HMS USA
HMS USA LLC is a privately held US Revenue Cycle Management company that provides outsourced medical billing, coding, credentialing, denial management, and virtual front-desk services to hundreds of SMB medical practices, hospitals, nursing facilities, and home health agencies across all 50 US states.
- Company typePrivate
- Founded2017
- HeadquartersFloral Park, United States
- Headcount251–500
- GTM typeB2B
- OfferingServices
What HMS USA does
HMS USA LLC is a privately held US Revenue Cycle Management (RCM) company headquartered in Floral Park, New York, with a second office in Decatur, Texas. Founded in 2017 (with client relationships traceable to 2011), the company delivers outsourced medical billing, coding, credentialing, denial management, prior authorization, and virtual front-desk services to healthcare providers across all 50 US states. Its primary customer base is solo and small-group medical practices, with additional exposure to hospitals, nursing homes, skilled nursing facilities, home health agencies, and behavioral health providers. Named SMB clients include North Ocean Medical Group, North Orchard Medicine, Dr. Bryant Medical Practice, Advanced Medical Office, Psych Associates of North Texas, and Elpis Healthcare, each representing engagements of multi-year tenure.
The company's service stack combines workflow-driven RCM operations with proprietary performance claims (99% first-pass rate, 99% denial recovery, 93.6% denial rate reduction, 25% cost reduction, 2x faster claim resolution) and 100% HIPAA compliance. It does not disclose a flagship software platform; rather, it positions people-driven RCM delivery (251-500 employees, dedicated account managers) supplemented by add-on modules such as Chronic Care Management software, Quality Payment Program support (MIPS/PCMH), medical underpayment recovery, and audit services. Specialty-specific coding expertise is offered across 17+ medical specialties.
HMS USA operates a B2B direct-sales model with custom quote-based pricing, free billing audits as the lead-generation offer, and multi-year managed-service contracts. The company has no disclosed outside funding, parent entity, or M&A activity, indicating it has grown organically from operating cash flow. Marketing is content-driven via the HMS Blog, RCM University, case studies, and SEO-optimized state and specialty landing pages that function as a distributed acquisition channel.
HMS USA firmographics
Firmographics- Name
- HMS USA
- Legal name
- HMS USA LLC
- Website
- https://hcmsus.com
- Company type
- Private
- Founded year
- 2017
- Operating status
- Operating
- Headcount range
- 251–500 employees
- Short description
- HMS USA LLC is a privately held US Revenue Cycle Management company that provides outsourced medical billing, coding, credentialing, denial management, and virtual front-desk services to hundreds of SMB medical practices, hospitals, nursing facilities, and home health agencies across all 50 US states.
- Ownership category
- akta.pro rank
HMS USA industry classification
Industry- Product category
- Healthcare Revenue Cycle Management
- SIC
- Services-Computer Programming, Data Processing, Etc. (7370)
- akta.pro primary industry
- EMS Billing, Revenue Cycle & Compliance Services (HLAFANAM)
- akta.pro secondary industry
- Patient Access, Registration & Intake (Front-End RCM) (HLACACAE)
Keywords
Where HMS USA is headquartered
LocationHeadquarters
- HQ city
- Floral Park
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
HMS USA business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure
Revenue model
- Medical Billing and RCM Services: Comprehensive revenue cycle management services including medical billing, coding, and claim submission for healthcare providers. Services are provided on an ongoing basis as a managed service, with dedicated billing teams assigned to client practices to handle full-cycle revenue management from patient registration through final payment collection.
- Medical Credentialing Services: Provider enrollment and credentialing services with insurance companies to ensure providers are properly enrolled for reimbursement.
- Denial Management Services: Specialized denial management and appeal services to recover denied claims, offered as part of the comprehensive RCM package.
- Virtual Front Desk Services: Front office management services including appointment scheduling, insurance verification, and patient registration support.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Other | Multi-year contract | Custom Quote-Based Pricing |
Go-to-market motion1 record
Distribution channels2 records
Marketing channels4 records
HMS USA product offering
Product offeringCore offering
HMS USA LLC provides outsourced revenue cycle management (RCM) services for healthcare providers across the United States. The company delivers end-to-end medical billing, medical coding (CPT and ICD-10), provider credentialing and payer enrollment, denial management and appeals, virtual front desk support, prior authorization, and chronic care management software. It serves solo and group practices, hospitals, nursing homes, and home health agencies across numerous medical specialties including cardiology, dermatology, mental health, physical therapy, radiology, OB GYN, dental, and others.
