The best ASC billing companies of 2026: who works inside your EHR and who moves you to theirs
Eleven ASC billing companies scored on where the work happens, who you can reach, what leaving costs and published pricing, with a source on every number.
October 25, 2026 · 20 min read
If you run a surgery center and you've started looking at billing companies, the lists you'll find were written for someone else. The piece that holds the first page for this search is a sponsored top-5 from July 2022, and one of its five names had already been folded into a software company the year before it ran. The other list that shows up is Becker's "15+ ASC revenue cycle management companies to know", from April 2018. Since those two were published, the largest ASC-focused biller has changed its name, and each of the two biggest ASC software vendors has bought or bundled a billing company of its own.
So this is a 2026 list, and it was written for the person who lives with the decision after it's made: the administrator who takes the front-office calls when a prior authorization stalls, and whoever signs the billing contract on that administrator's behalf, whether that's the owner or someone at the platform.
One thing before the names. Expert Medical Billing is first on this list, and we wrote the list. We've tried to keep that fair. The criteria were written down before any company was scored. Every number about another company comes from that company's own pages or from the trade press, with the source and the month attached, and nothing in a competitor's entry is our opinion of how they perform. Where a vendor doesn't publish something, the entry says it isn't published rather than guessing. You can check every line with a browser.
What we scored, in order
1. Where the work happens. Some billing companies work inside your EHR, practice management system and clearinghouse. Others move your billing onto their platform and give you a portal. This decides whether you can open a claim yourself on a Tuesday afternoon, and it decides what you keep if you ever leave.
2. Who you can reach. A named team with direct lines for your front office, or a ticket queue behind an account manager. Prior authorization questions and patient billing calls land at the front desk, so the biller has to be reachable from the front desk.
3. What you can see. Claim-level visibility, who approves a write-off, how often reporting arrives and what's in it.
4. What leaving costs. The notice period, who owns the data and the reports, and what happens to receivables already in flight.
5. Pricing you can find before the call. Most billing companies quote only after a discovery call. We scored whether a rate or a range is published anywhere at all.
We also noted what each company is built for, because an ASC-only firm and a multi-specialty firm with an ASC page are different purchases.
The first criterion decides what you can open today and what you keep if you leave.
The list at a glance
The eleven, in detail
1. Expert Medical Billing
Expert Medical Billing, or EMB, is a specialized billing department for ambulatory surgery centers and clinics. A dedicated team runs the complete revenue cycle inside the center's own EHR, practice management system and clearinghouse: eligibility checked before the case, certified coding with op notes coded to the implant line, clean claims out the same day, every denial worked rather than filed, payments posted and reconciled daily. Credentialing and enrollment, old A/R recovery and coding audits run as separate services for centers that need them.
Where the work happens: in your systems. Anyone at the center can open any claim on any day and see where it stands. Every adjustment carries a name and a reason, and no write-off goes through without the center's sign-off. EMB reports a 98% first-pass clean claim rate and says on its site that it will show you how that number is counted (expertmedicalbilling.co, October 2026).
Who you can reach: a named team, with direct lines for front-office staff, so a prior authorization question doesn't have to route through leadership to get an answer.
What leaving costs: thirty days' notice. The data stays in your systems because it never left them.
Pricing: published, by monthly insurance collections. 4.9% up to $50,000 a month, 3.9% from $50,000 to $100,000, 3.5% from $100,000 to $400,000, and 2.9% above $400,000 (expertmedicalbilling.co/surgery-centers, October 2026).
Expert Medical Billing's published full-service rate by monthly insurance collections (expertmedicalbilling.co/surgery-centers, October 2026).
Proof: two published ophthalmology cases, both with the numbers taken from the centers' own billing data. A physician-owned ophthalmology ASC with four providers, running a high-volume cataract and retina schedule, had 30% of its receivables over 90 days old when EMB took over. Ten months later that share was 10%, a 66% reduction, while visit volume grew 45%. Collections finished 65.5% above the prior-year baseline and total receivables fell by $196,150. The second center, an ophthalmology ASC with an attached clinic and five providers, changed billers in the middle of a merger, the moment claims usually fall between teams. There was no dip in performance through the transition; receivables over 91 days fell from 25% to 14%, and the ASC and clinic collected $4.35 million in 2025 (expertmedicalbilling.co/case-studies, October 2026).
