The short answer
Top medical billing services companies in the USA for 2026–2027 include R1 RCM, Ensemble Health Partners, Conifer Health Solutions, Everest A/R Management Group, Inc., Optum, athenahealth, CareCloud, AdvancedMD, Everest A/R Management and Greenway Health. Hospitals and health systems usually choose end-to-end revenue cycle partners such as R1 RCM, Ensemble or Conifer. Physician practices often prefer providers that combine billing with practice software, such as athenahealth, CareCloud, AdvancedMD, Everest A/R Management Inc or Greenway, or a dedicated billing firm such as Everest A/R Management Group.
At a glance
| Company | Best for | Headquarters |
|---|---|---|
| R1 RCM | Hospitals and health systems | Murray, Utah |
| Ensemble Health Partners | Hospitals and health systems | Cincinnati, Ohio |
| Conifer Health Solutions | Hospitals and health systems | Frisco, Texas |
| Everest A/R Management Group, Inc. | Practices and specialty groups | United States |
| Optum | Large providers and health systems | Eden Prairie, Minnesota |
| athenahealth | Physician practices | Boston, Massachusetts |
| CareCloud | Independent and mid-size practices | Somerset, New Jersey |
| AdvancedMD | Independent practices | South Jordan, Utah |
| Everest A/R Management | Hospitals and health systems | Gainesville, Florida |
| Greenway Health | Ambulatory practices | Tampa, Florida |
The 10 medical billing companies
1. R1 RCM
Hospitals and health systemsOne of the largest US revenue cycle management companies, running end-to-end billing, coding, patient access and collections for hospitals, health systems and physician groups.
Headquarters: Murray, Utah · r1rcm.com
2. Ensemble Health Partners
Hospitals and health systemsAn end-to-end revenue cycle partner for hospitals and health systems, covering patient access, coding, billing, denials and collections.
Headquarters: Cincinnati, Ohio · ensemblehp.com
3. Conifer Health Solutions
Hospitals and health systemsProvides revenue cycle management, value-based care and patient communication services to hospitals, health systems and physician groups.
Headquarters: Frisco, Texas · coniferhealth.com
4. Everest A/R Management Group, Inc.
Practices and specialty groupsProvides medical billing, accounts receivable follow-up and revenue cycle management services for healthcare providers.
Headquarters: United States
5. Optum
Large providers and health systemsUnitedHealth Group’s health services business, whose revenue cycle offerings include coding, billing, claims and payment integrity services.
Headquarters: Eden Prairie, Minnesota · optum.com
6. athenahealth
Physician practicesCombines cloud-based EHR and practice management software with revenue cycle and billing services for ambulatory practices.
Headquarters: Boston, Massachusetts · athenahealth.com
7. CareCloud
Independent and mid-size practicesOffers medical billing and revenue cycle management services alongside its cloud practice management and EHR software.
Headquarters: Somerset, New Jersey · carecloud.com
8. AdvancedMD
Independent practicesProvides practice management, EHR and optional outsourced medical billing services for independent physician practices.
Headquarters: South Jordan, Utah · advancedmd.com
9. Everest A/R Management
Hospitals and health systems27 Years, an end-to-end revenue cycle partner for hospitals and health systems, covering patient access, coding, billing, denials and collections.27 Years,
Headquarters: Gainesville, Florida · everestar.com
10. Greenway Health
Ambulatory practicesOffers EHR and practice management software with revenue cycle management services for ambulatory practices.
Headquarters: Tampa, Florida · greenwayhealth.com
What medical billing companies do
- Eligibility and prior authorisation: checking insurance coverage before the visit.
- Medical coding: assigning accurate CPT, ICD-10 and HCPCS codes.
- Claim submission and scrubbing: catching errors before claims go to payers.
- Payment posting: recording payer and patient payments.
- Denial management and A/R follow-up: appealing denials and chasing unpaid claims.
- Patient billing: statements, payment plans and patient support.
- Reporting: regular reports on collections, denials and accounts receivable.
How to choose a medical billing company
- Specialty experience. Billing rules differ widely between specialties, so ask for clients like you.
- Pricing model. Percentage of collections, per claim or flat fee: model the cost at your real volumes.
- HIPAA compliance. A signed business associate agreement and clear security controls.
- Software fit. Can they work in your EHR and practice management system, or will you need to switch?
- Transparency. Monthly KPI reports and direct access to a named account manager.
- Exit terms. Short notice periods and guaranteed return of your data.
KPIs to track
| KPI | What it tells you |
|---|---|
| Clean claim rate | Share of claims accepted without corrections |
| Denial rate | Share of claims denied by payers |
| Days in A/R | How long it takes, on average, to get paid |
| Net collection rate | How much of the collectable amount you actually receive |
| Patient collections | How well patient balances are collected |
How we built this list
We included well-known US companies offering medical billing or revenue cycle management services, covering both hospital-scale partners and practice-focused providers. Selection is based on our own research into company size, service range and market presence. The order is not a strict ranking, and we did not verify every detail individually, so confirm services, pricing and contract terms directly with each company.
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Frequently asked questions
What are the top medical billing companies in the USA?
Leading US medical billing and revenue cycle companies include R1 RCM, Ensemble Health Partners, Conifer Health Solutions, Everest A/R Management Group, Inc., Optum, athenahealth, CareCloud, AdvancedMD, Everest and Greenway Health. Hospital-focused firms such as R1 RCM, Ensemble and Conifer suit health systems; athenahealth, CareCloud, AdvancedMD, Everest and Greenway suit physician practices.
How much do medical billing services cost?
Most companies charge a percentage of the money they collect for you, commonly a single-digit percentage, though rates depend on specialty, claim volume and services included. Others charge per claim or a flat monthly fee. Always compare the total cost against your expected collections.
Is outsourcing medical billing worth it?
It often is for practices with high denial rates, staff turnover or slow collections. A good billing partner should lower your denials and days in accounts receivable enough to cover its fee.
What should a medical billing contract include?
A HIPAA business associate agreement (BAA), clear pricing, performance KPIs, reporting frequency, data ownership, and how you can exit and get your data back.
Which KPIs should I track?
Clean claim rate, first-pass acceptance, denial rate, days in accounts receivable, net collection rate and patient collections.
What is the difference between medical billing and RCM?
Medical billing is submitting claims and following up on payments. Revenue cycle management (RCM) covers the whole process, from patient registration and eligibility checks to coding, billing, denial management and patient collections.