of oncology, which we know how to do very well. Without any onus about our margins and future commitments of the capital payments, which would affect our future earnings. We continue to be the most attractive for doctors and oncologists to work in every level of seniority. We have no doubt of that. Since the beginning of this year, we have added more than 100 doctors to our base, which demonstrates with facts the continuing attractiveness which the company is and continues to be, which is with us in this journey.
On slide three, we started with the highlights of the third quarter. I'd like to point out the highlights of this turnaround, which I referred to earlier, which is evidenced in our adjusted EBITDA in the quarter, which added up to BRL 241 million, with a margin of 17% and 246 basis points higher than the previous quarter. There was an operational gain of BRL 246 million, a significant advance in relation to the previous quarters, as you see in the lower part of the screen shows. Cristiano will detail this going forward. This was generalized all across the P&L, not just because we are looking at the performance of the company on a basic and occurring basis.
In other words, on slide four, we can see that there was a strong gain and the best dynamic of capital, which brought us to the generation of a free organic cash of BRL 64.2 million in the quarter, with a highlight of how quickly we are delivering our back-to-core agenda of repositioning of the company. We already announced the sale of the three general hospitals of the company, which the company maintained in our base of assets, and the rescission of contracts of BTS for future Cancer Centers in São Paulo and Belo Horizonte, along with the renegotiation of the contract in Goiânia. These bring us back to our basic core business exclusively of oncology.
It changes in an important way the level of profitability, remembering that the three hospitals responded to a negative EBITDA of almost BRL 26 million in the third quarter, and it alleviates important CapEx commitments in the future. I would like to mention that the thesis that this Cancer Center continues valid within our model of business, but our business model needs to be executed within a successful model of partnerships with hospitals and not just oncology hospitals, where we will not commit relevant capital. We have to mention also in slide six, the conclusion of our increase in capital last Friday, which raised a total of approximately BRL 1.4 billion in capital, reducing the level of leverage of 3.0x pro forma, and the leverage in the third quarter has already been reduced in relation to the second quarter, even prior to the pro forma effects for the increase in capital.
To give more details and impacts about the numbers in this quarter, I'm going to invite Cristiano Camargo to take over the microphone going forward. Cristiano, thank you, Bruno. Good morning to everyone. On slide seven, I think it's important to give a detailing of the principal accounting write-offs that the company wrote in the quarter, in function to the quick advance that we've had in the plan of sale of assets in the process of turnaround overall, beyond other recurring events of outside events. The first item, the write-off of the hospital assets of BRL 466.2 million, is a consequence of the agreements signed for the sale of the Marcos Morais in Rio de Janeiro, MIC in Orlando, and Vila da Serra in Nova Lima. This last announced last week on the 3rd of November, and therefore a subsequent event after the third quarter.
As the company has moved very quickly in the execution of these investments, these assets will be classified as available for sale. It's important to remember that all of these transactions are still depending on closings due to the compliance with specific requirements. The third item, the BTS write-offs, refers to the value, therefore previously registered as intangible assets, reference to anticipated rents for future projects of Cancer Centers. As the company broke these contracts, ended these contracts within the strategy of leaving these non-core assets and that commit to a great deal of future CapEx, these future rents were used to reduce the values of the fines paid on the rescission of these contracts. We had no cash payouts to rearrange these contracts. In the third item, we look at the provision of 100% of the conversion of debt from the Unimed FERJ of BRL 864 million.
The administration decided to make this provision, understanding that there were new facts and determinants which happened in the third quarter, which justified this decision. For example, the interruption of the attendance to clients except in a limited capacity and subject to previous payment, and an event of renegotiation of the balance of this debt instrument, indicative by itself of a deterioration of the credit of the counterpart. We should also mention that the question occurs due to the observance of the accounting norms, but does not implicate in any renouncement of this credit by the part of the company. The third item, the most relevant item, the administration decided to provision part of this balance with Banco Master due to the deterioration in the rating of that counterpart.
This provision, and we should mention, impacts negatively not only the P&L in the quarter, but also the accounting cash on hand of the company. As a consequence, the imposition of net debt, which reflects in the negative impact of this provision. It's important to mention that all of these things were non-recurring and non-cash, and are being added back to the adjusted numbers presented, so that it will be possible to see how the company has behaved in the operational way and recurring way during the third quarter. Looking at slide eight, we can see the evolution of our procedures average ticket. In the third quarter of 2025, the number of procedures reached approximately 151 million with a small sequential deceleration, a reflection of this more selective commercial strategy in the end of the contract with Unimed FERJ.