Product overview
HMS USA LLC is a comprehensive healthcare management services company offering a unified Revenue Cycle Management (RCM) platform. The core offering centers on Medical Billing Services, Medical Coding Services, and Medical Credentialing Services, supplemented by specialized add-on modules including Virtual Front Desk, Provider Quality Payment Program, Denial Management Services, Audit Services, and Patient Billing Services. The company serves multiple medical specialties including Cardiology, Dermatology, Mental Health, Physical Therapy, Radiology, Internal Medicine, OB GYN, Dental, Chiropractic, Hematology, Pulmonology, Orthopedic, Wound Care, Rehab, General Surgery, Pathology, and Urology. Additional specialized services include Psychiatry and Physician Billing, Nurse Practitioner Credentialing, Telemedicine Credentialing, and Chronic Care Management software. The platform also provides educational resources including a blog covering billing codes (POS 31/32, Revenue Code 0636), CMS regulations (WISeR Model, MIPS), and reimbursement topics.
Differentiator
Problem solved
Functional benefit
Products and services
- Medical Billing Services End-to-end revenue cycle management services including claim submission, denial management, and payer enrollment to streamline healthcare billing processes for medical practices, hospitals, nursing homes, and home health agencies.
- Medical Coding Services Accurate CPT and ICD-10 coding performed according to AMA guidelines to ensure proper claim documentation and reimbursement for healthcare providers.
- Medical Credentialing Services Provider enrollment and credentialing services ensuring accurate credentialing with insurance companies for proper claim processing and reimbursement.
- Denial Management Services Expert claim denial tracking, root cause analysis, and resubmission services with documented success rates in recovering denied claims for healthcare providers.
- Virtual Front Desk Medical virtual receptionist services handling appointment scheduling, patient registration, insurance verification, and prior authorizations for medical practices.
- Patient Billing Services Solutions to minimize administrative costs and efficiently collect patient payments for healthcare practices.
- Provider Quality Payment Program (QPP/MIPS) Compliance with CMS/NCQA guidelines related to MIPS and PCMH quality payment program metrics for healthcare providers.
- Audit Services Medical billing and coding audit services to identify compliance vulnerabilities and prevent claim denials before they occur, including free billing audits for prospective clients.
- Psychiatry Billing Services Specialized medical billing for mental health and psychiatric practices with documented revenue uplift outcomes.
- Physician Billing Services Billing services tailored for physician practices across various specialties.
- Nurse Practitioner Credentialing Services Credentialing services specifically designed for nurse practitioners to enroll with insurance payers.
- Telemedicine Credentialing Services Credentialing support for telemedicine and telehealth providers enrolling with insurance payers.
- Chronic Care Management Software Services Software and services supporting chronic care management (CCM) programs for patients with ongoing health conditions.
- Medical Underpayment Recovery Services to identify and recover underpayments from insurance payers based on contracted allowed amounts.
- Prior Authorization Services Coordination and management of prior authorization requirements before medical services are rendered.
- Claim Submission Services Electronic claim submission services for healthcare providers.
Quantifiable outcome
- 99% first pass rate on claim submissions
- +4 more outcomes
Companies that use HMS USA
Customer profileNamed customers6 records
Segments5 records
Ideal customer profiles3 records
HMS USA technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Feature4 records
HMS USA partnerships and signals
Strategic signalScale indicators7 records
Recent moves6 records
Expansion highlights6 records
HMS USA competitors and assessment
Company assessmentBroad incumbents
- R1 RCM: R1 RCM is a leading US revenue cycle management services company serving hospitals and large healthcare systems. It is comparable to HMS USA as a direct RCM services competitor, although it operates at significantly larger scale and is enterprise/health-system focused rather than SMB.
- Athenahealth: Athenahealth is a leading US EHR, practice management, and RCM platform serving physician practices and health systems. It competes with HMS USA in medical billing/RCM for ambulatory providers, but at much larger scale and with a tech-platform-led (rather than services-led) model.
