Top medical billing companies in the United States, ranked by ChatGPT answers

If you mean outsourced medical billing / revenue-cycle management (RCM) rather than just billing software, there are several strong U.S. options. The “best” choice depends heavily on practice size, specialty, EHR, and whether you want a fully outsourced billing team or an integrated software platform. Current 2026 industry comparisons consistently put companies such as athenahealth, R1 RCM, GeBBS, AdvancedMD, CareCloud, Tebra, and specialized RCM firms among the leading options.

My shortlist

Company	Best for	My take
athenahealth	Small–large physician practices	Best overall integrated option
R1 RCM	Hospitals, health systems, large groups	Best enterprise RCM
GeBBS Healthcare Solutions	Mid-size/large physician groups	Best outsourced RCM/coding
AdvancedMD	Small & mid-size practices	Strong technology + billing combination
CareCloud	Independent/mid-size practices	Good all-in-one option
Tebra	Solo & small practices	Good for independent physicians
Medical Billers and Coders (MBC)	Multi-specialty physician groups	Strong specialty-oriented outsourced billing
Coronis Health	Specialty practices	Good for specialty-specific RCM
AGS Health	Mid-size/enterprise	Strong coding and RCM outsourcing
Optum	Large health organizations	Enterprise-scale capabilities

Industry research also identifies Optum, AGS Health, Conifer, Ensemble, Omega, Access Healthcare and others as significant participants in the U.S. medical-billing outsourcing market.

My picks by situation

• Solo physician / small practice: Tebra, athenahealth, AdvancedMD
• 5–50 providers: athenahealth, GeBBS, MBC, AdvancedMD
• Large multi-specialty group: GeBBS, R1 RCM, MBC, Optum
• Hospital/health system: R1 RCM, Optum, Ensemble, Conifer
• Specialty practice: Coronis Health or a specialty-focused RCM firm
• Want an EHR + billing system together: athenahealth or AdvancedMD
• Want a true outsourced billing team: GeBBS, MBC, AGS Health, Coronis, R1

One important distinction: athenahealth, AdvancedMD, Tebra and CareCloud are heavily platform-oriented, whereas firms such as GeBBS, R1 RCM, AGS and MBC are more appropriate when you're looking to outsource substantial portions of the revenue cycle. Current comparisons explicitly make this distinction.

What I'd look at before choosing

Don't select a billing company based primarily on its advertised collection rate. Ask each finalist for:

1. Net collection rate, not just gross collection rate.
2. Clean-claim/first-pass acceptance rate.
3. Denial rate and denial recovery rate.
4. Average A/R days.
5. Percentage of A/R over 90 and 120 days.
6. Exact pricing—including coding, credentialing, eligibility, patient statements, denial appeals and A/R follow-up.
7. Whether you get a dedicated account manager.
8. HIPAA/security certifications and data-handling procedures.
9. References from practices in your specialty and of similar size.
10. Contract termination terms and what happens to your outstanding A/R after termination.

Pricing can vary substantially by practice size, specialty, claim volume and services. Published 2026 comparisons generally report outsourced billing around 4–10% of collections, although enterprise arrangements can be structured quite differently.

If you tell me your specialty (e.g., cardiology, psychiatry, dermatology), number of providers, approximate monthly collections/claim volume, and whether you want full outsourcing or just billing/coding, I can narrow this to the 3–5 companies I'd actually interview and compare their pricing, specialties, reviews, and contract terms.

For small and mid-size U.S. medical practices, I’d put the strongest options into three tiers rather than simply picking the biggest RCM company. The best choice depends heavily on whether you want outsourced billing, an all-in-one EHR/PM + billing platform, or a billing company that works with your existing EHR.

My shortlist

Company	Best fit	Main strength	Watch-out
AdvancedMD	5–50 provider practices	Strong all-around RCM + PM/EHR	Best value if you're willing to use its platform
Tebra	Solo–10 provider practices	Small-practice simplicity	Less suited to complex/multi-location operations
CareCloud	5–50+ providers	RCM, analytics and specialty support	Can be more involved/expensive for very small practices
athenahealth	Growing practices	Excellent payer/claims infrastructure	Often better suited to practices with enough volume to justify it
CureMD	Cost-conscious small/midsize groups	Integrated EHR + billing	Less compelling if you already have a strong EHR
Medical Billers and Coders (MBC)	Practices wanting an independent outsourced billing firm	Broad specialty coverage and EHR-agnostic service	Need to carefully validate the assigned team and pricing
eClinicalWorks RCM	Practices already using eClinicalWorks	Tight EHR/RCM integration	Most attractive within the eCW ecosystem

Current industry comparisons consistently put AdvancedMD, Tebra, CareCloud, athenahealth and CureMD among the leading options for independent practices.

1\. AdvancedMD — my best overall choice

AdvancedMD is probably where I'd start for a 5–50 provider independent practice that wants professional RCM rather than just basic claims submission.

