What MD Commerce does

MD Commerce (legal entity MDCOMMERCE LLC, formerly Cascade Billing) is a U.S. healthcare technology and services company founded in 1994 and headquartered in Tacoma, Washington. The company provides integrated medical billing, revenue cycle management, and practice value-building services to ambulatory/outpatient practices, hospitals and large central business offices, urgent care facilities, and 30+ specialty verticals across 30 states, led by CEO Gordon Bell. Its service portfolio is anchored on a Gold Standard RCM methodology that targets 95%+ first pass payment and 97%+ collections of allowable payments, delivered through dedicated account managers and supported by certified ICD-10 coders covering 30+ medical specialties.

The underlying technology stack combines AI deep-learning medical coding (processing 50,000+ transactions per month at 98%+ accuracy and 40%+ automated throughput), AI-assisted claims scrubbing, deep AR analysis via Microsoft Power BI plus proprietary tooling, and integration with the three dominant EMR platforms — AdvancedMD, Athena Health, and EPIC Resolute. The company also operates an AMD Telemedicine Platform with secure video/phone visits, ePrescribing, patient portal, online scheduling, and remote medical assistant support, plus an expanding portfolio of value-add services: Remote Patient Monitoring, Chronic Care Management, Transitional Care Management, Behavioral Health Integration, Remote Therapeutic Management, Principal Care Management, Annual Wellness Visits, Physician Office Lab, Primary Care at Home / Mobile Care, and Hybrid Membership Practice consulting.

MD Commerce generates revenue through managed-services RCM fees, professional-services staff extension (Virtual MA, certified coders, AR specialists), and consultative engagements around telemedicine enablement, membership practice conversion, and Value Cycle Management. Pricing is unit-priced against CMS CPT and G-codes for the care-management services and quote-based for the broader RCM and consulting work. The company employs 200+ staff, distributes via direct sales and inside-sales intake across dedicated service-line appointment forms, and co-markets through AMA and AAFP telehealth resources. No external funding rounds, M&A, or institutional investors are disclosed.

Name

MD Commerce

Legal name

MDCOMMERCE LLC

Website

https://mdcommerce.com

Company type

Private

Founded year

1994

Operating status

Operating

Headcount range

51–100 employees

Short description

MD Commerce is a U.S. medical billing and revenue cycle management company, founded in 1994 and based in Tacoma, Washington, serving healthcare practices across 30 states with Gold Standard RCM, AI-powered coding, telemedicine, staff extension, and care-management services.

Ownership category

akta.pro rank

Product category

Medical Billing & Revenue Cycle Management

NAICS

Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (518210), Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (5182)

SIC

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

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)

Keywords

• Revenue cycle management
• Medical billing services
• Telemedicine platform integration
• Medical coding services
• Practice value consulting

Headquarters

HQ city

Tacoma

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Gold Standard Revenue Cycle Management Services: Comprehensive RCM services offered on a full-service or a la carte basis, including coding, prior-authorizations, credentialing, payer contract negotiations, and AR follow-up. Revenue is generated through service fees for each function performed, with dedicated account managers delivering ongoing support to healthcare practices.
2. Staff Extension / Remote Team Services: Virtual MA, front desk, and back-office staff extension services where MD Commerce remote staff support practice operations including scheduling, authorization, coding, and AR follow-up. Offered as modular support packages tailored to practice needs.
3. Telemedicine and Remote Care Services: Telemedicine platform and remote care services (RPM, RTM, TCM, CCM, Remote Wellness Visits, Behavioral Health Integration, Mobile Care) that expand practice service offerings. Revenue generated through facilitating billing for new approved CPT codes and associated consulting services.
4. Membership Practice Consulting: Consulting and back-office support to convert practices to a hybrid membership/insurance business model, including patient membership plan design, sales support, and ongoing membership communications and billing management.

Pricing tiers

Go-to-market motion2 records

Distribution channels3 records

Marketing channels5 records

Core offering

MD Commerce delivers Gold Standard Revenue Cycle Management (RCM) for U.S. healthcare practices, covering pre-set-up account mapping, eligibility and benefits verification, prior-authorization, certified coding, claims processing, payment posting, AR follow-up, patient payment management, and performance reporting. Offerings are augmented by AI-powered medical coding, staff extension services (Virtual MA, certified coders), telemedicine platform support, and value-added remote care programs (RPM, CCM, TCM, BHI, RTM, Membership Practice). Integrated with AdvancedMD, Athena Health, and Epic Resolute EMRs.

