Clinical Billing Solutions, Inc

What Clinical Billing Solutions, Inc does

Clinical Billing Solutions, Inc. (CBS) is a privately held, founder-owned medical billing and revenue cycle management company founded in 1999 and headquartered in Orange, California. The company provides AI-powered RCM services exclusively to outpatient physical therapy (PT), occupational therapy (OT), and speech therapy (ST) clinics across the United States, covering all 50 states. It operates as the designated exclusive RCM partner of Practice Perfect EMR, with which it maintains a native, shared-database integration for real-time claim status, automated charge capture, and workflow synchronization.

The core technology stack centers on an AI Scrub Engine trained on millions of PT/OT/ST claims and 734 specialty-specific billing rules. The platform executes a five-stage automated pipeline — Document Intake (OCR + AI extraction at 1.2 seconds per document), Validate & Fix (97.2% clean claim rate), Match & Reconcile (ERA/835 posting at 3.1 seconds per payment), Denials & Appeals (72% appeal win rate), and Aged AR Cleanup ($38K+ average recovery per practice). Supporting modules include Insurance Verification, CPT/ICD-10 Coding, Payment Posting & Reconciliation, and Accounts Receivable & Collections, all delivered by 25+ US-based billing specialists with 10+ years of rehabilitation-specific experience.

The business model is contingency-based, structured as a percentage of client collections, aligning CBS compensation with revenue outcomes and enabling the company to guarantee lower rates than incumbent billers. The go-to-market is sales-led, combining direct website lead capture (free 12-month claims assessment), inside sales conversion, and referral flow from Practice Perfect EMR's customer base. CBS claims 500+ practices and thousands of providers as customers, with reported operational metrics of 97% clean claim rate (vs. 82% industry), 4.1% denial rate (vs. 10–15% typical), 5.2% AR over 90 days (vs. 20–25% typical), and 28 days in AR (vs. 42–50 typical). The company is bootstrapped with no disclosed external funding, parent company, or M&A activity.

Name

Clinical Billing Solutions, Inc

Legal name

Clinical Billing Solutions

Website

https://clinicalbillingsolutions.com

Company type

Private

Founded year

1999

Operating status

Operating

Headcount range

11–50 employees

Short description

Clinical Billing Solutions is an AI-powered revenue cycle management and medical billing service for US-based physical, occupational, and speech therapy clinics. As Practice Perfect EMR's exclusive RCM partner, it serves 500+ practices with specialty-trained AI and US-based billing experts.

Ownership category

akta.pro rank

Product category

Healthcare Revenue Cycle Management

NAICS

Offices of Physical, Occupational and Speech Therapists, and Audiologists (62134), Offices of Physical, Occupational and Speech Therapists, and Audiologists (621340)

SIC

Hospital & Medical Service Plans (6324), Services-Health Services (8000)

akta.pro primary industry

Medical Billing & Coding Automation (HLACACAA)

akta.pro secondary industries

RCM Outsourcing & Managed Billing Services (HLACACAN), Claims Management, Scrubbing & Clearinghouse (HLACACAB), Medical Coding, Billing & Clinical Documentation Support (BPAAAFAD)

Keywords

• Medical billing services
• Revenue cycle management
• Therapy billing solutions
• AI claims processing
• EMR integration billing

Headquarters

HQ city

Orange

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. Contingency-based Billing Services: Pricing structured as a percentage of collections, aligning the company's compensation with client revenue outcomes. The AI-powered efficiency allows competitive pricing while delivering superior results. The company offers to beat clients' current billing rates.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels4 records

Core offering

Clinical Billing Solutions, Inc. provides AI-powered revenue cycle management (RCM) and medical billing services exclusively for outpatient physical therapy (PT), occupational therapy (OT), and speech therapy (ST) clinics in the United States that use Practice Perfect EMR. The company combines an AI scrub engine trained on millions of PT/OT/ST claims and 734 specialty rules with US-based billing specialists to deliver claim submission, denial management, appeals, aged AR recovery, insurance verification, coding, payment posting, and real-time analytics.

Product overview

Clinical Billing Solutions offers a single unified AI-powered RCM platform built exclusively for Practice Perfect PT, OT, and ST practices in the United States. The core platform centers on an AI Scrub Engine that validates claims against 734 specialty rules before submission. Supporting modules include Document Intake & OCR Processing, Denial Management & Appeals, Aged AR Recovery, Real-Time Dashboard & Analytics, Insurance Verification, CPT/ICD-10 Coding, Payment Posting & Reconciliation, and Accounts Receivable & Collections — all delivered by US-based specialists. The system operates as a five-stage automated pipeline (Read, Scrub, Post, Resolve, Recover) with AI handling exceptions and billers perfecting revenue.