Its advantages are:

• Full revenue-cycle management
• Strong practice-management/EHR integration
• Claim scrubbing and denial management
• Good reporting
• Broad specialty support
• Can accommodate practices that grow into multiple locations

AdvancedMD says it serves more than 65,000 practitioners across 13,000 practices, and its current offering supports both per-provider and per-encounter pricing models.

Best for: established practices that want a serious RCM infrastructure and may grow.

2\. Tebra — best for very small practices

Tebra is particularly attractive for solo physicians and small groups that don't want a complicated enterprise RCM implementation.

It combines EHR, practice management, billing and patient-engagement functions. Tebra was also recognized by Software Advice in 2026 as its "Most Rated" medical billing software for small and midsize healthcare practices, based on more than 1,300 verified reviews.

Best for: 1–10 providers, straightforward specialties, and practices that value simplicity.

Less ideal: complex multispecialty groups, sophisticated central billing operations, or practices needing extensive customization.

3\. CareCloud — best for analytics and more sophisticated RCM

CareCloud is worth serious consideration for mid-size practices and specialty groups.

Its strengths include:

• Outsourced RCM
• Coding/billing
• Denial management
• Analytics and dashboards
• Broad specialty support
• EHR/PM integration

Independent-practice comparisons currently place CareCloud near the top, particularly for practices that want stronger analytics and specialty-oriented billing rather than the simplest possible system.

Best for: roughly 5–50+ providers, especially specialty practices.

4\. athenahealth — best for practices expecting substantial growth

athenahealth has an exceptionally strong claims, payer-connectivity and revenue-cycle infrastructure.

It's particularly attractive when you want the RCM vendor to take substantial responsibility for the billing process rather than simply giving your staff billing software.

The tradeoff is that athenahealth can be more system-intensive than what a tiny practice needs.

Best for: growing independent groups with significant claims volume and practices willing to standardize their workflows around the platform.

5\. CureMD — good value-oriented alternative

CureMD offers an integrated EHR, practice-management and billing environment and is frequently positioned toward small and midsize practices. Current industry comparisons identify it as a potentially attractive choice for budget-conscious practices.

Best for: small/midsize practices looking for an integrated system without necessarily choosing one of the largest RCM platforms.

6\. Medical Billers and Coders — best if you want a true outsourced billing company

Medical Billers and Coders is different from the platform-centric options above. If you already have an EHR/PM system and want someone else to actually operate the revenue cycle, this type of vendor can be a better fit.

Its stated offering covers a broad range of specialties and is designed to work across different systems. Industry comparisons currently place MBC among the leading independent RCM providers.

Best for: practices that don't want to replace their EHR simply to obtain billing services.

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How I'd narrow it down

If I were evaluating vendors for a typical independent practice:

• 1–3 providers: Tebra or a specialized independent billing company
• 3–10 providers: AdvancedMD, Tebra, CareCloud
• 10–50 providers: AdvancedMD, CareCloud, athenahealth
• Complex specialty practice: CareCloud, AdvancedMD, or a specialty-specific RCM firm
• Already happy with your EHR: look first at an EHR-agnostic outsourced RCM company
• Want to replace EHR + billing together: AdvancedMD, Tebra, CareCloud, athenahealth or CureMD

One important distinction: "medical billing software" and "outsourced medical billing" aren't the same thing. A platform can give your staff excellent billing tools while leaving your employees responsible for eligibility, claim follow-up, denials, A/R and appeals. If your objective is to hand the billing operation to a third party, I'd weight the comparison quite differently.

What I would demand before signing

Don't select based primarily on the advertised percentage of collections. Ask each company for:

1. Net collection rate for practices similar to yours.
2. Days in A/R, specifically excluding unusually old legacy A/R.
3. Denial rate and denial-resolution time.
4. Whether coding is included or billed separately.
5. Whether they handle prior authorizations and eligibility verification.
6. Who works your denials and appeals.
7. Whether you receive a named account manager.
8. Exactly what percentage is charged—and what is not included.
9. Contract length and termination provisions.
10. Three references from practices with your specialty and approximately your size.

Published industry estimates put outsourced billing commonly around 4–10% of collections, although actual pricing varies substantially by specialty, volume, services and contract structure.

My overall ranking for a typical small/midsize independent physician practice would be:

1\. AdvancedMD → 2. Tebra → 3. CareCloud → 4. athenahealth → 5. CureMD, with Medical Billers and Coders moving into the top three if your priority is outsourcing the actual billing operation while keeping your existing EHR.

If you tell me (a) your specialty, (b) number of providers, (c) approximate monthly collections/claims volume, and (d) which EHR/PM you use, I can narrow this to the 3 best companies for your particular practice and compare likely costs, contract terms, and pros/cons.

Yes. For specialty physician practices where denial management is a major priority, I would put a somewhat different group at the top than a generic “best medical billing companies” list.