Product overview

MDCommerce is a healthcare technology and service company offering an integrated platform centered on Gold Standard Revenue Cycle Management (RCM) augmented by AI-powered data management, telemedicine services, and care coordination solutions. The platform architecture consists of the core Gold Standard RCM service (providing end-to-end claims processing, payment management, and AR follow-up) combined with staff extension modules (Virtual MA, Medical Coding), value-added service modules (Telemedicine, Remote Patient Monitoring, Care Coordination, Chronic Care Management, Behavioral Health Integration), and EMR integration support (Epic, Athena Health, AdvancedMD). Additional offerings include Value Cycle Management consulting, Credentialing & Payer Contract Negotiations, and specialized services for Hospitals & CBO. The company was founded in 1994 as Cascade Billing and rebranded to MDCommerce as it expanded nationally, now serving customers in thirty states.

Differentiator

Problem solved

Functional benefit

Products and services

• Gold Standard Revenue Cycle Management (RCM) Comprehensive end-to-end revenue cycle management for healthcare practices: pre-set-up account mapping, eligibility/benefits verification, prior-authorization, certified coding, claims processing, payment posting, AR follow-up, denial management, patient payment management, and KPI-based performance reporting.
• Build A Winning Team (Staff Extension Services) Remote staff extension providing virtual Medical Assistants, certified coders, and administrative support for scheduling, insurance follow-up, pre-authorization, prescription processing, patient triage, and EMR management.
• Telemedicine Services Telemedicine platform enabling synchronous video visits, asynchronous store-and-forward technologies, e-visits, interprofessional consultations, and 24-hour urgent care coverage across family medicine, pediatrics, women's health, behavioral health, cardiology, and dermatology.
• AI Empowered IT (AI-Powered Data Management) AI-powered analytics and digital strategy services that convert EMR and Practice Management data into insight and action for patient panel analysis, AR aging management, payer performance tracking, fee schedule optimization, and practice performance reporting.
• Value Cycle Management Consulting Business management consulting that helps practices develop new service offerings, implement subscription/membership models, and regain control of patient satisfaction and professional return.
• Medical Coding Services Certified medical coding across cardiology, OBGYN, molecular labs, radiology, anesthesia, and other specialties, combining AI deep learning with certified coders to achieve 98%+ accuracy, 99%+ interrater reliability, up to 70% denial reduction, and 30%-50% cost savings.
• Remote Patient Monitoring (RPM) End-to-end remote patient monitoring deployment supporting CPT codes for setup, education, supply, and monthly monitoring reimbursement (99453, 99454, 99457, 99458).
• Chronic Care Management (CCM) Chronic care management providing team-based care plans, regular monitoring, and care coordinator support for patients with multiple chronic conditions.
• Transitional Care Management (TCM) Post-discharge care coordination that engages hospital discharge processes to ensure follow-up care with patient-focused monitoring.
• Remote Therapeutic Management (RTM) Remote monitoring and treatment management for respiratory and musculoskeletal conditions requiring at least one interactive communication with patient/caregiver per calendar month.
• Behavioral Health Integration (BHI) Online behavioral care program that connects primary care physicians with qualified behavioral specialists, handling referral, documentation, billing, and reporting.
• Remote Annual Wellness Visits Annual wellness visit services with risk assessment evaluation guides enabling clinical staff to achieve national standards.
• Primary Care at Home (Mobile Care) Home-based primary care for traveling doctors with full Business-In-A-Box support including business format, organization help, credentialing, marketing, remote medical assistant, mobile and central office communications, EMR and tablet front end, patient eligibility, registration, reporting, and revenue cycle management.
• Virtual MA Remote Medical Assistants performing scheduling, inbound call handling, insurance follow-up, pre-authorization, prescription management, patient triage, EMR updates, referral calls, and patient balance collection via phone and video.
• Membership Practice (Hybrid Member Plans) Consulting and back-office support to convert practices to a hybrid membership/insurance business model, including patient membership plan design, sales support, and ongoing membership communications and billing management, with the potential to add $50,000–$80,000 per doctor.
• Electronic Patient Payment Electronic patient statement and online payment management that automates collections and reduces cost-to-collect as patient payments approach 50% of total claims.
• Credentialing & Payer Contract Negotiations Credentialing support ensuring timely payer network status with Medicare, Medicaid, and commercial payers, combined with payer contract negotiation services to maximize revenue.
• Prior-Authorizations Pre-authorization services with workflow management, schedule review, and front-desk reminders to ensure authorizations are secured before care delivery.
• Hospitals & CBO Services Central Business Office transformation and outsourced RCM for hospital systems covering outreach lab, hospitalist billing, emergency room services billing, and outpatient practice billing.
• Telemedicine Urgent Care Telemedicine urgent care with triage, care team matching, and after-hours coverage using nurse answering, chatbots, email, text, and patient portals to reduce emergency room visits.
• Principal Care Management Care management for patients with single high-risk conditions allowing up to 60 minutes of billable time per month, with separate clinical staff and provider codes.
• Care Coordination Care coordination services staffed by certified care teams implementing full-spectrum care coordination and chronic care services with patient health plans and regular communications.
• Physician Office Lab (POL) Molecular lab services for respiratory and UTI pathogen panels using advanced lab technology for faster results, targeted drug selection, and increased practice income.