Differentiator

Problem solved

Functional benefit

Products and services

• AI-Powered RCM Platform End-to-end revenue cycle management platform for PT, OT, and ST clinics featuring AI-driven claim scrubbing, automated denial management, and real-time analytics dashboard with Practice Perfect EMR integration. Delivered as a managed service by US-based billing specialists.
• Insurance Verification Services Patient insurance verification confirming coverage, remaining benefits, authorization requirements, and plan limits before visits to prevent surprise denials. Targeted at PT, OT, and ST clinics.
• CPT and ICD-10 Coding Services Certified coders apply current CPT and ICD-10 codes, time-based unit rules, NCCI edits, and therapy modifiers (GP, GO, GN, KX, 59) specific to physical, occupational, and speech therapy. Provided as a managed coding service.
• Payment Posting & Reconciliation ERA/835 matching, ledger application, and reconciliation services processing payments at 3.1 seconds per payment with automated matching.
• Accounts Receivable & Collections Insurance follow-up and patient/payor payment collection services with dedicated US-based billers managing the full collections process.
• Denial Management & Appeals AI-powered denial classification and automated appeal drafting with 72% appeal win rate, handling CO-16 (missing modifier) and other denial types for therapy practices.
• Aged AR Recovery Automated aged accounts receivable cleanup identifying old claims, re-working and resubmitting eligible balances, and generating automated appeals — recovering $38K+ from aged AR per practice.

Quantifiable outcome

• Clean claim rate: 97% vs 82% industry average
• +8 more outcomes

Named customers1 record

Segments4 records

Ideal customer profiles1 record

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration1 record

AI capability8 records

Feature5 records

Partnerships

One partnership is on record.

• Practice Perfect EMRcoreTechnology or IntegrationClinical Billing Solutions is the exclusive Practice Perfect-approved RCM partner with native database integration. The partnership enables real-time claim status, automated charge capture, and seamless workflow between clinical documentation and billing. This is the only billing company offering this level of integration with Practice Perfect EMR, as certified by the EMR vendor on their integrations page.

Scale indicators13 records

Recent moves1 record

Expansion highlights5 records

Broad incumbents

• Athenahealth: Major health IT platform offering EHR, practice management, and billing services to physician practices nationwide. While not therapy-specialized, it represents the broad-incumbent competitive threat to niche RCM players like CBS.
• AdvancedMD: Cloud-based practice management, EHR, and medical billing platform serving independent practices across multiple specialties. Competes with CBS for therapy clinic technology budgets but is not specialty-specialized.
• R1 RCM: Large-scale revenue cycle management company primarily serving hospital systems and large physician groups. Adjacent competitor with vastly greater scale and capital that could enter the therapy specialty vertical.

Direct peers

• CollaborateMD: Cloud-based medical billing software and services for small and mid-sized practices. Offers claims scrubbing and clearinghouse services that overlap with CBS's AI scrub engine functionality, though less therapy-specialized.
• WebPT: Therapy-specific EMR and practice management platform serving PT, OT, and ST clinics. WebPT also offers billing services, making it the most direct competitive overlap with Clinical Billing Solutions in the rehab billing vertical.
• Clinicient: Therapy-focused EMR with integrated RCM and billing services targeting PT, OT, and ST practices. Directly competes with CBS in the rehab-specialty RCM segment.
• Net Health: Specialized EHR and practice management software for outpatient therapy, wound care, and other post-acute providers. Competes for the same therapy clinic technology and billing workflow budget as CBS.
• TherapyBilling.com (Therapy Brands): Therapy-specialty billing and practice management services targeting behavioral health, autism, and rehabilitation practices. Directly comparable in its therapy-vertical specialization and outsourced billing model.
• BMS Practice Solutions: Medical billing and practice management company with rehabilitation therapy specialty focus. Provides outsourced RCM services to PT/OT/ST clinics in a directly comparable model to CBS.

Emerging players

• Tebra (Kareo): All-in-one practice management, EHR, and billing platform for independent practices. Competes in the broader small-practice billing market but lacks CBS's deep PT/OT/ST specialty expertise.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks6 records

Key highlights6 records

Customer concentration

• LinkedInlinkedin.com/company/clinical-billing-solutions-inc

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

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 Clinical Billing Solutions, Inc