ClaimCare Medical Billing
- Company typePrivate
- Founded2003
- HeadquartersIrving, United States
- Headcount51–100
- GTM typeB2B
- OfferingServices
What ClaimCare Medical Billing does
ClaimCare Medical Billing is a privately held US-based medical billing services provider founded in 2003 and headquartered in Irving, Texas. The company delivers outsourced revenue cycle management (RCM) to medical practices and healthcare facilities across all 50 US states, covering 25+ medical specialties including cardiology, ambulatory surgical centers, dermatology, emergency medicine, orthopedics, radiology, and physical therapy. The core offering combines end-to-end medical billing with a proprietary pre-adjudication system that evaluates claim payment likelihood before submission to payers, automated insurance verification, real-time 24/7 dashboard reporting, denial management, an Electronic Medical Record (EMR) system offered without upfront cost, and a Patient Checkout Tool for front-desk collections. The company also provides a Vendor Instant Payment Program that offers 60-day bridge loans to new practices, a payment plan automation system, and a no-upfront-cost EMR.
ClaimCare Medical Billing firmographics
Firmographics- Name
- ClaimCare Medical Billing
- Legal name
- ClaimCare, Inc.
- Website
- https://claimcare.net
- Company type
- Private
- Founded year
- 2003
- Operating status
- Operating
- Headcount range
- 51–100 employees
- Ownership category
- akta.pro rank
Where ClaimCare Medical Billing is headquartered
LocationHeadquarters
- HQ city
- Irving
- HQ country
- United States
- HQ region
- North America
Offices7 records
Markets served
ClaimCare Medical Billing 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 Services: Outsourced medical billing services for healthcare practices. Services include claims submission, denial management, insurance verification, patient collections, and complete revenue cycle management.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Other | Multi-year contract | Custom medical billing services based on practice size and specialty |
Go-to-market motion2 records
Distribution channels3 records
Marketing channels5 records
ClaimCare Medical Billing product offering
Product offeringCore offering
ClaimCare provides outsourced end-to-end medical billing and revenue cycle management services to US healthcare practices, including claims submission, denial management, insurance verification, patient collections, and bundled Electronic Medical Record (EMR) capabilities. Its proprietary pre-adjudication platform screens claims before they reach payers to reduce denials, and clients access real-time performance metrics via a 24/7 online dashboard. Services are supported by front-desk patient checkout tools, automated patient payment plans, and an EMR module offered without upfront cost.
Product overview
ClaimCare Medical Billing is a unified medical billing platform offering comprehensive revenue cycle management services. The core offering is Medical Billing Services supplemented by an Electronic Medical Record (EMR) system. Additional modules include the Expedited Billing Service, Denial Management, Dashboard Reports for real-time analytics, the Patient Checkout Tool for front-desk collections, Low Cost Medical Billing, and the Vendor Instant Payment Program for practice cash flow. The company also provides educational resources through its Medical Billing Blog and Medical Billing Questions & Answers Forum. Services are available across 25+ medical specialties and all 50 U.S. states, with guaranteed results and a proprietary claims pre-adjudication process.
Differentiator
Problem solved
Functional benefit
Products and services
- Medical Billing Services End-to-end outsourced medical billing and revenue cycle management for healthcare practices, including claims submission, insurance verification, patient collections, denial management, and reporting. Uses proprietary pre-adjudication technology to screen claims before payer submission.
- Electronic Medical Record (EMR) Electronic medical record system offered as part of ClaimCare's complete billing solution, enabling practices to go paperless without upfront investment. Bundled with the medical billing service offering.
- Expedited Billing Service Fast-track billing service for practices needing rapid claim processing and reimbursement. Designed for time-sensitive revenue cycles and practices recovering from billing backlogs.
- Denial Management Specialized service to identify, appeal, and resolve denied insurance claims to maximize revenue recovery. Targets practices with elevated denial rates or complex payer follow-up needs.
- Dashboard Reports 24/7 online access to real-time billing dashboards and actionable reporting for monitoring practice performance. Provides transparency into collections, AR days, and claim status from any internet-connected computer.
- Patient Checkout Tool Front-desk payment tool that automates insurance verification, provides patient balance estimates, and enables payment collection before patients leave the office. Drives down bad debt and accelerates patient balance collections.
- Low Cost Medical Billing Cost-effective billing service designed to reduce overhead costs for medical practices. Targeted at price-sensitive practices comparing outsourced billing to in-house alternatives.
- Vendor Instant Payment Program Free 60-day bridge loan program that minimizes working-capital needs for new practices by negotiating fast-pay discounts with vendors. Provided as part of ClaimCare's startup-practices service bundle.
