Billing Care Solutions

What Billing Care Solutions does

Billing Care Solutions (BCS), operating as Billing Care Solutions LLC, is a private U.S.-based medical billing and revenue cycle management (RCM) services provider headquartered in Sheridan, Wyoming. Founded in 2008 (per company history) and reporting 11–50 employees, the company delivers outsourced billing, coding, credentialing, denial management, prior authorization, analytics, and compliance services to more than 1,200 healthcare providers across all 50 states and 50+ medical specialties, including cardiology, oncology, gastroenterology, neurology, infusion therapy, and home health. Its technology stack centers on an AI-assisted RCM platform featuring ICD-10 and CPT coding validation across 50+ specialties, AI-integrated denial management, automated compliance checks, and real-time analytics dashboards, delivered through HIPAA-compliant cloud-based monitoring and certified by CBCS and AAPC credentials.

The company monetizes primarily through a transaction-based pricing model at 2.99% of collections on a pay-for-paid basis, supplemented by bundled credentialing and consultation services. Go-to-market is sales-led and inside-sales driven, combining inbound content marketing and SEO with outbound direct sales and consultation booking (Calendly), supported by a free revenue assessment lead magnet. BCS distributes through deep integration with 30+ EMR/EHR platforms including Epic, Oracle Health (Cerner), eClinicalWorks, NextGen, Kareo, and Practice Fusion, which functions as a switching-cost moat for provider clients. The company claims operational KPIs of 99% clean claim rate, 35–40% denial reduction, 24-hour processing turnaround, 100% client retention, and a 5.0 Google rating, though these are self-reported and not third-party validated.

BCS operates as a founder-led, privately-held entity with no disclosed institutional investors, funding rounds, acquisitions, or parent company; testimonials reference founder Adnan Qamar as the primary client relationship lead. The absence of capital events and the SMB-skewed customer mix suggest organic, reinvestment-driven growth rather than venture-scale expansion, positioning the business as a bootstrapped specialty RCM operator rather than a high-growth technology platform.

Name

Billing Care Solutions

Legal name

Billing Care Solutions LLC

Website

https://billingcaresolutions.com

Company type

Private

Founded year

2008

Operating status

Operating

Headcount range

11–50 employees

Short description

Billing Care Solutions is a private U.S. medical billing and revenue cycle management services provider delivering outsourced coding, claims, denial management, and credentialing to 1,200+ healthcare providers across 50+ specialties and all 50 states on a 2.99% of collections pricing model.

Ownership category

akta.pro rank

Product category

Healthcare Revenue Cycle Management

NAICS

Business Support Services (5614), Custom Computer Programming Services (541511)

SIC

Services-Computer Programming, Data Processing, Etc. (7370), Services-Management Services (8741)

akta.pro primary industry

RCM Outsourcing & Managed Billing Services (HLACACAN)

akta.pro secondary industries

Patient Billing, Statements & Payment Processing (HLACACAG), Patient Access, Registration & Intake (Front-End RCM) (HLACACAE), Accounts Receivable (A/R) & Collections Management (HLACACAJ), Medical Coding, Billing & Clinical Documentation Support (BPAAAFAD)

Keywords

• Medical billing services
• Revenue cycle management
• Medical coding services
• Healthcare claims processing
• Credentialing services

Headquarters

HQ city

Sheridan

HQ country

United States

HQ region

North America

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. Medical Billing Services: Revenue cycle management and medical billing services charged as a percentage of collections. Pricing model: 2.99% of collections on pay-for-paid basis.
2. Credentialing Services: Provider enrollment and credentialing services included as part of comprehensive RCM package.
3. Specialty-Specific Billing: Billing services for 50+ medical specialties including cardiology, oncology, gastroenterology, with specialized coding expertise.

Pricing tiers

Go-to-market motion2 records

Distribution channels3 records

Marketing channels8 records

Core offering

Billing Care Solutions provides outsourced medical billing and end-to-end revenue cycle management (RCM) services for healthcare providers in the United States. Its core offerings span medical billing and coding, claims submission, denial and AR management, credentialing and provider enrollment, prior authorization and VOB, billing/coding audits, reporting and analytics, compliance assistance, and patient help support, delivered across 50+ medical specialties and all 50 states. Services are priced at 2.99% of collections on a pay-for-paid model and are supported by an AI-driven coding platform with HIPAA-compliant cloud monitoring.

Product overview

Billing Care Solutions is a medical billing and revenue cycle management (RCM) services company offering a unified platform of billing services rather than a software product. The core offerings include Medical Billing & Coding, Revenue Cycle Management, Credentialing Services, AR & Denial Management, Billing and Coding Audits, Reporting and Analytics, VOB & Prior Authorization, Infusion Billing, Consultation Services, Compliance Assistance, and Patient Help Support. These services are delivered as an integrated package supporting 50+ medical specialties across all 50 U.S. states, with AI-driven coding validation and cloud-based compliance monitoring integrated throughout their service delivery.