My shortlist for 2026 would be:

Company	Best fit	Specialty depth	Denial/appeals	My take
Coronis Health	Multi-specialty, surgical, anesthesia, radiology, behavioral health	★★★★★	★★★★★	Best overall fit
AGS Health	Larger groups / complex clinical denials	★★★★★	★★★★★	Best for serious denial operations
Medusind	Physician groups, anesthesia, ortho, pathology, radiology	★★★★★	★★★★½	Excellent specialty-focused alternative
GeBBS Healthcare Solutions	Mid-market groups needing scale/coding capacity	★★★★½	★★★★	Strong value/scale option
Access Healthcare	Larger physician groups / enterprise RCM	★★★★	★★★★½	Strong technology + operations
Omega Healthcare	Large organizations and high-volume RCM	★★★★½	★★★★½	Better suited to larger operations

1\. Coronis Health — my first call for a specialty practice

Coronis stands out because its offering is explicitly built around specialty medicine, rather than simply offering generic physician billing. Its physician/multi-specialty operation includes specialty-trained teams, payer-specific rules, coding, authorization, denial prevention, root-cause analysis, clinical appeals, AR recovery and underpayment recovery.

It also has dedicated programs for specialties including anesthesia, radiology, surgical specialties, behavioral health and emergency medicine. For example, its surgical program specifically addresses prior-authorization denials, NCCI edits, global-period disputes, payer-specific edits and implant reimbursement disputes.

Why I'd shortlist it: If your problem is not merely “submit claims” but “why are these particular claims being denied, and how do we stop the same denials from recurring?”, Coronis looks particularly well aligned.

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2\. AGS Health — particularly strong for denial & appeal management

AGS is especially interesting if denial management is the primary reason you're outsourcing.

In August 2026, AGS announced that Black Book Research ranked it the top clinical denial and appeal management services vendor for 2026. AGS describes a workflow involving denial classification, root-cause identification, documentation review and appeals, with human review for complex clinical cases.

That makes it particularly attractive for practices dealing with:

• Medical-necessity denials
• Documentation-related denials
• Coding denials
• Prior authorization issues
• High-dollar specialty claims
• Large volumes of recurring payer denials

My caveat: AGS is more of an enterprise-scale RCM operation. For a small independent practice, I'd compare its service model carefully against a more specialty-focused vendor.

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3\. Medusind — excellent for physician specialty groups

Medusind is worth serious consideration, particularly for anesthesia, orthopedics, pathology, radiology and other physician specialties. It offers end-to-end RCM as well as modular billing/coding services and uses a hybrid U.S./offshore delivery model.

Its orthopedic offering, for example, includes professional/ASC billing alignment, surgical coding governance, denial management, AR follow-up, credentialing and reporting.

Best use case: A specialty group that wants a dedicated RCM partner but doesn't necessarily need the enormous enterprise infrastructure of R1/Optum-type organizations.

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4\. GeBBS — strong if scale and coding capacity matter

GeBBS is a good candidate when you're dealing with large claim volumes, coding complexity and substantial AR/denial work. Industry comparisons identify GeBBS as having broad specialty coverage and outsourced coding/denial/AR capabilities.

Its major advantage is capacity and cost efficiency. The tradeoff is that I would scrutinize how much of your denial work is actually handled by people with deep knowledge of your specific specialty and payer mix, rather than a generalized RCM team.

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5\. Access Healthcare — good enterprise alternative

Access is another strong choice for larger physician organizations. Its RCM approach covers front-end, mid-cycle and back-end performance, and its published materials emphasize denial-rate and first-pass-resolution KPIs.

A KLAS ambulatory RCM report also found that some Access clients valued consistent account-management relationships, although the report noted mixed experiences around offshore delivery across the market.

I'd put Access on the RFP if you're a sizable multi-location organization.

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How I'd narrow the list

If I were choosing for a specialty practice, my shortlist would look like this:

For 5–50 physicians: Coronis Health + Medusind + one specialty-specific boutique RCM firm

For 50–200+ physicians: Coronis + AGS + GeBBS/Access

For a hospital-affiliated or very large enterprise: AGS + Access + Omega + Coronis

If denials are the #1 problem: AGS + Coronis + Medusind

If specialty coding is the #1 problem: Coronis + Medusind + GeBBS

One important warning

I would not choose based on a vendor's advertised “99% clean claim rate” or generic denial rate.

For specialty practices, ask each company for performance specifically for your specialty and payer mix. A vendor can have an excellent overall denial rate while performing poorly on, say, orthopedic surgery, cardiology, behavioral health, dermatology or radiology.

I'd require these metrics in the RFP:

• Clean-claim rate
• Initial denial rate
• Denial rate by CPT/service line
• Denial rate by payer
• First-pass resolution rate
• Appeal overturn rate
• Average days from denial → corrected claim
• % of denials worked within 5/10/15 days
• AR >90 and >120 days
• Net collection rate
• Underpayment recovery
• Dollars recovered from previously written-off/aged AR
• Top 10 denial root causes
• How they prevent recurrence of each denial category

That last item is critical. A good denial-management company doesn't just appeal denials; it feeds the denial information back into eligibility, authorization, coding, documentation and claim-edit workflows so the denial stops happening. Coronis, for example, explicitly describes that root-cause/prevention loop in its specialty RCM model.

