Hometown Billing

What Hometown Billing does

Hometown Billing is a privately held, US-based outsourced medical billing and revenue cycle management (RCM) company headquartered in Mendota Heights, Minnesota, serving healthcare providers across the United States. Its service catalog is built around a core RCM platform — insurance verification, charge entry, claims submission, payment posting, and denial management — and is extended by specialty billing modules for behavioral health (with a dedicated addiction treatment/rehab sub-module), ambulance/EMS, dermatology, occupational therapy, ophthalmology, physical therapy, radiology, and speech therapy. The company emphasizes specialty-specific coding expertise (e.g., the Medicare 8-minute rule for PT/OT/speech, Modifier 25/59 for dermatology, BLS/ALS/SCT coding for EMS, behavioral health pre-authorization) and is proficient in integrating with more than 13 practice management, EHR, and billing platforms including Epic, AdvancedMD, Simple Practice, Theranest, and Therapy Notes. All work is performed domestically by a US-based team of 30+ billing experts with 36+ years of combined experience; HIPAA-compliant processes are explicitly applied across claims submission, behavioral health, and EMS service lines.

The company operates a B2B, sales-led go-to-market: customers are acquired via phone outreach (612-404-0784), email ([email protected]), website contact forms, and an educational content-marketing program on its blog. Pricing is quote-based and the company does not publish rates; in line with industry convention, services are likely structured as a percentage of collections or per-claim. Revenue is generated as professional services fees for end-to-end RCM, with customers spanning solo practitioners through large healthcare organizations (including nursing homes, pain management clinics, and adult foster care). Disclosed customer logos (Aviva Therapy and Healing; Warren Area Ambulance Service) are SMB/government, and the firm markets measurable outcomes such as a 40% reduction in denied claims for a mental health practice and 30-day resolution of claim denials. The company is privately held with no disclosed funding, acquisitions, or institutional investors, and its website operator is identified as Beautiful Group Management, LLC.

Name

Hometown Billing

Legal name

Hometown Billing

Website

https://hometownbilling.net

Company type

Private

Operating status

Operating

Headcount range

11–50 employees

Short description

Hometown Billing is a privately held US-based outsourced medical billing and revenue cycle management firm serving small and mid-sized healthcare providers nationwide, with specialty modules across behavioral health, EMS, dermatology, PT/OT/speech, ophthalmology, and radiology.

Ownership category

akta.pro rank

Product category

Medical Billing Services

NAICS

Ambulatory Health Care Services (621)

SIC

Services-Health Services (8000)

akta.pro primary industry

RCM Outsourcing & Managed Billing Services (HLACACAN)

akta.pro secondary industry

EMS Billing, Revenue Cycle & Compliance Services (HLAFANAM)

Keywords

• Medical billing services
• Revenue cycle management
• Healthcare claims processing
• Denial management services
• Specialty medical billing

Headquarters

HQ city

Mendota Heights

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. Medical Billing Services: Provides comprehensive medical billing and revenue cycle management services to healthcare providers including claims submission, denial management, payment posting, insurance verification, and charge entry. Revenue is generated through service fees for billing management, likely structured as a percentage of collections or per-claim basis typical in the medical billing industry.

Pricing tiers

Go-to-market motion1 record

Distribution channels2 records

Marketing channels3 records

Core offering

Hometown Billing provides outsourced medical billing and revenue cycle management (RCM) services to healthcare providers across the United States. Its core offerings include insurance verification, charge entry, claims submission, payment posting, and denial management, delivered by a team of 30+ billing specialists with 36+ years of combined experience. The company tailors its services to multiple specialties including behavioral health, ambulance/EMS, dermatology, occupational therapy, ophthalmology, physical therapy, radiology, and speech therapy.

Product overview

Hometown Billing offers a unified medical billing platform with a modular service structure. The core Revenue Cycle Management (RCM) platform encompasses Claims Submission, Denial Management, Payment Posting, Insurance Verification, and Charge Entry as foundational services. Specialty-specific billing modules extend the platform across Ambulance/EMS, Behavioral Healthcare (including Addiction Treatment/Rehab sub-module), Dermatology, Occupational Therapy, Ophthalmology, Physical Therapy, Radiology, and Speech Therapy. All services are delivered by a team of 30+ billing experts with 36+ years of combined experience, providing end-to-end billing support from patient eligibility through final payment collection.

