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Review leading medical billing companies serving USA clients, with company profiles that explain each provider's expertise, delivery focus and fit.
Use the comparison to build a shortlist, then review each company profile for its specialty, location and approach.
Updated October 10, 2026
Side-by-side comparison of leading providers serving USA clients
| Company | Specialty | Location | Website |
|---|---|---|---|
| #1R1 RCM | Largest enterprise RCM provider, processing over $30 billion in annual net patient revenue for hospitals and large health systems. | Murray, UT, USA | Visit site |
| #2Ensemble Health Partners | End-to-end RCM outsourcing partner for large health systems, named alongside R1 as the reference option for organisations seeking to standardise complex… | Cincinnati, OH, USA | Visit site |
| #3Optum | Healthcare services arm of UnitedHealth Group, cited as the leading option for large-scale financial forecasting and data analytics within revenue cycle… | Eden Prairie, MN, USA | Visit site |
| #4AGS Health | Provides an AI-assisted revenue cycle platform combined with human-in-the-loop billing services, launched as the AGS AI Platform in September 2022. | Washington, DC, USA | Visit site |
| #5GeBBS Healthcare Solutions | Global RCM outsourcing firm with an offshore delivery model, covering inpatient, outpatient and specialty coding, claims processing, DRG validation, cod… | Culver City, CA, USA | Visit site |
| #6Access Healthcare | Outsourced medical billing and coding services company operating at large scale across multiple specialties for provider groups and health systems. | Dallas, TX, USA | Visit site |
| #7CorroHealth | Revenue cycle outsourcing provider that completed the acquisition of Xtend healthcare RCM business from Navient in September 2024, serving a general mul… | Plano, TX, USA | Visit site |
| #8Infinx Healthcare | AI-assisted revenue cycle automation provider that expanded through the May 2025 acquisition of i3 Verticals healthcare RCM business for $96 million. | San Jose, CA, USA | Visit site |
| #9Coronis Health | Medical billing and revenue cycle outsourcing company serving providers across multiple general specialties, positioned as a generalist outsourced billi… | Largo, FL, USA | Visit site |
| #10Med USA | Comprehensive RCM services centred on operational continuity and execution, supporting billing, denial resolution and accounts receivable management for… | Round Rock, TX, USA | Visit site |
Use this comparison to identify a shortlist, then review the detailed company profiles and USA buyer’s guide below.
Review the available information for each provider before requesting references, pricing and a project proposal.
Largest enterprise RCM provider, processing over $30 billion in annual net patient revenue for hospitals and large health systems. Uses an operating-partner model that rebadges a hospital existing RCM staff as R1 employees, allowing process standardisation across multi-state systems.
Visit website →End-to-end RCM outsourcing partner for large health systems, named alongside R1 as the reference option for organisations seeking to standardise complex multi-site revenue cycle operations.
Visit website →Healthcare services arm of UnitedHealth Group, cited as the leading option for large-scale financial forecasting and data analytics within revenue cycle operations.
Visit website →Provides an AI-assisted revenue cycle platform combined with human-in-the-loop billing services, launched as the AGS AI Platform in September 2022. Structured workflow approach supporting consistent high-volume coding, billing and denial processing.
Visit website →Global RCM outsourcing firm with an offshore delivery model, covering inpatient, outpatient and specialty coding, claims processing, DRG validation, coding audits, compliance reviews and revenue integrity services.
Visit website →Outsourced medical billing and coding services company operating at large scale across multiple specialties for provider groups and health systems.
Visit website →Revenue cycle outsourcing provider that completed the acquisition of Xtend healthcare RCM business from Navient in September 2024, serving a general multi-specialty client base.
Visit website →AI-assisted revenue cycle automation provider that expanded through the May 2025 acquisition of i3 Verticals healthcare RCM business for $96 million. Platform and pricing built around academic medical centres and large provider groups.
Visit website →Medical billing and revenue cycle outsourcing company serving providers across multiple general specialties, positioned as a generalist outsourced billing partner rather than a specialty platform.
Visit website →Comprehensive RCM services centred on operational continuity and execution, supporting billing, denial resolution and accounts receivable management for mid-sized healthcare organisations.
Visit website →Compare delivery models, rates, contracts and risk before selecting a provider for a US engagement.
This page lists 10 medical billing companies providers that work with United States clients. We look at delivery track record, whether the team overlaps with US time zones, how they scope and price work, and whether they can sign standard US contracts including an MSA, SOW, NDA and mutual indemnity.
Firms currently featured include R1 RCM, Ensemble Health Partners, Optum, and AGS Health.
Delivery footprints on this list span Murray, UT, USA, Cincinnati, OH, USA, Eden Prairie, MN, USA, and Washington, DC, USA, so you can choose between onshore US delivery, nearshore teams with 3–5 hours of overlap, and offshore teams priced for volume work.
US buyers usually see three engagement models for medical billing companies: fixed-scope projects, time and materials with a monthly cap, and a dedicated team retainer. Onshore US consultancies typically bill $125–$250 per hour, nearshore partners in Latin America $55–$95, and offshore teams $25–$55.
Ask for a rate card by role, not a blended rate — a blended number hides how much of the work is done by junior staff. For fixed-bid work, insist on a written change-order process, and for retainers, confirm the notice period and any minimum monthly hours.
Watch the total cost of ownership: discovery workshops, knowledge transfer, post-launch support, and the cost of taking the work back in house at the end.
Before you sign, confirm the provider carries professional liability (E&O) and cyber insurance with US-acceptable limits, and that the MSA clearly assigns IP ownership of all deliverables to you on payment.
If the engagement touches regulated data, get the compliance posture in writing: SOC 2 Type II for the provider's own systems, HIPAA with a signed BAA for health data, CCPA/CPRA handling for California consumer data, GLBA for financial services, and background-check policies for anyone with production access.
Also nail down worker classification and subcontracting — many US buyers require written approval before any part of the work is passed to a third party.
Run the same questions past two or three firms from this list and compare the answers side by side — the differences are usually more revealing than the proposals.
Practical answers for USA clients comparing providers, pricing and engagement models.