Differentiator

Problem solved

Functional benefit

Products and services

• Medical Billing & Coding Comprehensive medical billing and coding services for healthcare providers, including insurance verification, charge entry, claim submission, payment posting, denial management, and patient billing support using CPT, ICD-10, and HCPCS coding standards.
• Revenue Cycle Management End-to-end revenue cycle management from patient scheduling to final payment, including front-end quality checks, claims submission, payment posting, and accounts receivable management.
• Credentialing Services Provider enrollment and credentialing services including insurance panel enrollment, clearinghouse enrollment, hospital privileges, PECOS and CAQH credentialing, payer contract management, and re-credentialing services.
• AR & Denial Management Accounts receivable recovery and denial prevention solutions to recover delayed payments and reduce denied claims through proactive follow-up and appeals.
• Infusion Billing Specialized billing service for infusion therapies including prior authorizations, accurate coding with HCPCS/J-codes, charge capture, claims submission, denial management, and real-time analytics for biologics, immunoglobulins, and oncology drugs.
• Billing and Coding Audits Revenue integrity audits to identify revenue leakage, coding risks, and improve overall billing performance through comprehensive review and analysis.
• Reporting and Analytics Financial performance analytics with clear reports and real-time insights into collections, accounts receivable, and denials to enable data-driven decision-making.
• VOB & Prior Authorization Verification of benefits and prior authorization services to prevent claim rejections before services are rendered and ensure faster approvals.
• Consultation Services Expert revenue cycle consulting to reveal revenue cycle gaps and inefficiencies with tailored healthcare solutions for long-term operational and financial success.
• Compliance Assistance Risk and compliance solutions ensuring accurate processes that support compliant billing workflows, protecting against costly audit penalties and data breaches.
• Patient Help Support Patient-centric billing support including flexible payment options, transparent billing, automated communication, patient portals, and personalized outreach.
• Specialty Billing Services Specialty-focused medical billing for 50+ specialties including cardiology, oncology, neurology, gastroenterology, dermatology, orthopedics, psychiatry, radiology, and more.

Quantifiable outcome

• 99% Clean Claims Rate
• +7 more outcomes

Named customers7 records

Segments4 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration37 records

AI capability4 records

Feature5 records

Partnerships

One partnership is on record.

• AAPCcoreOthersAmerican Academy of Professional Coders membership. Certified coders trained and credentialed through AAPC. Ensures compliance with latest coding standards and regulations.

Scale indicators17 records

Recent moves1 record

Expansion highlights5 records

Broad incumbents

• Athenahealth: Integrated EHR, practice management, and RCM platform serving ambulatory providers; broader incumbent BCS integrates with but also competes against for outsourced billing.
• MedData (now R1 RCM legacy): Larger RCM and patient financial services provider serving hospitals and health systems, broader incumbent with overlapping A/R, billing, and patient responsibility services.
• Waystar: Cloud-based healthcare payments and RCM software platform serving providers of all sizes; broader portfolio incumbent with overlapping claims management and analytics capabilities.

Direct peers

• Omega Healthcare: RCM and medical coding outsourcing provider with extensive US client base and similar percentage-based pricing, comparable delivery model and specialty coverage to BCS.
• BillingParadise: Outsourced medical billing and RCM services firm serving US providers across multiple specialties, very similar in size, scope, and offshore-augmented delivery model to Billing Care Solutions.
• IKS Health: End-to-end RCM, coding, and clinical documentation services firm serving US healthcare providers, comparable in offering mix (coding, denial, AR) and pay-for-performance pricing.
• Aviacode: Medical coding and RCM services provider with specialty-specific expertise across hospitals and physician groups, overlapping significantly with BCS's core coding and billing offerings.
• GeBBS Healthcare Solutions: Mid-to-large scale RCM outsourcing and medical coding BPO serving US providers and payers, comparable service catalog (coding, AR, denial management) and specialty breadth.
• 24/7 Medical Billing Services: US-based RCM and medical billing outsourcing company covering 40+ specialties with a percentage-of-collections pricing model, directly comparable to BCS's offering.

Emerging players

• Practice Fusion (Veradigm): Cloud-based EHR with embedded billing workflows targeted at smaller practices; overlapping customer segment with BCS and partial overlap on the billing/coding workflow.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks7 records

Key highlights7 records

Customer concentration

• Xx.com/billing_care
• Facebookfacebook.com/billingcaresolutionsllc
• LinkedInlinkedin.com/company/billingcaresolutions
• Instagraminstagram.com/billingcaresolutions
• Pinterestpinterest.com/Billingcaresolutions

Compliance3 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

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 Billing Care Solutions