Nimble Solutions Alternatives in 2026 (Formerly National Medical Billing Services)

If you search for alternatives to National Medical Billing Services, you get an auto-generated page from a data company and a list of billing software. If you search for alternatives to nimble solutions, you get a CRM. Neither tells you anything about the largest ASC-focused billing company in the country, what it has become since it changed its name, or who a surgery center compares it against. This page does.

Expert Medical Billing is one of the alternatives below, and we wrote the page. The facts about nimble come from its own releases, the trade press and KLAS, with the source and the month on each. Where a buyer's experience is described, it's quoted from a published client comment, not from us.

What nimble solutions is

National Medical Billing Services was founded in 2003 in St. Louis by Lisa Rock, who remains its president (Becker's ASC Review, February 2021; PR Newswire, May 2023). Aquiline Capital Partners took a stake in February 2021 (Becker's ASC Review, February 2021), and the company then bought four ASC billing businesses in ten months: mdStrategies, a coding, auditing and transcription firm, in January 2022; National Billing Partners, a surgical-practice revenue cycle firm, in February 2022; Medi-Corp, a Cranford, New Jersey, anesthesia, ASC and pain management biller founded in 1998, in May 2022; and MedTek, a transcription and coding company with more than 100 surgical coders serving ASCs in nearly 50 states, in October 2022 (Becker's ASC Review, January, February and October 2022; PR Newswire, May 2022).

It rebranded as nimble solutions on 12 May 2023, saying clients had trusted it with more than $10 billion in net collections over twenty years (Becker's ASC Review, May 2023). Kelley Blair, previously chief operating officer of Therapy Brands and a senior vice president at Change Healthcare, became chief executive in January 2024, succeeding Nader Samii after fourteen years; Samii moved to executive chair. At that point nimble reported more than 1,100 clients, about 1,300 employees, $10 billion collected and more than 25 million surgical charts coded (Becker's ASC Review, January 2024). In June 2025 it acquired Contego, which represents out-of-network surgeons in claims, appeals and payment forecasting, and added a payer strategy line (Becker's ASC Review, June 2025). In May 2026 it announced a partnership with Mednet, an ASC software company, built on what it called a best-of-breed philosophy of separating software from revenue cycle services (nimblercm.com, May 2026).

The service list runs the whole cycle: front-end work, transcription, coding, billing, denials, payment recovery including independent dispute resolution, patient accounts, managed care contracting and credentialing, with chart management software and a client portal on proprietary technology (nimblercm.com, October 2026). Its clients are ASCs, surgical practices, anesthesia groups and health systems. It is one of five alliance partners listed by HST Pathways (hstpathways.com, October 2026).

Pricing: not published.

Where the work happens: nimble describes proprietary technology, AI-enabled workflows and a client portal, and integrations with practice management systems; its site doesn't say whether the team works in your system or on its own (nimblercm.com, October 2026).

Where the staff are: nimble's sites are in Chesterfield and Wildwood, Missouri, and New Hyde Park, New York, per its job listings. In September and October 2026 it was also recruiting senior A/R callers in Hyderabad, India, under its own name and under the National Medical Billing Services name (jobs.aapc.com, talentmate.com and jobtarget.com, October 2026). The company's own site lists no offices.

Why buyers look at alternatives

KLAS publishes client comments on nimble's surgical RCM service. Between October 2025 and September 2026 it collected 70 of them, and on the page's own tags a little more than half are positive. The positive ones are about responsiveness: "Our account manager is extremely responsive and can troubleshoot and solve issues," from a director in December 2025; "nimble solutions has been absolutely fabulous to work with," from a chief executive in April 2026. The negative ones cluster around four things. Results: "The vendor has failed to meet expectations regarding the resolution of outstanding A/R," from a manager in March 2026. Appeals: "nimble solutions is not good at appeals," from a manager in January 2026. Fees: "Outsourcing is very expensive. What we pay each month as a percentage of revenue is shocking," from a manager in January 2026. And handling: the page's recurring themes include patient phone access, too many staff touching each claim, and staff turnover (KLAS, nimble solutions Surgical RCM Services comments, October 2025 to September 2026).

That is one company's client sample and KLAS says so. But the four themes are the ones the ASC trade press has warned about for a decade, and they describe the structural tradeoff of a roll-up. In 2024 Surgical Notes' senior vice president of RCM services told Becker's that "the biggest complaint we hear is ASCs feel there's no meaningful relationship with the billing company" (Becker's ASC Review, May 2024). A Becker's list of billing-partner red flags that October led with a dedicated person at the billing company who responds promptly, and included "disorganized management and staff turnover" (Becker's ASC Review, October 2024). And Caryl Serbin, writing in 2018 about overseas billing, noted that it "typically eliminates real-time access to patient accounts" (Becker's ASC Review, February 2018).