If you tell me your specialty (e.g., cardiology, orthopedics, dermatology, GI, behavioral health, anesthesia, radiology), number of providers, approximate monthly collections, and current EHR/PM system, I can narrow this to the 3 best companies and compare their likely strengths, weaknesses, pricing model, U.S./offshore staffing, and denial-management capabilities.

If by “collect fastest” you mean lowest days in A/R + high net collection rate, and by “keep denial rates lowest” you mean actual denial rate rather than just clean-claim rate, there are several firms worth putting on an RFP shortlist.

The important caveat: there is no reliable independent national ranking of medical billing companies by these metrics. Most published numbers are vendor-reported case studies or internal client-book averages, so I would not treat a claim like “99% clean claims” as proof that the company has a 1% denial rate. Clean-claim rate and denial rate are different measures.

My shortlist

Company	Published performance	My take
AMS Solutions	<5% denial rate, 30–40 days A/R, 96% net collection rate, 95%+ clean claims	Strongest overall published KPI profile
Go Medical Billing	4.8% denial rate, 31 days A/R, 97.6% clean claims in cardiology case	Very strong, especially specialty practices
Clarity Health RCM	Featured engagement went from 45% to <5% denials	Excellent denial-reduction evidence
Medxcode	5.8% denial rate, 44→41 days A/R, 99.2% first-pass acceptance	Strong cardiology evidence
Billed Right	Case studies showing 18–24 days A/R and 47–71% denial reductions	Potentially excellent cash velocity
Advantum Health	Reported 60%+ increase in average payments/day and A/R improvement	Worth considering for larger/more complex RCM

1\. AMS Solutions — probably my first call reports performance across its active client book, rather than just one unusually successful case:

• Denial rate: <5%
• Days in A/R: 30–40
• Net collection rate: 96%
• Clean-claim rate: 95%+
• A/R >90 days: <10%

Those are unusually good numbers if they're being measured consistently across the client base. The company says the figures come from its active clients and compares them with MGMA/HFMA benchmarks.

Verdict: I'd put AMS near the top of the RFP list.

2\. Go Medical Billing — particularly compelling for physician groups reports a cardiology engagement where:

• Denials fell 16.2% → 4.8%
• A/R fell 62 → 31 days
• Clean claims rose 82% → 97.6%
• Annual collections increased by $340K

That's exactly the combination you're asking about: faster cash + fewer denials.

Verdict: One of the more compelling choices if you're a physician practice rather than a hospital system.

3\. Clarity Health RCM — strongest denial-reduction example reports an inpatient-physician engagement in which the denial rate went from 45% to below 5% within one quarter. It also reports $5M+ recovered across its engagements.

That's impressive, although I'd want to see the absolute A/R days and net collection rate before ranking it above AMS or Go Medical Billing.

Verdict: Particularly interesting if your existing problem is denials/aged A/R, rather than simply claim submission.

4\. Medxcode — excellent specialty example reports a cardiology group improving:

• A/R: 71 → 44 days, eventually 41
• Denial rate: 16% → 5.8%
• First-pass acceptance: 99.2%
• $1.1M recovered in six months

Verdict: Very interesting if you're cardiology or another procedure-heavy specialty.

5\. Billed Right — potentially the fastest A/R reports several engagements with A/R reaching 18–24 days, alongside substantial reductions in denials. For example, its cardiology case went from 38 to 19 days in A/R and reported a 61% denial reduction.

Verdict: Worth interviewing if cash velocity is your #1 priority.

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What I would actually use to select the winner

I wouldn't select a billing company based on its advertised denial rate. I'd require each finalist to give you the same six numbers, measured over the preceding 12 months:

1. Days in A/R
2. Net collection rate
3. Initial denial rate
4. Final denial rate after appeals
5. % of A/R >90 days
6. First-pass clean-claim rate

Then ask for those numbers by specialty and payer, not just company-wide.

For context, a 2026 benchmark synthesis citing MGMA/HFMA puts top-performing first-pass clean-claim performance around 95%+, while the industry median is in the high 80s.

My target thresholds for an RFP

I'd consider these excellent:

• Days A/R: ≤35
• Net collection rate: ≥95%
• Initial denial rate: <5%
• A/R >90 days: <10%
• Clean claims: ≥95%
• Denial follow-up: <48–72 hours
• Patient balances: separately tracked rather than mixed into insurance A/R

And I'd be especially suspicious of a company advertising 99%+ clean claims but refusing to disclose its actual denial rate, A/R aging, and net collection rate.

If you tell me your specialty, I can narrow this dramatically

The best billing company for primary care can be very different from the best one for cardiology, orthopedics, behavioral health, dermatology, GI, anesthesia, or hospital-based physicians.

If you tell me your specialty, approximate annual collections/number of providers, and whether you're currently in-house or outsourced, I can build you a top-5 shortlist with pricing, specialties served, reported A/R/denial metrics, contract terms, and which one I'd choose.

Yes. If by “locations across the United States” you mean medical billing/RCM companies that either have offices in multiple states or explicitly operate nationwide, there are quite a few. The important distinction is that many are nationwide service providers but have only one U.S. office.