We'd rather you weigh that proof for what it is: two surgery centers, published with full numbers, against competitors who report client counts in the hundreds and publish no case-level figures at all. Which of those you trust more is a fair question, and it's the right one to ask every company on this page.
Best for: centers that want a dedicated team working inside their own systems, owners who want to sign off on every write-off, and anyone who wants to read the price before the call. Strongest in ophthalmology, pain management, anesthesiology, orthopedics and multi-specialty centers.
2. Nimble solutions (formerly National Medical Billing Services)
The largest ASC-focused billing company by its own count. National Medical Billing Services was founded in 2003 (sponsored ASC billing list, July 2022), merged mdStrategies, MedTek, Medi-Corp and National Billing Partners into one platform over the following years, and rebranded as nimble solutions in May 2023 (Becker's ASC Review, May 2023). It's a portfolio company of Aquiline Capital Partners (Aquiline portfolio page, October 2026). In June 2025 it acquired Contego, an out-of-network payer strategy firm, and reported more than 1,100 surgical organizations as clients (Becker's ASC Review, June 2025). Its service list runs from front-end work through coding, billing, denials, payment recovery, patient accounts, managed care contracting and credentialing, with transcription and chart management alongside.
Where the work happens: nimble describes proprietary technology with real-time visibility and a client portal. Its site doesn't say whether the team works in your system or on its own (nimblercm.com, October 2026).
Who you can reach: not stated on the site.
What leaving costs: not published.
Pricing: not published.
Best for: multi-site groups that want one large vendor across many centers, and out-of-network surgeons who need payer strategy bundled with the billing.
3. SIS Revenue Cycle Services (Surgical Notes)
Surgical Notes, founded in Dallas in 1997 (Becker's ASC Review, April 2018), was acquired by Surgical Information Systems on 19 November 2024. SIS says the combined companies serve more than 2,700 ASCs and hospitals (SIS, November 2024). Surgical Notes RCM stays a legal entity under the SIS umbrella; clients were told their contracts, pricing and contacts stay the same, with invoices now issued by Surgical Information Systems and no new business associate agreement required (SIS client transition page, 2026). The service covers billing, coding and transcription, with an optional end-to-end bundle and KPI reporting built for management and boards.
Where the work happens: SIS says its billing services work with any ASC technology and don't require a system change (sisfirst.com/asc-billing, October 2026). SIS also sells SIS Complete, its own practice management platform, so the same vendor can be your software and your biller.
Who you can reach: a dedicated primary contact and a focused team, with SIS billing managers coordinating each stage of billing.
What leaving costs: not published.
Pricing: not published. The page offers an ROI calculator.
Best for: centers already on SIS software that want the same vendor running billing, and centers that want transcription and coding inside the same contract.
4. HST Pathways, with SYNERGEN Health
HST Pathways is ASC software, trusted by more than 1,600 ASCs by its own count (HST, September 2024), and a Bain Capital company (Becker's ASC Review, April 2018). It acquired Simplify ASC in April 2022 (BusinessWire, April 2022). On 4 September 2024 it announced a partnership with SYNERGEN Health to sell what the release calls a fully integrated revenue cycle solution: HST's software with SYNERGEN's end-to-end RCM services inside it. SYNERGEN was founded in 2011, operates in more than 45 states, and was processing over 2 million claims a month at the time of the announcement (BusinessWire, September 2024).
Where the work happens: in HST, with SYNERGEN's services and dashboards integrated into the software.
Who you can reach: SYNERGEN's team. The release doesn't describe the staffing model.
What leaving costs: not published.
Pricing: SYNERGEN says savings are passed on through a reduced percentage-of-revenue fee. No figure is published (September 2024). The release also claims clients see a 15% to 25% revenue increase after switching; that's the company's own figure.
Best for: HST centers that want software and billing on one contract, and are comfortable with the software vendor's partner running collections.