On the same sequential comparison, the average ticket grew by 5.7%, attenuating the smaller volume and the higher quality of the revenue in this period after changing our portfolio of clients. On slide nine, the gross revenue of the company reached approximately BRL 1.6 billion in the third quarter of this year, presenting a small reduction of approximately 4.7% in the sequential as a result of the interruption of the services offered to Unimed FERJ. You should remember that this operator was, up until August, the biggest client of the company, representing more than 10% of our sales. A fall of 4.7% shows that the company has been successful in the replacement of this revenue, of which it has given up.
Going to slide 10, the net revenue presented a small fall of 3.5% in relation to the quarter immediately prior, smaller than the reduction of gross revenue due to the improvement in the PCLD during this quarter when compared to the previous quarter, as you see in the following slide, on slide 11. We see a sequential reduction pushed by a better base of clients and better quality clients and with a better dynamic of receipts. As a consequence, the PCLD was 6.1% in the previous quarter, went to 4.4% now. On slide 12, the gross margin cash margin reached 32.3% in the third quarter of 2025, an important advance in relation to the previous quarter, with a sequential expansion of 200 basis points.
The cash profit reached BRL 456 million at the end of the period, demonstrating a tendency of the recovery of profitability as we see on the graph on the left. This is due not only to the commercial initiatives of improvement in our portfolio of clients, but also in the management of costs. If we exclude the hospitals from this account, the gross margin comes to 35%, which reinforces that the direction of the company of leaving these operations of hospital operations and focus only on our core business of oncology is the correct route to take. In the analysis of the last 12 months, the gross profit was BRL 1.8 billion with a margin of 30.7%. Looking at the next slide, number 13, you see the operating expenses reflected in the efforts of the restructuring plan and cut of expenses executed by the company over the last quarters.
This is the first quarter in which we can see the numbers based on a normalized basis without the relevant impacts of these rescissions. The result is a reduction of almost BRL 30 million when compared to the third quarter of 2025, with the same period of the previous year, a delivery of savings of BRL 710 million on an annualized basis. As a result, the operating expenses have represented 17.9% of net revenue, a sequential reduction of 300 basis points. We should remember that we are still running with a gross revenue almost BRL 80 million lower in this quarter when compared to the second quarter. In other words, even with the operational deleveraging and reducing drastically this ratio, if we exclude the effects of the hospitals, the operational impacts represent 17% of net revenue.
Looking at the adjusted EBITDA on this following slide, number 14, we can see a sequential growth of 30.4% at the end of the period in BRL 241 million, an expansion of 450 basis points of adjusted EBITDA margin by ending the quarter at 17.1%. This expansion of margin is solid and of high quality. It's not just due to the elimination of the hospitals. It would have gone from 12.7% in the second quarter to 15% in the third quarter, even with the hospitals included in these numbers. In other words, 270 basis points of expansion due to the gains in gross margin and efficiency in cuts in expenses.
On slide 15, the loss of BRL 39.7 million without the hospital shows a relevant revolution in a sequential basis, but remembering that in the context of a capital structure which is not adequate, with many financial expenses weighing on the bottom line. Going to the next slide, number 16, we present a working capital, which shows an expressive improvement sequentially, ending the third quarter with 25 days of net capital working capital, an improvement of 16 days, with a highlight for the days of receivables, which ended the quarter at 88 days, a sequential improvement of 8 days. On slide 17, we show the generation of the free cash flow, organic free cash flow of BRL 62.4 million in the quarter. On slide 18, we see the reconciliation of the cash flow between quarters.
Finally, on slide 19, we have the financial leverage, and we should mention that in the third quarter, even with a cash effect affected by BRL 217 million in provisions for part of the CDBs, the net debt grew less than that, less than BRL 160 million. This shows an organic cash flow in the period. Even so, there was a reduction in the leverage of the company in the sequential comparison of 4.4 to 4.2 times on a pro forma basis. For the increase in capital of BRL 1.8 billion, BRL 1.4 billion included on the 14th of November, the leverage will go down to three times the adjusted EBITDA on an annualized basis. With that, we close here the exposition of our results, and we open now for the questions and answers. Thank you. Ladies and gentlemen, we will now begin the question and answer session.
To make a question, please click on the raised hand icon based at the bottom of the screen. Our first question comes from Caio Moscardini from Santander. Please, Caio, please go ahead. Thank you for taking my question. Two from my side. First, in relation to the PCLD, can you please talk a little bit about the PCLD, which still has come in quite high at 1.4, I believe, and how we should look at that 4.4, how we should observe this reduction in the level of doubtful receivables and the number of days of receivables. The quarter to quarter, even though it is better. I want to understand where do you think that the days of receivables should stabilize since we now have no longer the hospitals in the base. Just these two questions. Thank you. Okay, this is Chris.