Strong nationwide options

Company	U.S. footprint	What stands out
Billed Right	Offices in Florida and Ohio; serves all 50 states	Established medical billing/RCM company with 400+ team members and nationwide client coverage.
Medical RCM Services	Multiple U.S. locations, including AZ, FL, MD, MN, MT, NY and TX	Explicitly describes itself as having a nationwide presence and lists numerous U.S. locations.
RCM Matter	Nationwide; offices listed in California and Pennsylvania	Medical billing, coding, credentialing and RCM across all U.S. states.
NextRCM	All U.S. states	Remote nationwide RCM partner headquartered in Texas; specifically says it works with providers anywhere in the U.S.
MediBill RCM	All 50 states	Billing, coding, credentialing and full RCM, with state-specific services.
USRCM	Nationwide	Medical billing, coding, credentialing, denial management and A/R services across the U.S.
Healix RCM	25 states / 50+ major markets	Particularly emphasizes state-specific payer and Medicaid expertise.

If you specifically mean multiple physical U.S. offices

This narrows the field considerably. Billed Right and Medical RCM Services are two examples where I found explicit evidence of multiple U.S. locations rather than simply nationwide remote service. Billed Right lists its Florida headquarters and additional U.S. offices, while Medical RCM Services lists locations in seven states.

There are also larger healthcare RCM organizations worth considering if you're looking for a national-scale employer/vendor rather than a small outsourced billing company. For example, RCM Technologies reports 18 U.S. branch offices across multiple states, although its business is broader than medical billing alone.

A useful distinction

If you're researching this for employment, opening a location, selling to medical practices, or finding a billing partner, I would use different criteria:

• National service footprint: Can serve practices in all/most 50 states.
• Physical footprint: Actually maintains offices/employees in multiple states.
• Enterprise RCM: Handles hospitals, health systems, large physician groups, etc.
• Physician-practice billing: Primarily serves independent practices and smaller medical groups.
• Specialty RCM: Radiology, anesthesia, behavioral health, DME, dental, etc.

For example, Billed Right is particularly interesting if you're looking for a company with both a physical U.S. presence and nationwide service, whereas NextRCM is explicitly a remote nationwide provider.

If you tell me why you need companies with nationwide locations (e.g., looking for a job, potential acquisition targets, competitors, vendors for a medical practice, or companies that could hire billers in multiple states), I can narrow this to the 10–20 best companies and include headquarters, number of offices, states, specialties, employee size, and website.

Yes. For small and mid-size U.S. medical practices, I’d narrow the field considerably rather than simply choosing the biggest RCM company.

One important distinction: some companies below are true outsourced billing/RCM providers, while others are primarily EHR/practice-management platforms with managed billing. That distinction matters.

My shortlist

Company	Best fit	My take
AdvancedMD	5–25 providers, multi-specialty	Best overall for a growing practice
Tebra	Solo–10 providers, independent practices	Best for smaller practices
athenahealth	10–100+ providers, high volume	Best payer/RCM infrastructure
CareCloud	Specialty and multi-provider groups	Strong analytics + RCM
CureMD	Small/midsize practices wanting all-in-one	Good integrated option
Medical Billers and Coders	Practices keeping their existing EHR	Interesting independent RCM option
GeBBS Healthcare Solutions	Larger midsize groups	Good when complexity increases

1\. AdvancedMD — my overall pick for a growing practice

I'd put AdvancedMD at or near the top for a 5–25 provider practice that wants a relatively sophisticated combination of practice management, EHR and billing/RCM.

Its advantages are particularly strong if you want scheduling → documentation → coding → claims → payments → reporting in one ecosystem. Recent comparisons also consistently put it among the stronger options for multi-provider practices.

Best for: primary care, behavioral health, multi-specialty, growing independent groups.

Watch-out: it's more platform-oriented than a pure outsourced billing company. If you already have an EHR you're happy with, I'd also get bids from EHR-agnostic RCM firms.

• * *

2\. Tebra — best for smaller independent practices

For a solo physician or 2–10 provider practice, Tebra is one of the first I'd investigate.

Tebra combines EHR, practice management, billing and patient-engagement capabilities and specifically targets independent practices. It also offers lower-volume pricing, which can be attractive for smaller practices.

Best for: solo physicians, small groups, independent practices, primary care and behavioral health.

Watch-out: if you're a sophisticated specialty group with complicated coding and a large AR problem, I'd look beyond Tebra.

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3\. athenahealth — best for sophisticated RCM

If your practice is large enough to justify the implementation, athenahealth deserves serious consideration.

Its major advantage is its enormous payer/claims ecosystem and managed revenue-cycle approach. It's particularly attractive for practices that don't want to build a large internal billing department.

The downside is that it can be more expensive and more complex than necessary for a small practice. Recent industry comparisons generally position it more toward mid-size and larger groups.

Best for: roughly 10+ providers, high claim volume, multi-specialty practices.

• * *

4\. CareCloud — worth considering for specialty groups

CareCloud is particularly interesting if you care about RCM analytics, denial management and financial visibility.

I'd put it on the shortlist for a midsize specialty practice rather than a two-doctor office. Independent-practice comparisons also rate its specialty and analytics capabilities relatively highly.