Differentiator

Problem solved

Functional benefit

Products and services

• Revenue Cycle Management Services End-to-end healthcare revenue cycle management services that track patient encounters from appointment through final payment, including insurance verification, coding, claims submission, payment posting, and denial management for healthcare providers of all sizes.
• Claims Submission Comprehensive claim submission services including claim readiness review, charge entry, clean claim preparation, scrubbing, timely electronic submission, clearinghouse review, tracking, follow-up, and rejection/denial support for healthcare providers.
• Denial Management Healthcare denial management services that identify root causes of denied claims, manage appeals, and strengthen billing processes to recover lost revenue within 30 days.
• Ambulance Medical Billing Specialized EMS billing services for ambulance providers including medical necessity documentation, BLS/ALS/SCT coding, Medicare/Medicaid compliance, and revenue cycle management for emergency and non-emergency transport.
• Behavioral Healthcare Billing Revenue cycle management for mental health clinics, substance use treatment centers, and psychiatric practices, handling authorization, medical necessity documentation, and payer-specific compliance requirements.
• Addiction Treatment / Rehab Billing Specialized substance use disorder treatment billing covering residential, PHP, IOP, outpatient services, MAT, and telehealth addiction treatment programs.
• Dermatology Medical Billing Billing services for dermatology practices covering medical, surgical, and cosmetic procedures including Mohs surgery, biopsies, laser treatments, and phototherapy with proper modifier usage.
• Occupational Therapy Medical Billing Billing services for occupational therapists and clinics handling time-based CPT codes, modifier usage, payer-specific documentation, and Medicare compliance.
• Ophthalmology Medical Billing Billing services for ophthalmologists and eye surgery centers covering medical and surgical coding for exams, diagnostics, and surgical procedures.
• Payment Posting Medical payment posting services including ERA/EOB posting, insurance and patient payment reconciliation, adjustment review, and discrepancy identification.
• Physical Therapy Medical Billing Physical therapy billing services covering timed CPT codes, Medicare's 8-minute rule, prior authorization, medical necessity documentation, and GP/KX modifier compliance.
• Radiology Medical Billing Billing for diagnostic and interventional radiology including CPT/ICD-10 coding, modifier usage, global vs. professional component billing, and compliance with payer-specific rules.
• Speech Therapy Medical Billing Billing services for speech-language pathologists and clinics addressing therapy caps, documentation demands, and payer-specific session limitations.
• Insurance Verification Insurance eligibility and benefits verification services confirming coverage, copays, deductibles, prior authorization requirements, and coordination of benefits before services are rendered.
• Charge Entry Medical charge entry services translating provider services into billable charges, entering CPT, HCPCS, ICD-10 codes, modifiers, and fee schedule information into billing systems.

Quantifiable outcome

• 40% reduction in denied claims for mental health practice
• +1 more outcomes

Named customers2 records

Segments9 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration13 records

Feature2 records

Scale indicators3 records

Recent moves6 records

Expansion highlights3 records

Broad incumbents

• AdvancedMD: Cloud-based EHR/practice management with integrated RCM and outsourced billing services targeting small-to-mid-sized practices. Directly comparable technology overlap and target customer base to Hometown Billing, but with a much broader product portfolio.
• Athenahealth: Large healthcare IT platform combining EHR with managed RCM services for ambulatory providers. Compares as a broad incumbent offering overlapping outsourced billing capability as part of a wider technology suite versus Hometown Billing's specialized service-only model.
• eClinicalWorks: Major ambulatory EHR vendor offering RCM outsourcing services as an integrated offering. Comparable as a broad incumbent competing for the same outsourced billing budget as Hometown Billing, with bundled technology and scale advantages.
• CureMD: EHR and RCM vendor with managed billing services for ambulatory practices. Broad incumbent offering overlapping outsourced billing capability, comparable target market but broader technology portfolio than Hometown Billing's service-only model.

Regional players

• Brightree (ResMed): Specialty-focused RCM and software for home medical equipment, hospice, and therapy providers. Comparable in specialty billing focus (particularly therapy verticals) that intersect with Hometown Billing's PT/OT/SLP modules, though serves different end markets.
• Medical Billing Wholesalers: Outsourced medical billing services firm serving small to mid-sized US practices. Comparable as a regional outsourced RCM peer, with similar service offerings though broader rather than specialty-focused approach.

Direct peers

• Office Ally: Healthcare clearinghouse and outsourced RCM services provider offering claims processing, billing, and denial management. Direct peer in outsourced billing services with comparable workflow offerings to Hometown Billing's claims submission and denial management modules.
• Kareo (Tebra): Cloud-based EHR and RCM platform targeting independent practices with outsourced billing services. Closely aligned business model and target customer (small ambulatory practices) to Hometown Billing, with both delivering specialty-aware billing expertise.
• Coronis Health: Outsourced RCM and medical billing company specializing in multiple specialties. Direct comparable peer offering similar end-to-end revenue cycle management services with multi-specialty focus analogous to Hometown Billing.

Emerging players

• Revele: Specialized RCM services focused on behavioral health and addiction treatment practices. Highly comparable specialty focus to Hometown Billing's behavioral healthcare and addiction treatment billing modules, competing directly for the same mental health provider clients.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat3 records

Key risks5 records

Key highlights6 records

Customer concentration

• LinkedInlinkedin.com/company/hometown-billing

Compliance3 records

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 Hometown Billing