Addressing your first question about the doubtful receivables, though we've seen a substantial improvement on a sequential basis of PCLD going from 6.1% to 4.4%, we still have the offensive impact of the hospitals. The tendency is that we will see our doubtful receivables normalized when we have had a closing of the hospital assets in our P&L. Remember that the non-adjusted doubtful receivables for the effect without the hospitals, without receivables, the number that we looked at in the third quarter, if we look at this photo adjusted without the hospitals of 86 days, should be more or less in a recurring rhythm, normalized rhythm going forward, remembering that there are several quarters we have not reached this level. It did not even show up here on the history, on the table.
If we look back at these levels of 86 or 85 days, it has been a long time since we did not operate at these levels, and this should be the closest of the recurring operation of the company. This should be very close to the recurring amounts of the company. Thank you very much, Chris. Thank you. Our next question comes from Gustavo Miele of Goldman Sachs. Gustavo, please go ahead. Hi, guys. Good morning. Thank you for the presentation. Two questions from my side as well. The first is a follow-up from Caio's question about the working capital and accounts receivable. How can this be translated into a performance of net debt looking at the fourth quarter? If we look at this third quarter adjusted by the provision for the Banco Master, we see a big fall.
The tendency should be to have some effort playing against this delta of net debt in this fourth quarter since these days should encounter stability by the end of the year. That would be the first question. The second, I just want to understand a little bit more about the level of margin looking at the business without the hospitals, as you mentioned, projecting stability of gross margins. If this reflects a little bit of the efficiencies that you've had in the business with it being a little bit more mature, or if you see space for the expansion looking at 2026, just these two points. Thank you, Miele.
As far as the net debt in the dynamic going forward, what we can say is that the company has come back to a model of cash generation, and we are now seeing free cash generation on an organic basis in the third quarter. We expect a trajectory of reduction of net debt, gradual reduction over the next quarters, and that remembering that we have a tailwind in this sense, which is the inorganic nature. As we follow going forward, including the closing of these operations, the transactions of the sale of hospitals, we will have a benefit also related to the debt, which will leave our balance sheet in the case of the sale of the transaction of the OMC and also of a payment to be received in the case of the transaction of the sale of the Vila da Serra.
We expect, because of that, to have a, also because of this, a deleveraging happening gradually and with a nominal reduction of the net debt. Thinking about margins, we think that there's, yes, space to have an expansion because even though the work of efficiency and costs and expenses is quite advanced, not to say that we don't have space, there's always space, but we always see that a large part of this work of efficiency has already been concluded. When we look at the top line of the company, then we still have a lot of operational leverage to recover. We need to remember that the company has had in this third quarter of 2025 almost BRL 220 million less in gross revenue, net revenue, if we compare it to the same quarter of the previous year.
This is obviously due to the decisions made which we deliberately took to make this change in our portfolio of clients. As we continue to recover our top line, and this is happening, when we look at, for example, at the sequential fall of net revenue that we had of 3.5%, this reflects the revenues which we let go of as we made the offering, which we let go during the quarter. It suggests that in this sequential, if it had not been the additional revenue that we had, we are substituting with other clients. This movement to continue growing together with other payers will continue. We are expecting an operating leverage, and this will give us also a dilution of this base of expenses and therefore more margin expansion, more EBITDA margin expansion. That is clear, Chris. Thank you very much.
Just to add one thing, recovering is slower than letting it go. These movements are done in a way that we stop the losses all at once, but then the commercial actions are happening, but they come in a little more cadenced way. Thank you, Bruno. Our next question comes from Eduardo Hezengi from UBS. Please, Eduardo, go ahead. Good morning, Bruno, Cristiano, Isaac. Two questions from my side here. If you could, the impairments that have happened in the third quarter, we want to know if these operations announced up until now have all been recognized in the third quarter or if there is anything that will still show up in the fourth or next fourth quarter or next quarters. That is the first question.
Also about growth, when we look at the guidance of net revenue that you have compared in a pro forma way that you put X hospital in this quarter, we see that this has been very relevant for the following year. We wanted to see a little bit of the strategy for the recovery of these volumes, which you expect next year. We are looking now at the guidance in CapEx in 2026, which is a little bit below the historic levels. This growth in volume should come with the unused capacity of the current units. What would be your strategy in this sense? Any information you can give us on that would be very helpful. Okay, Eduardo, Isaac , thank you for the question.