Best for: specialty practices and multi-provider groups.

Watch-out: it may be more infrastructure than a very small practice needs.

• * *

5\. CureMD — good integrated alternative

CureMD is another all-in-one option covering EHR, practice management and billing.

It's worth considering if you want to replace several systems at once rather than simply hire a billing company.

Best for: small-to-midsize practices that want one integrated platform.

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6\. Medical Billers and Coders — interesting if you want to keep your existing EHR

This is a different proposition from Tebra/AdvancedMD.

MBC positions itself as an EHR-agnostic outsourced billing/RCM company, which can be valuable if you already like your EHR and don't want to migrate. Its own published material says it serves practices from roughly 3 providers through much larger groups and across numerous specialties.

Best for: practices that want to outsource billing while retaining their existing EHR/PM.

Watch-out: because some of the performance numbers you'll see online come from the companies themselves, I'd insist on independently verifiable client references before relying on those metrics.

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7\. GeBBS — good as you get toward the upper end of midsize

GeBBS is more of a substantial healthcare outsourcing/RCM operation. It becomes more interesting when you're dealing with 10–50+ providers, multiple specialties, substantial claim volume or complicated revenue-cycle operations.

For a three-doctor office, I'd probably look elsewhere first.

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What I would choose by practice size

1–3 providers

1. Tebra
2. AdvancedMD
3. A specialized independent RCM company

4–10 providers

1. AdvancedMD
2. Tebra
3. CareCloud
4. EHR-agnostic outsourced RCM

10–25 providers

1. AdvancedMD
2. athenahealth
3. CareCloud
4. GeBBS / specialized RCM

25–50+ providers

1. athenahealth
2. CareCloud
3. GeBBS
4. Specialized RCM company
5. AdvancedMD, depending on specialty and existing technology

I would not put R1 RCM near the top of this list. It's a major RCM company, but its model is much more naturally suited to hospitals, health systems and very large organizations than to the typical independent 5–20 physician practice.

The bigger question: outsourced billing vs. billing software

This is where many practices make an expensive mistake.

If you mean "Who should completely handle our billing?", my shortlist changes to:

• Medical Billers and Coders
• GeBBS
• CareCloud
• athenahealth
• specialized specialty-specific RCM firms

If you mean "What billing/EHR platform should we use?", I'd focus on:

• AdvancedMD
• Tebra
• athenahealth
• CareCloud
• CureMD

And I wouldn't select based on the advertised percentage alone. A 4% billing company that collects 94% of collectible revenue can be dramatically better than a 3% company that leaves substantial money in A/R.

What I'd ask every vendor for

Before signing, request 12 months of actual client performance for practices similar to yours:

• Net collection rate
• Days in A/R
• A/R over 90 days
• First-pass/clean-claim rate
• Denial rate
• Average time to payment
• Percentage of A/R they actually work
• Coding audit results
• Credentialing included or extra?
• Prior authorization included or extra?
• Patient statements/calls included?
• Clearinghouse fees?
• Setup/implementation fees?
• Contract length and termination fees?
• Who owns the billing data?
• Can you retain your existing EHR?

Also ask for three references from practices with your same specialty and roughly your provider count. That's much more useful than a generic 5-star rating.

If you tell me (1) your specialty, (2) number of providers, (3) approximate monthly collections/claims, and (4) whether you want to keep your current EHR, I can narrow this to the 3 best companies for your specific practice and compare likely pricing, pros/cons, and what I would negotiate in the contract.

If your goal is the lowest reasonable percentage of collections without sacrificing full-service billing, I’d focus on companies publicly quoting roughly 3–5%, rather than simply choosing the lowest advertised number.

A useful benchmark: Tebra’s industry report found that nearly half of percentage-based billing companies charged 5–7%, while only 7% reported charging 4% or less.

Best-priced options I found

Company	Published rate	My take
Apex Health RCM	2.9–4%	⭐ Potentially the best price; full RCM, no setup/per-claim/monthly-retainer fees
Medical Billing United	4.5%	⭐ Very competitive, especially if you want straightforward pricing
NEXACC	5–6%	Reasonable, particularly for single-specialty practices
Saint Health Group	4–6%	Excellent if you're in behavioral health and have enough collections to reach the lower tiers
MedPrecision Billing	6% groups / 7% solo	Fair, but not among the cheapest
ClaimCarePro	6%	Reasonable full-service option, with $1,000/month minimum
White Glove Medical Billing	6–8%	More expensive than the above

1\. Apex Health RCM — 2.9–4%

This is the most attractive published percentage I found. Apex says it charges 2.9%–4% of collections, depending on specialty, claim volume and scope. It also says there are no setup fees, per-claim charges, or fixed monthly retainer.

Important: I'd ask them specifically what services are included at 2.9–4%. A low percentage isn't necessarily a bargain if coding, credentialing, patient collections, or difficult A/R are excluded.

