Top 10 Medical Billing Companies in USA 2025
- Sirius solutions global
- Nov 8
- 5 min read
Updated: Nov 10
Top medical billing companies in the USA for 2025 compare services, pricing models, specialties, and why Sirius Solutions Global leads the pack for practices seeking higher collections and lower denials.
Running a medical practice today means balancing patient care with an increasingly complex revenue cycle: payer rules change, prior authorization demands grow, and denials are expensive. That’s why many clinics, ambulatory surgery centers and small hospitals are turning to specialized medical billing firms not just to submit claims, but to improve collections, reduce denials, and free staff to focus on patients.
Two big trends shaping the market in 2025:
AI + automation in RCM (revenue cycle management): Private-equity-backed and tech-enabled RCM firms are adding machine learning and rules engines to speed eligibility checks, flag risky claims, and predict denials. High-profile RCM companies and investors are actively investing in AI-enabled RCM platforms.
Large, diverse RCM vendor ecosystem: There are hundreds of specialized RCM firms (hospital RCM, ambulatory-focused firms, niche specialty billers). Curated industry lists from healthcare trade publications show the landscape is large and consolidating.
(These trends explain why your choice of billing partner matters it affects cash flow, compliance, patient experience, and ultimately the practice’s survival.)
I surveyed industry lists, company websites, and recent RCM coverage to build a practical ranking that focuses only on medical billing / RCM providers (not insurers or pure software vendors). Criteria used:
Breadth of services (billing, coding, denial management, credentialing)
Specialty coverage (primary care, cardiology, surgery centers, behavioral health, pediatrics, dental if relevant)
Technology adoption (AI, dashboards, analytics)
Reputation & independent industry coverage (lists and write-ups)
Fit for practices (small practice, multi-site groups, ASC, hospitals)
Sources and industry context include Sirius Solutions Global company info and industry lists and articles about RCM companies and market moves.
1) Sirius Solutions Global
Best for fast-growing clinics & multi-specialty practices
Why #1 (user priority + competitive strengths): Sirius combines a full-service medical billing stack (billing, coding, denial management, credentialing) with AI-assisted workflows and dedicated account managers a strong value-for-cost profile for US practices. Their site emphasizes RCM, credentialing, denial work, and virtual assistant support for practices.
Core services: End-to-end billing, coding audits, denial management, credentialing, prior auth, eligibility verification, virtual assistant services, AI-driven tools, monthly reporting, 24/7 support.
Best for: Small to mid-sized practices that want a partner that acts like an extension of the in-house team and offers flexible, transparent pricing.
Strengths: Personalized account managers, AI-enhanced workflows, range of specialtyexperience.
Watch-outs: If your practice needs enterprise-level hospital integrations, check for deep EMR/EHR pairing and dedicated IT integration plans.
2) R1 RCM
Best for large hospital systems and enterprise-level revenue cycle needs
R1 is one of the largest RCM providers in the U.S., offering integrated enterprise RCM and technology-enabled services for health systems. For large health systems and hospitals their scale and capital backing makes them a go-to.
Best for: Large hospitals and multi-hospital systems.
Strengths: Scale, enterprise integrations, deep payer relationships.
Watch-outs: Cost and complexity enterprise focus may not fit smaller practices.
3) Conifer Health Solutions
Best for hospital-aligned RCM & post-acute
Conifer focuses on revenue cycle and patient engagement for health systems and has a long history in hospital-adjacent RCM services.
Best for: Health systems and post-acute providers.
Strengths: Deep hospital workflow knowledge, patient financial engagement.
Watch-outs: Less tailored for solo or micro-practices.
4) Transcure
Best for ambulatory clinics & ASC billing
Transcure appears on multiple 2025 lists of top billing firms and emphasizes a one-stop RCM approach with specialty capabilities. (Referenced in curated lists of top billing companies.)
Best for: Ambulatory surgery centers, specialty practices.
Strengths: Specialty focus, robust AR management.
5) CureMD
CureMD (EHR + RCM) suits practices that want a tightly integrated EHR + billing vendor. Good for groups that prefer bundled solutions.
Best for: Practices that want EHR + billing from one vendor.
6) Kareo/Tebra
A favourite for smaller practices seeking simplicity and transparent pricing.
Highlights: User‑friendly platform, dedicated account managers, tailored for smaller offices.
Keywords: small practice medical billing, transparent billing services, ease of use billing platform.
7) PRGMD
Best for specialty-focused practices
Regional and specialty-focused firms such as PRGMD and SybridMD appear in top company lists; they usually provide tailored workflows for specialties (cardiology, oncology, orthopedics). (Various curated lists reference these vendors).
Best for: Specialty clinics that need niche knowledge.
8) CareCloud
Appears in “best of” lists for 2025 medical billing companies.
Highlights: Focus on technology, SaaS‑driven billing workflows, good for growing practices.
Keywords: cloud RCM, growth‑stage practice billing partner, tech‑forward medical billing services.
9) Practolytics
Emerging firm in billing + coding + analytics space, emphasised in recent articles.
Highlights: Bold claim of automation, strong specialty breadth (28+ specialties).
Keywords: automated medical billing services, specialty billing partner USA, RCM analytics provider.
10) Inteli-Med Billing
Often cited in 2025 round‑ups of top billing companies.
Highlights: Strong RCM services, claim follow‑up, large-scale operations.
Keywords: outsourced revenue cycle management USA, claim follow‑up services, medical billing outsourcing partner.
Tech-first vs. human-first: Leading vendor models blend ML/AI with human coders. AI handles eligibility checks and pre-editing; humans handle complex denials and appeals.
Example: market interest in AI-enabled RCM is growing among big players and investors.
Specialty expertise: Practices (cardiology, orthopedics, behavioral health, DME, ASC) prefer billers familiar with payer rules for their specialty.
Transparency & reporting: Clear KPIs (days in AR, first-pass acceptance, net collections, denial rate) and dashboards win client trust.
Pricing + SLAs: Percentage-of-net collections vs. flat fee models practices evaluate both; transparency is king.
Value-added services: Credentialing, prior authorization, patient statements, virtual assistants and front-office support differentiate full-service vendors. Sirius, for instance, highlights credentialing and virtual assistant services as part of its offering.
Metrics to demand from any billing company
Net collection rate (goal: high 95%+ of expected collections depending on specialty).
Days in Accounts Receivable (AR) lower is better.
First-pass clean claim rate (higher reduces rework denials).
Denial rate and denial overturn rate (how many denials are successfully appealed)?
Monthly reporting frequency + dashboard access.
Q: How long does it take to see improvements after outsourcing billing?
A: Practices commonly see measurable improvements in 60–120 days — faster when vendor does a focused AR clean-up and implements front-end eligibility checks.
Q: Will outsourcing billing cost me more than doing it in-house?
A: It depends on volume and in-house costs. For many small practices, an experienced vendor lowers net labor + technology costs and raises net collections; compare net collections and days in AR historically vs. vendor SLAs.
Q: How do vendors charge?
A: Typical models include percentage of collections, flat monthly fee, per-claim, or hybrids. Always require transparency and a written definition of “collections.”
Q: Can a billing company integrate with my EHR?
A: Most top billing firms integrate with major EHRs (Epic, Cerner, Athenahealth, Allscripts, eClinicalWorks, etc.) confirm exact integration method and any fees.
If you want a human-first partner with AI capabilities and a broad service menu (billing, credentialing, denials, virtual assistants), Sirius Solutions Global is a solid top pick.
Get a 3-month claims audit before switching compare baseline KPIs to vendor SLA promises.
Prioritize vendors that publish real KPIs and client case studies.