Starting with the impairments, the accounting adjustments, we understand that everything that we have performed, the sale of the hospitals, the Cancer Centers, all of this is behind us. The other adjustments will be more constant in the information that we have now. We should have none that are relevant, no relevant adjustment going forward. Obviously, with everything that we have seen today, for growth next year, we have two points. Up until now, as Bruno and Cristiano mentioned, we've been adopting this commercial strategy more selective, which gave its signals in the next quarters, the next year, more specifically. We should return to levels of growth close to the market levels, remembering that it is in the low double digits, 10-12% in the next periods. This is translated in our guidance.
Also, aligned with your point of the capacity, we have quite a bit of capacity to continue growing, and we have relevant investments being made in recent years. It's worth mentioning here that it's very virtuous, the partnership that we have in Rio de Janeiro with São José, and that we are inaugurating now our unit next to the hospital, which will be a big catalyst of growth and other commercial agreements that we have been or have announced or will be announcing shortly. We are heading towards the finalization of these agreements. There are lots of good things that could be happening to help us deliver this growth in the next periods. Looking at answering your question, we have capacity to continue growing without demanding lots of CapEx in next years. As it's translated in the guidance, the CapEx has already been done.
The major construction are done or are finishing. In fact, right now, we have the anticipation of operations in some cities such as São Paulo and Rio. This is the first aspect. The second is, yes, other partnerships, hospital partnerships, and with health plans with insurers and payers are underway in a way to permit a sustainable growth. We are very comfortable with the guidance that we have given in terms of CapEx, less CapEx, and more growth. What had to be done has been done, and it has been delivered or will be delivered shortly. Thank you, Bruno and Isaac. It is very clear. Thank you. Our next question comes from Ricardo Boyach of Safra. Sir Ricardo, please go ahead. Hi, good morning, Bruno, Chris, Isaac. Thank you for the opportunity. I have a follow-up question in relation to the level of debt.
If you could detail for us a little bit more how was the pro forma in relation to the cash position of the company and how the position of cash position in relation to and where this money is applied. In fact, what is the remainder from the Banco Master, if anything is left over from that, which has not been written off? Also, looking at the debt, what's the breakdown between short term and long term after this restructuring? It's lots of moving parts, and we see if we can get a picture a little more of the pro forma numbers, which help us to understand the position that we should think of the company. The second point is in relation to the competitive environment. I think that you've given us some very interesting in terms of commercial agreements, partnerships with operators, this position of you.
If we look at the competitive scenario, have you seen been more coming from competitors? We see the hospital players moving forward in oncology. The question is, if this is a more challenging environment in a competitive world, or if that's under control from the standpoint of management to be able to deliver this guidance for the next years. Thank you very much. Thank you, Boyach. I'm going to start here with your first half of your question. Afterwards, I'll let maybe perhaps Bruno can answer the second help to address the question of perspectives for growth in the competitive environment going forward.
Looking at the pro forma of the cash position of the company at this moment after the increase in capital, it should not be very different than this photo that we have seen on the 30th of September, remembering that the increase in capital was predominantly underwritten with the utilization of debts of financial instruments, not as creditors converted in relation to the company. Obviously, this is good in the same way because it reduces our leverage. It should not change very much the photo from the standpoint of repositioning of cash. The good news is that obviously, going forward, we have a lot less financial expenses.
The cash outlays, which had been previously expected to happen during November and December, especially relative to payments of interest, this number at this moment is revising this number as we receive the final information and we start to tabulate all of this in our projections. We are seeing, obviously, and it could not be any different, a reduction, a relevant reduction in financial expenses and the payment of cash expenditures, which will reflect positively in our cash position over the next few months. The same thing is being done. We have not yet finished to have a photo of the chronogram of amortization going forward. What we can say is that it would be something that is encouraging as well. We saw a participation of the debt instruments between all of the eligible instruments to participate in this increase in capital.
The debt instruments with due dates in this medium to short terms were those that were most utilized by investors in this process of increasing our capital in a way that this by itself generates a reprofiling of the chronogram of amortization, which will leave the situation much easier for the company, much softer. So that we are now in 2026, and principally in 2027 and 2028, this increase of capital has wind up working to generate a relief about the amortization program, especially over the next two years. Sorry, I just wanted to add one thing in relation to the growth, the environment. Again, we continue to see a market which reincidence will increase. New cases will come up. The complexity, cost-effectiveness, looking at the future, which has permitted us to grow in this market and establish more partnerships, more hospital partnerships.