2\. Medical Billing United — 4.5%

They publicly advertise 4.5% of monthly collections for full medical billing/RCM, with no setup fee and no long-term lock-in. Their listed scope includes claim submission, payment posting, denial management, A/R follow-up and patient statements.

This is probably the cleanest 4.5% offer I found because the company actually spells out what's included.

3\. Saint Health Group — 4–6%

If you're behavioral health, this is particularly interesting:

• Under $100K/month collections: 6%
• $100K–$250K: 5%
• Over $250K: 4%
• $995 monthly minimum

The rate applies to the entire month's collections rather than being marginal/tiered.

4\. NEXACC — 5–6%

NEXACC publishes 5% for single-specialty practices and behavioral health and 6% for multi-provider groups, with a $950/month floor.

I'd consider 5% very reasonable if the service is genuinely full-cycle and includes aggressive A/R and denial management.

• * *

What I would consider a "reasonable" deal

For a typical U.S. physician practice:

• 2.5–3.5%: Excellent, but scrutinize what's excluded.
• 3.5–5%: Very good target for a healthy-volume practice.
• 5–6%: Reasonable/market-competitive.
• 6–8%: Normal for smaller practices or more labor-intensive specialties.
• 8–10%+: I'd want a compelling reason—very small volume, difficult specialty, extensive coding/credentialing, etc.

Current published industry estimates generally put outsourced billing around 4–10%, with many small/midsize practices around 5–8%.

One important caveat

Don't compare percentages until you establish what "collections" means.

For example, ask every company:

1. Is the percentage based on gross collections or net collections?
2. Does it include patient payments?
3. Is coding included?
4. Is credentialing included?
5. Are denial appeals and aged A/R included?
6. Are there minimum monthly fees?
7. Are clearinghouse/software fees extra?
8. Is there a separate fee for patient statements?
9. Are refunds/recoupments deducted when calculating the percentage?
10. Is there a contract or termination fee?

A 4% company with $1,000 in monthly extras can easily cost more than a genuine all-inclusive 5% company.

If you tell me your specialty, number of providers, and approximate monthly collections (e.g. "$150K/month, 3 providers, internal medicine"), I can narrow this to 3–5 companies that are likely to give you the best economics, including what percentage I'd try to negotiate them down to.

Yes. If by “family-owned or locally owned” you mean firms where the owners are still involved, the company is not a private-equity roll-up, and practice owners can actually reach the people running their account, there are some good independent options.

I would not equate “family-owned” with “good,” though. I looked for three things: verified independent/family ownership, longevity/specialty experience, and evidence of positive relationships with physicians or practice owners. On that basis, these are the firms I would put on a serious shortlist.

My shortlist

Company	Ownership / location	Why I'd consider it	Best fit
eMP Billing	Family-owned, U.S.-based; founded 1989	Long operating history, intentionally small, dedicated contacts, focused on independent practices	Independent physician practices wanting a personal RCM partner
Physicians Management Network (PMN)	Family-owned, California; since 2000	4.9/5 from 73 reviews on Birdeye; physician-led leadership and long-term client focus	Multi-specialty physician practices
Practicefirst	Privately owned, Western NY; founded 1960	65+ years in business, nationwide reach, physician/practice-manager testimonials	Practices wanting a more established independent RCM company
Healthcare Automations (HCA)	Family-owned; founded 1991	Family business spanning generations; 50+ accounts and multiple specialties	Midwest-based or multi-state independent practices
Direct Billing Services (DBS)	Independently/local owned, Birmingham, AL; since 1999	Strong independent-owner positioning, 98%+ clean-claim metric, practice-owner testimonials	Behavioral health, PT, wound care and specialty practices
Focused Billing & Collections	Family-owned, New Jersey; founded 2017	Particularly strong recent owner reviews; named people rather than a call center	Smaller practices wanting hands-on service
Physician Management Services of Iowa (PMSI)	Family-owned, Iowa; since 1996	Specifically focused on physician/practitioner billing and coding; smaller relationship-oriented operation	Iowa/Illinois/Midwest practices
Emotive Medical Solutions	Family-owned, Tampa, FL	20+ years, full RCM + credentialing + practice-management support	Florida practices, especially those wanting a local relationship

1\. — one of my first calls

eMP is particularly interesting if you're deliberately trying to avoid the large national RCM companies. It says it has remained family-owned and independently operated since 1989, serves independent healthcare providers, and gives clients a dedicated point of contact.

The important distinction is that this isn't simply a tiny startup calling itself “personal.” It has been around for decades while deliberately remaining independent.

I'd investigate it for: primary care, specialty practices, and groups that want a long-term RCM relationship rather than a high-volume outsourced billing factory.

• * *

2\. — strongest review signal

PMN is a family-owned California company founded in 2000. Its leadership includes founder Sunny Sadri, a certified professional coder, and Dr. Ray Ghodsi, a physician with an MHA.

More interestingly, its third-party review profile currently shows 4.9/5 across 73 reviews, including comments praising its billing/coding knowledge, responsiveness and ability to develop customized solutions for practices.

That combination—independent ownership + physician involvement + meaningful volume of public reviews—puts PMN fairly high on my list.