Quantifiable outcome

• 95%+ First Pass Payment Rate (Gold Standard benchmark)
• +10 more outcomes

Named customers3 records

Segments4 records

Ideal customer profiles4 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration4 records

AI capability7 records

Feature5 records

Partnerships

Five partnerships are on record, tiered core.

• AdvancedMDcoreTechnology or IntegrationMD Commerce partners with AdvancedMD as a preferred EMR and telemedicine platform for its customers. The AdvancedMD EMR with its highly customizable forms and workflow enables each provider to fit the system to their treatment and documentation process. MD Commerce provides surrounding services including RCM support, coding, and telemedicine back-office using the AMD platform.
• Athena HealthcoreTechnology or IntegrationMD Commerce provides specialized support for practices using Athena Health, the fastest growing integrated and scalable information management system for multi-specialty providers. MD Commerce comes alongside in-office teams and Athena services with specialized support for coding, prior-authorization, and AR follow-up to ensure Gold Standard performance.
• EPIC (Epic Resolute)coreTechnology or IntegrationMD Commerce offers a skilled Epic Billing Team to help practices maximize revenue from their Epic Resolute practice management system. Services include a la carte support for specific functions like coding, prior-authorization, and AR follow-up, or full outsourcing of revenue cycle management practice support for practices using Epic Community Connect.
• American Academy of Family Physicians (AAFP)coreStrategic or Co-development PartnerMD Commerce distributes the AAFP 2020 Telehealth Toolkit on its website and incorporates AAFP guidelines into its telemedicine implementation services. The AAFP telehealth resources are part of MD Commerce's healthcare resources library for practice transformation.
• American Medical Association (AMA)coreStrategic or Co-development PartnerMD Commerce distributes the AMA Telehealth Implementation Playbook on its website and aligns its telemedicine services with AMA guidelines and recommendations. AMA approval of telehealth reimbursement made permanent is referenced as a key market driver for MD Commerce's telemedicine service offerings.

Scale indicators6 records

Recent moves6 records

Expansion highlights6 records

Direct peers

• Waystar: Cloud-based revenue cycle and healthcare payments technology platform serving hospitals and ambulatory providers with claims management, denial management, and patient payments. Competes with MD Commerce in RCM and patient billing software.
• Availity: Healthcare information network and RCM platform offering eligibility, prior authorization, claims management, and denials workflows. Overlaps with MD Commerce's front-end RCM and prior-authorization services.
• R1 RCM: One of the largest pure-play RCM outsourcing companies in the U.S., serving hospitals and ambulatory groups with end-to-end revenue cycle management. Direct competitor to MD Commerce's Gold Standard RCM offering at a much larger scale.
• Athenahealth: Provides an integrated EMR and revenue cycle management platform for ambulatory practices. MD Commerce augments Athenahealth's RCM with specialized coding and AR follow-up services, but Athenahealth also sells RCM directly to the same customer base.
• Experian Health: Provides RCM, patient access, eligibility, claims management, and patient payment solutions to U.S. healthcare providers. Closely comparable across MD Commerce's eligibility, claims scrubbing, and patient billing service lines.

Broad incumbents

• Optum (UnitedHealth Group): Diversified healthcare services and technology platform with large RCM, analytics, and care management capabilities. Competes across virtually all of MD Commerce's service lines with greater scale and capital.
• eClinicalWorks: Ambulatory EHR vendor with RCM services (eCW RCM) and a telemedicine module. Competes for the same mid-size ambulatory and specialty practices that MD Commerce serves.
• AdvancedMD: Cloud EMR and practice management vendor with built-in RCM and telemedicine capabilities. MD Commerce partners with AdvancedMD but AdvancedMD itself sells competing RCM and telehealth solutions to the same ambulatory market.
• NextGen Healthcare: Ambulatory-focused EHR and practice management vendor with integrated RCM services. Provides a competing full-stack offering for many of the same specialty and primary care practices MD Commerce targets.

Emerging players

• Health Catalyst: Healthcare data and analytics platform with AI-driven insights for clinical, financial, and operational use cases. Comparable to MD Commerce's AI-empowered data management and Power BI-based analytics layer.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/CommerceMd
• Facebookfacebook.com/MD-Commerce-935675656520906
• LinkedInlinkedin.com/company/mdcommerce

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 MD Commerce