5. Regent RCM
The revenue cycle division of Regent Surgical Health, an ASC management and development company. It launched in October 2014 (Becker's ASC Review, October 2014), is based in West Chester, Illinois, and bills and collects exclusively for ASCs (Becker's ASC Review, April 2018). Services run from insurance verification and patient financial counseling through billing, payment posting, A/R, customer service, workflow optimization and real-time dashboards (Becker's ASC Review, October 2016).
Where the work happens: not stated. The dashboards are described; the systems aren't named.
Who you can reach: dedicated revenue cycle specialists assigned to each facility. At launch, its billers and collectors averaged 17 years of experience and were bilingual in English and Spanish (Becker's ASC Review, October 2014).
What leaving costs: not published.
Pricing: not published.
Best for: centers that want an ASC-only biller and are comfortable with a management company's division running it.
6. in2itive Business Solutions
A full-service revenue cycle and consulting firm in Overland Park, Kansas, with coding and audit services (Becker's ASC Review, April 2018), serving ASCs and physician-owned facilities. Its model pairs the billing with monthly reporting and a monthly client meeting, and it offers patient financial education for front-office staff (Becker's ASC Review, July 2016).
Where the work happens: its reporting is pulled from multiple systems. The firm doesn't say whether the team works in yours.
Who you can reach: a monthly meeting cadence is stated; the day-to-day staffing model isn't.
What leaving costs: not published.
Pricing: not published.
Best for: centers that want a consulting relationship and board-ready reporting alongside the billing.
7. Serbin Medical Billing
An ASC-only coding and billing firm in Fort Myers, Florida. Its founder, Caryl Serbin, RN, built a first ASC billing company, Serbin Surgery Center Billing, sold it to SourceMedical in 2010 (AORN Outpatient Surgery, December 2010), and returned to the market in 2016 (Becker's ASC Review, September 2016; October 2019). Clients include de novo, mature, independent and joint-venture ASCs (Becker's ASC Review, October 2019).
Where the work happens: not stated.
Who you can reach: a concierge model, with an individual team assigned to each client and all work done in-house (Becker's ASC Review, September 2016).
What leaving costs: not published.
Pricing: not published.
Best for: independent and de novo centers that want a small, ASC-only firm and help with front-office policies.
8. Coronis Health
A multi-specialty revenue cycle company with an ASC service line covering coding, implant reimbursement, claims and patient billing, with dedicated account teams (coronishealth.com, October 2026). The ASC page gives no client counts, no history and no outcome figures.
Where the work happens: Coronis says it works with most practice management and EHR systems.
Who you can reach: dedicated account teams.
What leaving costs: not published.
Pricing: not published. The page offers a free consultation.
Best for: centers inside a larger physician group that already uses Coronis for other specialties, especially implant-heavy ones.
9. Medcare MSO
A multi-specialty billing company whose ASC page covers multispecialty, GI and endoscopy, orthopedics and spine, ophthalmology, pain management and single-specialty centers, with credentialed surgical coders trained by specialty (medcaremso.com, October 2026). It also sells its own EHR, HealUS, and a practice management product.
Where the work happens: either in its own system or inside yours; the page says it integrates with most EHR and PM systems.
Who you can reach: not stated beyond the coding staff.
What leaving costs: not published.
Pricing: not published. The page cites an industry range of 3% to 7% of collections, and claims a 96% collection ratio, a 98.5% first-pass rate and a revenue increase of up to 35%, without a time period for any of them.
Best for: practices that want billing and an EHR from the same vendor.
10. Fortis Medical Billing
An Austin, Texas firm with 2 to 9 employees (GoodFirms, October 2026) that led the sponsored top-5 list from July 2022. ASCs are one of several specialties, alongside hospital coding, ambulance coding and hospice filing. The sponsored piece credited it with a 95% claims rate and a 75% retention rate (July 2022).
Where the work happens: not stated.
Who you can reach: not stated.
What leaving costs: not published.
Pricing: GoodFirms lists an hourly rate under $25.
Best for: small practices that want hourly billing and coding support rather than a percentage-of-collections contract.
