E-Code Solutions

What E-Code Solutions does

E-Code Solutions is a privately held, bootstrapped B2B professional services firm founded in 2008 and headquartered in Canton, Illinois. The company provides medical coding, billing, and revenue cycle management (RCM) consulting to hospitals, ambulatory surgery centers (ASCs), and physician practices across multiple specialties. Its service portfolio is organized into three integrated lines — Coding & Claim Scrubbing, Denials Management, and Revenue Capture — spanning 12 discrete offerings including Coding Services, Charge Capture, Pre-Bill Scrubbing, Claims Editing, Denials Improvement, Claims Appeal Solutions, Coding Compliance Audits, PPO Contract Review, CDM & Fee Schedule Services, and a Third Party Payer Rules pre-submission review branded 'The Difference Maker.'

The company's differentiated technology stack consists of proprietary tools refined over 27+ years: an 'e-Scrubbing' system that re-runs previously billed claims through six months of historical data to surface missed billing opportunities; a Charge Capture Review tool that conducts full reviews in hours; a PPO Payment Audit/Assessment tool that identifies underpayments and unauthorized payer discounts; and a Medical Claims Editing and Auditing Technology that validates charges against medical records. Leadership combines 70+ years of medical coding/billing expertise and carries RHIT, CCS-P, CPC, CCS, and PTA credentials; CEO Bill Maurice has been engaged by the US GAO to advise CMS. The firm differentiates commercially through a 100% ROI guarantee, claimed to be unique within the RCM space, and a low-friction 'Give Us An Hour' diagnostic offer.

Go-to-market is consultative and relationship-driven. Pricing is quote-based with no publicly disclosed rates; engagements are structured as ongoing professional services or managed services for healthcare provider organizations. Distribution is exclusively direct, with executive leadership (President & CEO Bill Maurice and Executive Director of Operations Kacey Schaefer) serving as primary business development contacts. Case study evidence includes $1.3M in 3-month cash recoveries for a hospital, $3M total missed revenue recovered (including pharmacy charge corrections) for a hospital, over $1M in new revenue for a critical access hospital, and $1.9M+ in annual revenue improvement for a cardiac IR provider. The firm reports clients experience an average 4x return on their investment.

Name

E-Code Solutions

Legal name

E-Code Solutions

Website

https://ecode.solutions

Company type

Private

Founded year

2008

Operating status

Operating

Headcount range

11–50 employees

Short description

E-Code Solutions is a privately held B2B professional services firm providing medical coding, billing, and revenue cycle management consulting to hospitals, ambulatory surgery centers, and physician practices, anchored by proprietary claim-scrubbing and charge capture tools and a 100% ROI guarantee.

Ownership category

akta.pro rank

Product category

Healthcare Revenue Cycle Management Services

NAICS

Computer Systems Design and Related Services (54151)

SIC

Services-Engineering, Accounting, Research, Management (8700), Services-Computer Programming, Data Processing, Etc. (7370)

akta.pro primary industry

Medical Billing & Coding Automation (HLACACAA)

akta.pro secondary industries

Claims Management, Scrubbing & Clearinghouse (HLACACAB), RCM Outsourcing & Managed Billing Services (HLACACAN)

Keywords

• Medical coding services
• Revenue cycle management
• Charge capture optimization
• Claims scrubbing
• Denial management

Headquarters

HQ city

Canton

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. Revenue Cycle Management Consulting Services: E-Code Solutions generates revenue through professional services engagements focused on healthcare revenue cycle management. Services include coding, claims scrubbing, denials management, and revenue capture optimization. Revenue is generated through consulting fees, typically structured as ongoing service engagements with healthcare provider organizations.
2. Coding & Claims Services: Provides long-term or temporary coding solutions, back-fill coding coverage, and pre-billing services. Services are priced to be cost-effective compared to in-house solutions while delivering guaranteed ROI.
3. Training & Education Services: Provider education and training services on coding complexities and billing practices, delivered as part of comprehensive revenue cycle engagements or as standalone services.

Go-to-market motion2 records

Distribution channels1 record

Marketing channels3 records

Core offering

E-Code Solutions provides healthcare revenue cycle management (RCM) consulting and medical coding services for hospitals, health systems, physician practices, and ambulatory surgery centers. The firm delivers coding, charge capture, pre-bill claims scrubbing, claims editing, denials management, CDM/fee schedule review, PPO contract review, and provider training services to identify missed charges, reduce denials, and recover underpayments. Engagements are supported by proprietary tools including the e-Scrubbing system, Charge Capture Review Tool, PPO Payment Audit/Assessment Tool, and medical claims editing/auditing technology, all backed by a 100% ROI guarantee.

