Top RCM companies, and how to choose one.

Medical billing usually starts once the claim is ready: sending it, following it and posting the payment. Revenue cycle management also covers the steps before the claim, such as insurance checks, prior authorizations and code review, and the steps after it, such as patient balances and reports. Many companies use both names, so ask which steps a company actually does.

Most charge a share of what they collect, a fee for each claim, or a flat monthly fee, and some combine them. Front-end work, such as insurance checks or prior authorizations, may be priced on its own. Ask what each fee covers, what costs extra, and how the price changes as your volume grows. Valian sets your price with you after the discovery call.

There is no official ranking. Some of the largest healthcare revenue cycle management companies work mostly for hospitals and health systems, which bill very differently from a practice. For a practice, the better question is which company knows your specialty, your payers and your size, and will show you every claim. Use the questions on this page to compare them.

The ones that fit how a small office works. Look for a company that takes the whole cycle or the exact steps you want, works with the practice software you have, shows you every claim without being asked, and signs a BAA before any data moves. Ask for the names of the people who will work your claims.

The same cycle, with dental rules. Companies that serve dentists check benefits such as the annual maximum and frequencies, send claims with CDT codes on the dental claim form, attach X-rays and notes, post EOBs and appeal denials. Several companies on this list say they serve dental practices, and Valian runs dental and medical billing on the same software.

It depends on how much of the cycle your team can cover every day. In-house keeps control close, but it rests on a few people, and steps slip when they are busy. An outside company gives the work a team, but you see less unless it shows you every claim. With Valian, your team can run the cycle in our software, or hand it to our team.

Ask which steps they take on, who does the work and where, how denials and appeals are handled, what reports you get and how often, and who picks the codes. Then ask about the contract: its length, the notice to leave, any fee for leaving, who finishes open claims, and how you get your data back. Get every answer in writing.

Numbers you can check yourself: what was collected, by carrier and by provider, how long each carrier takes to pay, what is still open by age, and what was denied and why. In Valian, each of these is built from the EOBs themselves and sits in Finances any day, so nobody builds a month-end report.

Some do. Several companies on this list name credentialing on their websites. Valian does not do payer credentialing, so a provider who is not yet in a payer's network finishes that first, with the payer or a credentialing service. Once a provider is enrolled, Valian handles the carrier sign-ups your office needs to send claims.

Yes. Under HIPAA, a company that does billing or claims work with your patients' information is a business associate. Your office needs a written business associate agreement with it before it gets any patient data. The BAA sets what the company may do with that data, requires it to report a breach to you, and covers the data when the contract ends. Valian signs one before any patient data moves.

Your contract should say so plainly. Under HIPAA, a company that does your billing may use your patients' information only as its business associate agreement allows, and when the contract ends it must return or destroy that information if it can. Ask how you get a full copy of your claims, payments and denials, in what format, and how fast.

Terms vary. Some run month to month. Others ask for a year or more, and some renew on their own unless you give notice in time. Before you sign, read the length, the notice period, any fee for leaving early, who finishes the claims still open when it ends, and how your data comes back to you.

It depends on your payers and your contract. Some payers need a sign-up before a different company can send your claims, so plan the start date around those. Give notice under your current contract, decide who finishes the claims already sent, and get an aging report first. Medicare denies a claim filed more than 12 months after the date of service, so nothing should sit unsent.

No. RCM software gives your own team the tools to run the cycle, and your team does the work. A company does the work for you, in its own software or in yours. Valian is both: one set of screens, run by your team or by ours, and you can switch later. Our revenue cycle management software page shows the tools.

No. Companies are listed A to Z. Each fact comes from the company's own website, on the page we link, read on November 11, 2026. We did not rate or score anyone, and no company paid to be listed. Websites change, so check each one yourself before you decide.