11. BillingParadise
A Diamond Bar, California, technology-enabled revenue cycle firm offering outpatient coding and billing (Becker's ASC Review, April 2018). It was second on the 2022 sponsored list, which credited it with automated payment processing and daily reporting. Nothing on record is specific to surgery centers.
Where the work happens: not stated.
Who you can reach: not stated.
What leaving costs: not published.
Pricing: not published.
Best for: outpatient practices that want automation-led billing.
Which one fits your situation
You're an independent center and you'd be switching mid-contract. Ask the fourth question first, what leaving costs, because the transition is where claims get dropped. Expert Medical Billing publishes its transition terms: seven days of system access and a full read of aging, payer mix and denials before any workflow changes, then a parallel period where new claims move over while existing work finishes, then a 90-day review. Serbin and Regent RCM are the other ASC-only options on the list.
You run a platform and you're standardizing across centers. The first and third criteria matter most, because the administrator at each center has to be able to see claims without asking head office. nimble solutions has the scale, and SIS can run both the software and the billing. Expert Medical Billing is built around that visibility, which is the reason it's first on this list.
You're opening a de novo center. Credentialing and payer enrollment are the first ninety days, and the billing has to be live on day one. Expert Medical Billing runs credentialing and enrollment as a service, and Serbin names de novo centers among its clients.
You're on HST or SIS and the vendor is offering to run billing. The convenience is real. Two questions are worth asking anyway: who at the vendor answers to your administrator, and what happens to the billing if you change software. Neither vendor publishes an answer to the second one.
You run an ASC with an attached clinic. Ask whether one team handles both facility and professional billing. Expert Medical Billing's five-provider ophthalmology case covers both; Medcare MSO's page lists both.
Questions to ask before you sign
- Will your team work in our EHR, practice management system and clearinghouse, or will our billing move to your platform?
- Who approves a write-off, and does every adjustment carry a name?
- Can our front office call your team directly, without going through our leadership?
- Can we open a claim ourselves, today, and see where it stands?
- What's the notice period, and what happens to receivables in flight when we leave?
- Who owns the data and the reports if we leave?
- What's the rate, what sits outside it, and is there a setup fee?
- Who coded our last twenty implant cases, and what are their credentials?
- If you've been acquired or merged in the last three years, what changed for your clients?
The last question applies to nimble solutions and to Surgical Notes, and the partnership version of it applies to HST.
Frequently asked questions
How much does ASC billing cost?
Published rates are rare. Expert Medical Billing publishes 2.9% to 4.9% of monthly insurance collections depending on volume. Medcare MSO cites an industry range of 3% to 7% without stating its own. SYNERGEN describes a reduced percentage-of-revenue fee with no number. Everyone else on this list quotes after a call.
Should we keep billing in-house instead?
It depends on what the in-house team costs fully loaded, how deep the coding bench is for your specialties, and who covers a resignation. Expert Medical Billing's surgery-center page carries a calculator that compares loaded in-house cost against its own fee without asking for contact details.
Is nimble solutions the same company as National Medical Billing Services?
Yes. National Medical Billing Services rebranded as nimble solutions in May 2023, after merging four acquired billing companies into one platform.
What changed when SIS bought Surgical Notes?
According to SIS, nothing in the contract: pricing and contacts stayed the same, invoices now come from Surgical Information Systems, and no new business associate agreement was needed. Surgical Notes RCM remains a legal entity under SIS.
Does a software vendor's billing service lock us in?
The HST and SIS offerings are integrated into their own platforms. Neither company publishes what happens to the billing relationship if a center changes software, so ask before signing.
How long does switching billing companies take?
It varies by biller. Expert Medical Billing's published transition runs seven days of access and review, a parallel period with no single cutover date, and a 90-day review.
How this list was built
Company websites were read on 15 October 2026, and trade press articles are cited with their publication month. No company paid for placement on this page. Every entry can be checked against the pages named in it, and corrections go to the address on our contact page.
To see how a dedicated team would run billing inside your systems, book a discovery call. If you're still deciding whether the center has outgrown in-house billing at all, the ASC guide at thepracticeoperator.co/asc-billing covers that decision first.
Wondering what this looks like in your center?
A discovery call is a straightforward conversation about where your revenue cycle stands today and who is accountable for it.