I'd investigate it for: multi-specialty physician groups and practices that need billing, coding, credentialing and broader RCM support.

• * *

3\. — best established independent option

Practicefirst is unusual because it has been around since 1960. It is headquartered in Western New York and describes itself as privately owned, while now serving practices throughout the country.

Its site also has unusually specific long-term client references—for example, a pediatric cardiology practice that says Practicefirst has handled its billing and A/R since 2011, and a hospitalist group using it since 2014.

That's the sort of evidence I find more meaningful than a billing company simply saying “we increase collections.”

Caveat: Practicefirst is considerably larger than the typical family billing shop. So if by “locally owned” you specifically mean small, I would look elsewhere.

• * *

4\. — interesting multigenerational firm

HCA was founded in 1991 by Edie Swiercz and is described as a family-owned, full-service medical billing company. Her son David joined in 1999 and became president in 2012. The company says it serves more than 50 accounts across numerous specialties and states.

That is a genuine family-business story rather than merely a company using “family values” in its marketing.

I'd investigate it for: practices in the Midwest and practices that value direct communication with an owner/operator.

• * *

5\. — particularly interesting for specialty practices

DBS is based in Birmingham, Alabama and has operated since 1999. It explicitly identifies itself as independently and locally owned, rather than venture-backed or controlled by a larger RCM organization.

Its specialization is also noteworthy: behavioral health/ABA, physical therapy, wound care, internal medicine, ENT and urgent care, among others. It reports a clean-claim rate above 98%.

There are also testimonials from an ABA organization and a physician/practice owner specifically describing DBS as responsive and dependable.

I'd investigate it for: behavioral health, ABA, PT and other specialty billing where generic “we bill everything” companies can struggle.

• * *

6\. — best small-firm/personal-service candidate

This one is much smaller and newer, but I think it's worth interviewing.

Founder Stephanie Schaffer started the company in 2017 after 20 years in medical billing/healthcare. The firm describes itself as family-owned and emphasizes named people on the account rather than a call center.

More compellingly, its current site displays 9 Google reviews at 5.0, including a small-practice owner who specifically praises being able to reach the billing team and says the company knows the practice rather than treating it as another account.

It's also BBB accredited with an A+ rating.

I'd investigate it for: small-to-medium practices where accessibility and relationships matter more than having a huge technology stack.

• * *

7\. — very relationship-oriented

PMSI has been operating since 1996 and grew from a one-person home-based business into a company serving multiple physician practices. It explicitly describes itself as family-owned and focuses on medical billing/coding for physicians and practitioners in Iowa, Illinois and surrounding states.

This is the sort of company I'd consider if you value owner accessibility and continuity over having a national footprint.

• * *

8\. — Florida option

Emotive is a Tampa-based, family-owned company with more than 20 years of experience. It provides full RCM, credentialing and practice-management evaluation and says it serves practices throughout Florida.

I'd put it on a Florida-specific shortlist, particularly if local knowledge and face-to-face accessibility are important.

One important name I would not put on the list

AccuMed Billing Services initially looked like one of the strongest candidates. It is family-owned and has some unusually good physician testimonials—including a surgeon and a heart/vascular practice praising its accessibility, A/R work and results.

However, AccuMed recently merged with EMS Management & Consultants, according to a 2025 municipal document.

So if your objective is specifically “I don't want a company that has been rolled into a larger corporate RCM organization,” I would remove AccuMed from the current list despite its excellent historical reputation.

That's an important example of why I wouldn't rely on old “best medical billing companies” lists.

If I were a practice owner, I'd interview these first

My initial five would be:

1. PMN — strongest combination of family ownership, physician expertise and third-party review volume.
2. eMP Billing — particularly attractive for an independent practice deliberately avoiding corporate RCM.
3. Practicefirst — best choice if you want a much more established operation without going to a PE-backed national consolidator.
4. Direct Billing Services — especially compelling for behavioral health, ABA, PT and specialty billing.
5. Focused Billing & Collections — compelling if you want a genuinely hands-on small-company relationship.

What I'd ask each company before signing

Don't ask merely, “What's your collection rate?” Ask for:

• Three current physician/practice-owner references in your specialty.
• Your actual net collection rate, not their company-wide average.
• A/R aging before and after taking over comparable practices.
• Their denial rate and first-pass clean-claim rate.
• Exactly who will be assigned to your practice and how many accounts that person handles.
• Whether coding is performed in-house or offshore.
• Whether they subcontract any portion of billing, coding or A/R.
• What happens to your account if your assigned biller leaves.
• How often the owner/administrator receives A/R, denial and payer reports.
• Contract termination terms and who owns your billing data if you leave.
• Whether they will perform a pre-contract billing audit and show you what they're finding.

And I would insist on talking to two or three practices that left another billing company for them. Those conversations are often much more revealing than testimonials from happy long-term customers.

If you tell me your specialty, approximate monthly collections/claim volume, state, and practice size (solo / 2–10 providers / 10+), I can narrow this to the 5–7 family/local billing companies I'd actually interview for your practice, including pricing model, specialties, reviews, ownership, and red flags.