So the questions a buyer leaving nimble, or deciding not to join it, tends to ask are: who exactly works my account, where do they sit, can my administrator see every claim, what is the fee, and who answers when the front office calls.

The alternatives, by situation

If you want a dedicated team inside your own systems: 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.

Each of the four themes above has a direct answer in how EMB is built. Results are visible: anyone at the center can open any claim on any day and see where it stands, and every adjustment carries a name and a reason. Appeals are the team's job, with every denial worked rather than filed, and no write-off goes through without the center's sign-off. The fee is 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). And handling is one named team with direct lines for front-office staff, so a prior authorization question doesn't route through leadership. Thirty days' notice to leave, and the data stays in your systems because it never left them. EMB reports a 98% first-pass clean claim rate and says on its site that it will show you how that number is counted.

Its two published surgery center cases are both ophthalmology ASCs with the numbers taken from the centers' own billing data. At a physician-owned center with four providers, receivables over 90 days fell from 30% of the total to 10% in ten months while visit volume grew 45%; collections finished 65.5% above the prior-year baseline. At an ASC with an attached clinic that changed billers in the middle of a merger, receivables over 91 days fell from 25% to 14% with no dip through the transition, and the two collected $4.35 million in 2025 (expertmedicalbilling.co/case-studies, October 2026).

The tradeoff: EMB is a specialist, not a roll-up. It publishes two surgery center cases against nimble's 1,100 clients. If you run thirty centers and want one vendor for all of them, nimble, SIS or the HST bundle are the scale options. If you run one to a handful and want to be able to open a claim yourself on a Tuesday afternoon, this is the model.

If you want scale from a company that is also your software: SIS Revenue Cycle Services (Surgical Notes)

Surgical Notes, founded in Dallas in 1997, was the other large ASC-focused biller until Surgical Information Systems bought it in a deal completed on 15 November 2024. SIS says the combined company serves more than 2,700 ASCs and hospitals, that its own RCM business had grown nearly 20% a year over five years, and that Surgical Notes' billing platform integrates with all leading ASC practice management systems (SIS, November 2024; Levin Associates, November 2024). Clients were told contracts, pricing and contacts stay the same, that invoices now come from Surgical Information Systems and that no new business associate agreement was needed; Surgical Notes RCM remains a legal entity under SIS (SIS client transition page, 2026). The service runs billing, coding and transcription with an optional end-to-end bundle, each client has a dedicated primary contact and a focused team, and Surgical Notes has described its teams as U.S.-based (sisfirst.com, October 2026; Becker's ASC Review, January 2017).

Pricing: not published; the page offers an ROI calculator.

The tradeoff: you're trading one large vendor for another, and this one also sells the practice management system. That's convenient on SIS software and worth a question on anyone else's: SIS says the RCM service is platform-agnostic.

If you want an ASC-only firm you can call by name: Serbin Medical Billing

Caryl Serbin built Serbin Surgery Center Billing, sold it to SourceMedical in December 2010, and relaunched as Serbin Medical Billing in 2016 from Fort Myers, Florida. The firm specializes in ASC coding and billing, assigns each client its own revenue cycle team under what it calls a concierge concept, and does all work in-house with oversight (Becker's ASC Review, September 2016). Its clients include de novo, mature, independent and joint-venture ASCs, and it reported a significant increase in partner clients in 2019 (Becker's ASC Review, October 2019). It is one of HST Pathways' five listed alliance partners and the featured partner in HST's referral program (hstpathways.com, October 2026).

Pricing: not published.

The tradeoff: a small firm built around its founder, with less public reporting than the large vendors. If "who works my account" is your first question, that's the point.

If you want ASC-only billing from a management company's division: Regent RCM

The revenue cycle division of Regent Surgical Health, in West Chester, Illinois, launched in October 2014 to bill and collect exclusively for ASCs. Revenue cycle specialists are assigned to specific facilities, and at launch its billers and collectors averaged 17 years of experience and were bilingual in English and Spanish (Becker's ASC Review, October 2014; April 2018). It publishes what it calls gold-standard targets: 98% clean claims, A/R over 90 days at 12% or less, and net collections above 97% (Becker's ASC Review, August 2016), and says it appeals all under-paid and unpaid claims within 24 hours (Becker's ASC Review, November 2018).

Pricing: not published.

The tradeoff: the most recent trade press coverage we found is from 2019, so ask for current client counts and staffing. And it belongs to a management company; if you're managed by someone else, ask how that sits.

