MedBillingExperts

What MedBillingExperts does

OutsourceRCM (formerly MedBillingExperts) is a healthcare revenue cycle management outsourcing company operating as a wholly-owned subsidiary of Flatworld Solutions Inc. Launched in 2012 as the dedicated healthcare delivery arm of Flatworld Solutions (which has been in healthcare RCM since 2004), the company provides end-to-end revenue cycle services to hospitals, ambulatory surgical centers, physician practices, urgent care facilities, emergency medical services, and healthcare consulting firms across 15+ medical specialties. The company is headquartered at 116 Village Blvd, Suite 200, Princeton, New Jersey, with delivery operations supported from Bangalore, India, and a 501-1000 employee base.

The company's service portfolio is built around a KPI-driven revenue cycle management platform with standardized claim validation workflows, real-time eligibility verification, root-cause denial analytics, ICD-10 coding validation, aging-based AR prioritization, and structured phased transition frameworks for client onboarding. It integrates with the major U.S. EHR and practice management systems (Epic, Cerner, Athenahealth, Kareo, AdvancedMD), clearinghouse infrastructure (Availity, Waystar, Change Healthcare, Ally, Zelis), RPA platforms (UiPath, Microsoft Power Automate), and analytics tools (Power BI, Tableau, Looker). Compliance posture is anchored on HIPAA-aligned workflows, RBMA standards adherence, and ISO 27001-certified information security practices. Documented operational outcomes include 95%+ verification accuracy, 30% fewer eligibility denials, ~50% reduction in front-desk manual workload, 15-30% reduction in Days in A/R, and up to 40% reduction in healthcare revenue cycle costs while improving collections.

Revenue is generated through a managed services model on a contingency-based pricing structure, with a 5% fee aligned to recovered dollars, tying compensation to client financial outcomes. Distribution combines enterprise field sales for large healthcare organizations, inside sales via toll-free lines for mid-market practices, and self-service website engagement for smaller accounts. Go-to-market leans on content marketing, case study showcases, and thought-leadership placement in publications such as Medical Economics, BBN Times, Modern Diplomacy, and MedIndia. Named enterprise customers include Fujitsu, Maximus, Rogers, ARI, Loomis, Movement, and Alcon, while the practice-level customer base is described as designed to serve 21,000+ healthcare providers.

Name

MedBillingExperts

Legal name

Flatworld Solutions Inc.

Website

https://medbillingexperts.com

Company type

Private

Founded year

2012

Operating status

Operating

Headcount range

501–1,000 employees

Short description

OutsourceRCM (formerly MedBillingExperts) is a HIPAA-aligned healthcare revenue cycle management outsourcing provider serving U.S. healthcare practices and enterprise clients with medical billing, coding, claims management, and AR services on contingency-based pricing.

Ownership category

akta.pro rank

Product category

Healthcare Revenue Cycle Management (RCM) Services

NAICS

Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (518)

SIC

Services-Computer Programming, Data Processing, Etc. (7370)

akta.pro primary industry

RCM Outsourcing & Managed Billing Services (HLACACAN)

akta.pro secondary industries

Claims Management, Scrubbing & Clearinghouse (HLACACAB), Patient Access, Registration & Intake (Front-End RCM) (HLACACAE), Patient Billing, Statements & Payment Processing (HLACACAG)

Keywords

• Medical billing services
• Revenue cycle management
• Medical coding services
• Claims processing services
• Denial management services

Headquarters

HQ city

Bangalore

HQ country

India

HQ region

Asia

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure

Revenue model

1. RCM Outsourcing Services: Healthcare revenue cycle management outsourcing covering front-end (patient access, eligibility verification), mid-cycle (medical coding, charge capture, claim submission), and back-end (AR management, denial management, payment posting) services. Delivered through dedicated RCM specialists aligned to specialty workflows with performance-based outcomes.
2. Contingency-Based Pricing: 5% contingency fee model aligned to recovered dollars only, tying company compensation directly to financial outcomes achieved for clients.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels4 records

Core offering

MedBillingExperts (OutsourceRCM) provides outsourced healthcare revenue cycle management services covering patient access/eligibility verification, specialty-aligned medical coding, electronic claims submission, denial management, accounts receivable follow-up, payment posting, and patient billing/collections. Engagements are delivered as managed services through dedicated RCM specialists, with a 5% contingency fee tied to recovered dollars and phased onboarding that integrates with clients' existing EHR and clearinghouse systems.

Product overview

OutsourceRCM (formerly MedBillingExperts) is a healthcare revenue cycle management company offering a unified platform with multiple integrated modules. The core offering includes Medical Billing, Medical Coding, Claims Management, Denial Management, and AR Management services, supported by specialized billing software expertise (Athena, ChiroTouch, eClinicalWorks, Kareo, Office Ally, Lytec, Medisoft, IMS). Additional modules include Medical Transcription, Healthcare Call Center, Healthcare IT, Pharmacy Management, Teleradiology, and Medical Animation services. The platform leverages technology integrations with major EHR systems (Epic, Cerner, Athenahealth, Kareo, AdvancedMD), clearinghouses (Availity, Waystar, Change Healthcare, Zelis), automation tools (UiPath, Power Automate), and analytics platforms (Power BI, Tableau, Looker) to deliver KPI-driven revenue cycle operations. Backed by Flatworld Solutions Inc., the company operates through HIPAA-aligned workflows and supports ISO 27001-certified information security practices.