To give you a typical example, in Belo Horizonte, the sale of the asset of Official Rocha strengthens us a great deal in the region. In the city of Belo Horizonte, we're much more competitive. The same thing happens in the center west with the center where we expand together with them, where they create hospitals, where we set up their oncology. Much more focus on partnerships rather than on assets that we own, non-core assets, and which want to demand time and energy from the company. At the same time, we are in a platform of franchises, but we're already making the eighth franchise operation. Helping us to enter markets where the large networks don't even go close.
For instance, there's an addressable market, which is very large, which will permit us to grow in that which we do well, which is the line of oncological care in all of its aspects. Also, just to mention one more thing, I spoke about this previously, but if we look at the falloff of net revenue sequential, which the company has had in the third quarter, which was 3.5%, and we consider that the third quarter was the quarter in which the company closed and discontinued the payer, which had been up until then their largest client, with approximately 13% of our billings. I did not go down 13%. I went down by 3% on a sequential basis. I still have July from revenue from this payer, but in August and September, it had already been removed from our base.
For this to happen means that obviously the company is growing at a velocity, which is very interesting, together with the other payers that we have in our base, and obviously bringing new clients. This is what leaves us comfortable in relation to a vision of this adjustment and this dynamic of reduction of the top line growth. We should not see this more in the next quarters. As Bruno said, as Isaac mentioned, in a segment in which we know has been consistently growing, at least in the low double digits, this type of performance that we desire going forward, that we are wishing for going forward. Very well. Thank you very much. Our next question comes from Joseph Giordano from JP Morgan. Joseph, please go ahead. Thank you for taking my question. Two principal questions.
The last question in relation to the retraction of the numbers of oncologists, seeing the changes in assets, et cetera. That is my first question. Also, my second question is in the question of new agreements. Historically, you work a lot with hospitals and cancer centers, such as we are now undoing our relationship with some of them. I wanted to ask you how these new contracts compare to the historical contracts, especially these with Unimed and any profitability of these partnerships that you are leaving with these cancer centers and the outpatient work that you do. I am going to start here. Thank you for the question, Joe. It has always been a churn in relation to doctors. Nothing that would be different than our historical goals. Nothing different this year.
We have in our clinical team, specifically what I want to mean by that, our Oncoclínicas has been a growth in doctors. We have partnerships. We have the attraction, and the model continues to have. It continues to be highly attractive for doctors within our plan of medical careers. Obviously, the franchises as well. We had not seen this, but greatly on the contrary, we also see some partnerships, exclusive partnerships give us even more margin to continue being a magnet of talents that attracts in all levels, in the higher level seniority and in newer doctors where it continues sending these people to Boston to be trained. The model, which continues very robust in terms of the medical payments without paying any commissions.
I think that's very important that the attractive for the doctors and for the group, and it's attractive for those who purchase this service, having an alignment between the best practices and the remuneration. We continue to see this market and the hospital partnerships established in this model. It's not a new model. It's a new way forward for the company to continue growing. The CapEx is very low. Improvements, which are punctual, one time offering high-quality oncology at a very high cost-effectiveness ratio. The outpatient model continues strong, but with the care to care for the patient in the area within the hospital continues to be a source of growth, unique and exclusively in these patients. Chris, would you like to complete? Yes, Joe.
I think completing and connecting with what Bruno has said, the assets which leave are obviously offenders from the standpoint of margin. We see this in the combined negative EBIT of these assets having been less than BRL 26 million in the third quarter. The offenders also from the standpoint of working capital. These hospital operations, by their nature, have a much longer cycle of receipts than our core operation of outpatient oncology, levels of non-payment, which are much higher than the operations than the outpatient due to the complexity of the payments together with a typical bill for outpatient treatments. The numbers speak for themselves. We see that we can see in this third quarter how much these operations were affecting our scale negatively.
Remembering that we are not leaving from the thesis of cancer center, as Bruno mentioned, these models of partnerships, of hospital partnerships, some already consecrated, such as the partnership with San José in Rio, in Santa Isabel, in Salvador, and the partnership with Santa Group. In these types of partnerships, since the scope is very limited and we're restricted only to oncology, we have contribution margins and gross margins, which are very much in line with what we have looking at our margins in outpatient oncology. That is why we're going to continue following down that road. Okay, thank you very much. We now close at this moment this session of questions and answers. We'd like to pass the microphone back to Dr. Bruno Ferrari for his final comments. Dr. Bruno, please go ahead. Thank you all for your questions. Have a good day.
The audio conference of Oncoclínicas is now closed, and we thank you all for your participation, and please have a good day.