Product overview

E-Code Solutions is a revenue cycle management (RCM) and medical coding consulting firm offering a suite of integrated services. The portfolio consists of three primary service lines: Coding & Claims Scrubbing (including Coding Services, Charge Capture, Pre-Bill Scrubbing, and Claims Editing), Denials Management (including Denials Improvement, Claims Appeal Solutions, Training & Education, and Coding Compliance Audit), and Revenue Capture (including PPO Contract Review, CDM & Fee Schedule Services, Revenue Cycle Review, and Third Party Payer Rules). The company positions these services as practical, results-driven alternatives to traditional over-complicated and overpriced RCM firms, with a unique 100% ROI guarantee.

Differentiator

Problem solved

Functional benefit

Products and services

• Coding Services Cornerstone service providing accurate medical coding for hospitals, ASCs, and physicians, eliminating backlogs and providing back-fill coding coverage to optimize the revenue cycle. Can be delivered as long-term or temporary engagements.
• Charge Capture Conducts comprehensive charge capture reviews utilizing the firm's proprietary toolset to identify revenue capture opportunities for hospitals, ASCs, and physician practices; delivered with revenue capture findings for 100% of clients.
• Pre-Bill Scrubbing Runs previously billed claims through the proprietary 'e-Scrubbing' system to identify missed billing opportunities that could result in increased revenue before claims are submitted to payers.
• Claims Editing Performs and reviews claim edits to correct potential reasons for denials before submission, implementing revenue optimizations through medical records reviews to determine if all charges were accurately billed and paid.
• Denials Improvement Focused on eliminating the root reasons for whole or partial claim denials rather than simply working the denials queue, by preventing denials from occurring in the first place through upstream process improvements.
• Claims Appeal Solutions Brings expertise to optimize the claims appeal process and navigate third-party payer contracts to effectively manage denied claims and recover revenue.
• Training & Education Provides education to providers and billing staff on the increasing complexities of coding and reimbursement; delivered as part of comprehensive revenue cycle engagements or as a standalone service.
• Coding Compliance Audit Comprehensive and time-efficient review of coding-related billing and reimbursement practices to identify potential problems and stop coding-related denials across the organization.
• PPO Contract Review Uses the proprietary PPO Payment Audit/Assessment Tool to identify and capture underpayments from payers and unauthorized PPO discounts across payer contracts.
• Charge Master (CDM) & Fee Schedule Services Conducts comprehensive CDM or fee schedule review to develop a complete picture of current charging practices and implements improvements to maximize revenue, including pharmacy charge setup corrections.
• Revenue Cycle Review & Practice Management Comprehensive practice management review evaluating the financial and operational health of a provider organization's revenue cycle, encompassing the firm's entry-point 'Give Us An Hour' assessment and broader revenue cycle reviews.
• Third Party Payer Rules Review Reviews all payer and medical policy rules on each patient claim before filing to ensure medical necessity and compliance with payer policy requirements; branded internally as 'The Difference Maker'.

Quantifiable outcome

• 4X average return on investment for clients
• +5 more outcomes

Named customers5 records

Segments3 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature4 records

Scale indicators11 records

Recent moves6 records

Expansion highlights4 records

Direct peers

• AGS Health: Provides medical coding, auditing, charge capture, and RCM services to hospitals, physician practices, and ASCs — a direct competitor for the same customer base with both onshore and offshore delivery.
• nThrive: Healthcare RCM services and technology firm offering coding, billing, denials management, and revenue capture for hospitals and physician groups — directly overlapping E-Code's core service portfolio and target customer segments.
• Infinx: Offers RCM services including coding, charge capture, denials management, and patient access for hospitals, ASCs, and physician practices — closely aligned segment coverage and service mix.
• R1 RCM: Technology-led RCM platform and services provider for hospitals and physician practices — competes for the same RCM outsourcing contracts with more automation and scale.
• Conifer Health Solutions: End-to-end RCM, coding, and revenue capture services for hospitals and health systems, owned by Tenet Healthcare — provides full-service competition to E-Code's hospital-focused offerings.
• Bolder Healthcare Solutions: Specializes in coding, auditing, denials, and revenue capture for hospitals and healthcare providers — a mid-sized peer in the same niche consulting/services category as E-Code.
• Aspirion: Specializes in complex claims, denials management, underpayment recovery, and revenue capture services for hospitals and health systems — closely aligned with E-Code's denials improvement and PPO contract review offerings.

Broad incumbents

• Optum (UnitedHealth Group): One of the largest RCM and healthcare technology/services incumbents offering coding, claims processing, and revenue optimization at enterprise scale — sets the competitive ceiling in the segment.
• Experian Health: Provides patient access, claims management, and RCM technology as part of a broader healthcare data portfolio — competes most directly in claims scrubbing and identity/billing accuracy.

Emerging players

• Waystar: Cloud-based RCM and claims management platform offering scrubbing, denial prevention, and patient billing — overlapping with E-Code's claims editing and pre-bill scrubbing services but as a SaaS product.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat3 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/e-code-solutions-inc

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 E-Code Solutions