Differentiator

Problem solved

Functional benefit

Products and services

• Medical Billing Services Comprehensive medical billing services including claim submission, payment posting, and patient billing delivered to healthcare organizations across multiple specialties.
• Medical Coding Services Specialty-aligned medical coding with ICD-10 validation, documentation workflows, and compliance-focused coding audits for healthcare practices.
• Claims Management End-to-end claims processing including claim preparation, validation, scrubbing, and timely electronic submission.
• Denial Management Root-cause denial analytics, structured appeals workflows, and preventive denial controls designed to reduce claim rejections.
• Patient Billing and Collections Patient billing services and collections management to streamline payment processes and improve collections for healthcare practices.
• Insurance Verification Real-time eligibility and benefits verification with 95%+ verification accuracy through standardized validation protocols.
• Financial Reporting and Reconciliation KPI-driven dashboards and structured performance reporting for financial visibility across billing operations.
• AR Management Accounts receivable management with aging-based prioritization, payer follow-up protocols, and high-value AR recovery strategies.
• Payment Posting ERA/EOB posting workflows with payment variance tracking and financial reconciliation support.
• Medical Transcription Services Accurate and timely medical transcriptions across multiple specialties including cardiology, neurology, radiology, and operative reports.
• Healthcare Call Center 24/7 healthcare call center support for seamless patient communication and improved satisfaction.

Quantifiable outcome

• 30% fewer eligibility denials through front-end validation workflows
• +6 more outcomes

Named customers15 records

Segments4 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration23 records

Feature6 records

Partnerships

13 partnerships are on record, tiered core and flagship.

• EpiccoreTechnology or IntegrationEHR/Practice Management platform integration capability enabling seamless connection with Epic systems for healthcare data exchange and workflow automation
• CernercoreTechnology or IntegrationEHR/Practice Management platform integration enabling interoperability with Cerner systems for healthcare data management
• AthenahealthcoreTechnology or IntegrationEHR platform integration with Athenahealth for billing software services and practice management connectivity
• KareocoreTechnology or IntegrationKareo billing software integration for optimized scheduling and comprehensive EHR platform connectivity
• AdvancedMDcoreTechnology or IntegrationAdvancedMD EHR/Practice Management platform integration for comprehensive medical billing services
• AvailitycoreTechnology or IntegrationClearinghouse and claims infrastructure integration through Availity for claim validation and submission ecosystem
• WaystarcoreTechnology or IntegrationClearinghouse integration with Waystar for healthcare payments and revenue cycle technology platform connectivity
• Change HealthcarecoreTechnology or IntegrationChange Healthcare clearinghouse integration for claims infrastructure and revenue cycle management connectivity
• UiPathcoreTechnology or IntegrationAutomation and workflow intelligence implementation using UiPath RPA platform for productivity and accuracy enablement
• Power AutomatecoreTechnology or IntegrationMicrosoft Power Automate workflow automation for healthcare RCM process efficiency and integration
• Power BIcoreTechnology or IntegrationReporting and analytics using Microsoft Power BI for financial visibility and KPI tracking dashboards
• TableaucoreTechnology or IntegrationTableau analytics platform for healthcare data visualization and performance reporting capabilities
• Flatworld Solutions Inc.flagshipStrategic or Co-development PartnerParent company and pioneer in healthcare RCM services since 2004. OutsourceRCM (formerly Medbilling Experts) operates as a web property backed by Flatworld Solutions, leveraging same experienced leadership, domain expertise, and seasoned RCM teams. Began operations in 2012 as extended delivery arm.

Scale indicators8 records

Recent moves6 records

Expansion highlights6 records

Broad incumbents

• R1 RCM: One of the largest US-based RCM outsourcing companies serving hospitals, health systems, and physician groups. Directly comparable to MedBillingExperts in core RCM outsourcing services but operates at significantly larger scale with proprietary technology.
• Optum (UnitedHealth Group): Largest US healthcare services and RCM operator offering end-to-end revenue cycle, billing, and coding through its OptumInsight division. Overlaps with MedBillingExperts in RCM outsourcing but as part of a much broader portfolio.
• Waystar: Healthcare payments and RCM technology platform offering claims management, patient billing, and denial management as software. Comparable in clearinghouse and revenue cycle technology integrations though primarily software rather than outsourced services.
• Cognizant (TriZetto): Global IT services firm with significant healthcare RCM and TriZetto platform offerings serving payers and providers. Comparable in large-scale RCM outsourcing but as part of broad IT services portfolio.
• Experian Health: Healthcare division offering eligibility verification, claims management, and patient billing technology. Comparable in front-end RCM and clearinghouse services though primarily technology-enabled rather than labor-arbitrage outsourcing.

Others

• Availity: Healthcare clearinghouse and provider engagement platform used by MedBillingExperts for claim submission. While not a direct outsourcing competitor, it is a key infrastructure partner and adjacent technology provider in the same RCM ecosystem.

Direct peers

• Omega Healthcare: India-based RCM, coding, and accounts receivable management outsourcing company serving US healthcare organizations. Direct competitor with comparable offshore delivery model and service scope.
• GeBBS Healthcare Solutions: India-based RCM and medical coding outsourcing company serving US providers, hospitals, and physician practices. Closely comparable in offshore delivery model, service portfolio, and US healthcare customer base.
• AGS Health: India-headquartered RCM outsourcing firm serving US healthcare providers across specialties. Closely comparable in offshore delivery model, specialty breadth, contingency pricing, and target customer profile.
• IKS Health: India-based RCM and care management outsourcing firm combining technology with human workflow for US healthcare providers. Closely comparable delivery model and specialty RCM outsourcing focus.

Market position

Strengths4 records

Weaknesses5 records

Competitive moat4 records

Key risks5 records

Key highlights7 records

Customer concentration

• Xx.com/medbillingxpert
• Facebookfacebook.com/medbillingexperts-217722648355109
• LinkedInlinkedin.com/company/medbillingexperts

Compliance3 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles4 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about MedBillingExperts