- eClinicalWorks: eClinicalWorks is a US EHR and practice management vendor serving thousands of physician practices, with integrated billing and RCM functionality. It is a partial competitor to HMS USA in the medical practice billing and front-office workflow space, primarily via its bundled software offering.
- NextGen Healthcare: NextGen Healthcare provides EHR, practice management, and RCM solutions to US ambulatory practices, including specialty groups. It competes with HMS USA in billing and revenue cycle management for medical practices, primarily through its integrated software platform.
Direct peers
- Advantum Health: Advantum Health is a US healthcare RCM and practice management services provider serving physician practices, hospitals, and ambulatory providers. It is closely comparable to HMS USA in target customer (medical practices), service mix (billing, coding, credentialing, denial management), and mid-market positioning.
- Coronis Health: Coronis Health provides end-to-end medical billing, coding, credentialing, and RCM services to physician practices and healthcare facilities across the US. It is a direct competitor to HMS USA with comparable service breadth, specialty-billing focus, and SMB to mid-market customer base.
- Medusind: Medusind is a US medical and dental billing, RCM, and practice management services firm serving physician practices, dental groups, and ambulatory providers. It directly competes with HMS USA across billing, coding, credentialing, and front-office services for SMB healthcare providers.
- BillingParadise: BillingParadise provides medical billing, coding, and RCM services to US physician practices across multiple specialties. It is directly comparable to HMS USA in target customer (small and mid-sized medical practices), service mix, and specialty-billing positioning.
- GeBBS Healthcare Solutions: GeBBS Healthcare Solutions is a global RCM, medical coding, and health information management services provider serving US hospitals and physician groups. It overlaps directly with HMS USA's billing, coding, and denial management offerings at a larger, more enterprise-oriented scale.
- CareCloud: CareCloud (formerly MTBC) provides cloud-based EHR, practice management, and RCM services to US small and mid-sized physician practices. It is a comparable competitor to HMS USA — both target SMB medical practices with outsourced RCM, though CareCloud is more tech-platform-led.
Market position
Strengths5 records
Weaknesses4 records
Competitive moat4 records
Key risks7 records
Key highlights7 records
Customer concentration
HMS USA social profiles
Digital presenceHMS USA compliance and trust
Trust signalCompliance1 record
HMS USA financial estimates
Financial estimateRevenue estimate
Valuation estimate
HMS USA leadership team
Management profileNumber of profiles
Profiles1 record
HMS USA funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
HMS USA M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about HMS USA
What does HMS USA do?
HMS USA LLC provides outsourced revenue cycle management (RCM) services for healthcare providers across the United States. The company delivers end-to-end medical billing, medical coding (CPT and ICD-10), provider credentialing and payer enrollment, denial management and appeals, virtual front desk support, prior authorization, and chronic care management software. It serves solo and group practices, hospitals, nursing homes, and home health agencies across numerous medical specialties including cardiology, dermatology, mental health, physical therapy, radiology, OB GYN, dental, and others.
Is HMS USA a public or private company?
HMS USA is a private company. It is classified as founder individual operated bootstrapped and is currently operating.
When was HMS USA founded?
HMS USA was founded in 2017. It employs 251 to 500 people.
Where is HMS USA based?
HMS USA is headquartered in Floral Park, United States, in the North America region.
How does HMS USA make money?
Four revenue lines are on record. Medical Billing and RCM Services are the primary driver. The others are medical Credentialing Services, denial Management Services and virtual Front Desk Services.
Who are HMS USA's main competitors?
Broad incumbents on record are R1 RCM, Athenahealth, eClinicalWorks and NextGen Healthcare. Direct peers are Advantum Health, Coronis Health, Medusind, BillingParadise, GeBBS Healthcare Solutions and CareCloud.
Does HMS USA have an API?
No public API is recorded for HMS USA.
What industry is HMS USA in?
HMS USA's product category is Healthcare Revenue Cycle Management. Its primary akta.pro industry code is HLAFANAM, EMS Billing, Revenue Cycle & Compliance Services, with a secondary code of HLACACAE, Patient Access, Registration & Intake (Front-End RCM). Its SIC code is 7370.