- Automated Patient Payment Plans Automated payment plan system that debits patient checking accounts, debit cards, or credit cards monthly until the balance is paid in full. Reduces bad debt by extending collection from a single point-of-service interaction into scheduled monthly payments.
Quantifiable outcome
- Increases client collections by 10 to 20 percent
- +3 more outcomes
Companies that use ClaimCare Medical Billing
Customer profileNamed customers1 record
Segments6 records
Ideal customer profiles3 records
ClaimCare Medical Billing technology and API
TechnologyTechnology focussed No
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Feature6 records
ClaimCare Medical Billing partnerships and signals
Strategic signalScale indicators6 records
Recent moves6 records
Expansion highlights4 records
ClaimCare Medical Billing competitors and assessment
Company assessmentDirect peers
- Tebra (formerly Kareo + PatientPop): Tebra is a practice management, EHR, and medical billing platform targeting independent practices and small medical groups. It is a direct SMB-focused competitor to ClaimCare's billing and EMR offering.
- Coronis Health: Coronis Health provides outsourced medical billing, coding, and RCM services to physician practices and healthcare facilities. Like ClaimCare, it sells a complete RCM outsourcing solution to practices across multiple specialties.
- CureMD: CureMD offers EHR, practice management, and medical billing services, including outsourced RCM. It targets a similar practice-base as ClaimCare and competes on integrated technology plus services.
- PracticeSuite: PracticeSuite offers a combined practice management, EHR, and medical billing platform aimed at independent practices. It overlaps with ClaimCare's bundled RCM-plus-EMR positioning for the SMB practice segment.
- AdvancedMD: AdvancedMD provides cloud-based practice management, EHR, and medical billing services to independent practices. It competes with ClaimCare on bundled RCM/EMR for small and mid-sized practices.
- Medusind: Medusind is a US-focused outsourced medical billing and RCM services provider serving practices and ambulatory groups. It competes directly with ClaimCare across end-to-end billing, denial management, and specialty-specific coding.
Broad incumbents
- Athenahealth: Athenahealth is a large, established RCM, EHR, and practice management platform serving practices and health systems. It is a broad incumbent offering overlapping claims management and billing capabilities, but at significantly larger scale and broader portfolio than ClaimCare.
- eClinicalWorks: eClinicalWorks is a major EHR and practice management vendor that includes RCM and billing services for ambulatory practices. It is a broad incumbent whose bundled platform competes with ClaimCare's RCM-plus-EMR positioning.
- NextGen Healthcare: NextGen Healthcare provides EHR, practice management, and RCM solutions to ambulatory practices and specialty groups. It competes broadly with ClaimCare on integrated billing technology and outsourced services.
- R1 RCM: R1 RCM is a large-scale outsourced RCM provider focused on health systems and hospital-based customers. It represents a broader, enterprise-tier incumbent operating in adjacent segments of the same market as ClaimCare.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat5 records
Key risks4 records
Key highlights7 records
Customer concentration
ClaimCare Medical Billing social profiles
Digital presenceClaimCare Medical Billing compliance and trust
Trust signalCompliance1 record
ClaimCare Medical Billing financial estimates
Financial estimateRevenue estimate
Valuation estimate
ClaimCare Medical Billing leadership team
Management profileNumber of profiles
Profiles1 record
ClaimCare Medical Billing funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
ClaimCare Medical Billing 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 ClaimCare Medical Billing
What does ClaimCare Medical Billing do?
ClaimCare provides outsourced end-to-end medical billing and revenue cycle management services to US healthcare practices, including claims submission, denial management, insurance verification, patient collections, and bundled Electronic Medical Record (EMR) capabilities. Its proprietary pre-adjudication platform screens claims before they reach payers to reduce denials, and clients access real-time performance metrics via a 24/7 online dashboard. Services are supported by front-desk patient checkout tools, automated patient payment plans, and an EMR module offered without upfront cost.
Is ClaimCare Medical Billing a public or private company?
ClaimCare Medical Billing is a private company. It is classified as founder individual operated bootstrapped and is currently operating.
When was ClaimCare Medical Billing founded?
ClaimCare Medical Billing was founded in 2003. It employs 51 to 100 people.
Where is ClaimCare Medical Billing based?
ClaimCare Medical Billing is headquartered in Irving, United States, in the North America region.
How does ClaimCare Medical Billing make money?
One revenue line is on record: medical Billing Services.
Who are ClaimCare Medical Billing's main competitors?
Direct peers on record are Tebra (formerly Kareo + PatientPop), Coronis Health, CureMD, PracticeSuite, AdvancedMD and Medusind. Broad incumbents are Athenahealth, eClinicalWorks, NextGen Healthcare and R1 RCM.
Does ClaimCare Medical Billing have an API?
No public API is recorded for ClaimCare Medical Billing.