If you're on HST and want the vendor to run billing: HST Pathways with SYNERGEN Health

HST, the practice management system in more than 2,000 ASCs by its own count, sells an end-to-end revenue cycle service delivered by SYNERGEN Health and integrated into HST, under a three-party order form (hstpathways.com, October 2026). A KLAS validation in May 2026 at Compass Surgical Partners' six pilot ASCs reported cost to collect falling from 3% to 2.5% of net revenue, days in A/R from 42 to 34, and collections rising from 71.8% to 90% of net revenue over 120 days, with project costs not disclosed (KLAS, May 2026).

Pricing: described as a significantly reduced percentage-of-revenue fee; no figure published (BusinessWire, September 2024).

The tradeoff: the billing decision and the software decision become one decision. nimble's own May 2026 partnership announcement argued the opposite case, for separating the two. Our page on outsourced billing for HST centers goes through the contract terms.

If you want a published rate and work in your own system: MD Revenue Group

A Jersey City, New Jersey, billing company whose ASC page says it synchronizes with the center's existing surgical management system during onboarding, naming HST Pathways and SIS as examples, and publishes pricing "typically ranging between 2.99% and 6.5% of net collections" (mdrevenuegroup.com, October 2026). Client counts, staffing model and ASC case results aren't stated on the page.

The tradeoff: one of two companies on this page with a public rate, and the one with the least public record. Ask for references in your specialty.

If your centers sit inside a larger multi-specialty group: Coronis Health or Medcare MSO

Coronis Health is a multi-specialty revenue cycle company with an ASC line covering coding, implant reimbursement, claims and patient billing, dedicated account teams, and a stated policy of working in the client's system of record (coronishealth.com, October 2026). Medcare MSO is a multi-specialty biller whose ASC page covers GI, orthopedics and spine, ophthalmology, pain management and multi-specialty centers, works alongside your existing EHR or on its own, and cites an industry range of 3% to 7% of collections without stating its own rate (medcaremso.com, October 2026). Neither publishes ASC client counts.

The tradeoff: neither is ASC-focused. If the group already uses one of them for physician billing, the convenience is real; if not, the ASC-only firms above know the facility side better.

Who should stay with nimble

Three kinds of center, on the evidence above. A multi-site platform that wants one vendor across every center, with transcription, coding, managed care contracting and credentialing on one contract, because nothing else in the market bundles that much at that scale. A center with heavy out-of-network volume, because the Contego acquisition gave nimble a payer strategy and dispute resolution line nobody on this page matches. And any center whose KLAS-style experience is the positive half of the sample: a responsive account manager and results that hold. If that's you, the switch costs more than it returns.

What to check before switching

1. Who exactly will work our account, where do they sit, and who covers when they're out?
2. Will your team work inside our practice management system and clearinghouse, or does our billing move to your platform?
3. Can our administrator open any claim, today, and see where it stands?
4. Who approves a write-off, and does every adjustment carry a name?
5. What is the fee as a percentage, what sits outside it, and is there a setup fee?
6. What happens to receivables already in flight when we leave nimble, and who works them during the transition?
7. How many ASC clients do you have in our specialty, and can we see one before-and-after?

Frequently asked questions

Is nimble solutions the same company as National Medical Billing Services?

Yes. National Medical Billing Services rebranded as nimble solutions on 12 May 2023, after acquiring mdStrategies, National Billing Partners, Medi-Corp and MedTek in 2022 (Becker's ASC Review, May 2023).

Who owns nimble solutions?

Aquiline Capital Partners has been an investor since February 2021 and lists nimble as a current portfolio company (Becker's ASC Review, February 2021; aquiline.com, October 2026). Lisa Rock, the founder, remains president; Kelley Blair has been chief executive since January 2024.

How big is nimble solutions?

More than 1,100 surgical organizations as clients, about 1,300 employees, $10 billion in net collections managed over twenty years and more than 25 million surgical charts coded, per Becker's in January 2024.

Does nimble solutions use offshore staff?

Its own site doesn't say. In September and October 2026 it was recruiting senior A/R callers in Hyderabad, India, under its own name and the National Medical Billing Services name, according to listings on jobs.aapc.com, talentmate.com and jobtarget.com.

What does nimble solutions charge?

It doesn't publish a rate. The one public data point is a KLAS client comment from January 2026 calling the monthly percentage of revenue "shocking," without a number.

What's the easiest switch from nimble?

A biller that works inside your existing practice management system, because nothing migrates: the new team takes over the accounts you already have. 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 page was built

nimble solutions' site, KLAS's comment page, Aquiline's portfolio page and the job listings were read on 17 October 2026. Press releases and trade press are cited with their publication month. Expert Medical Billing is an alternative on this page and says so. Corrections go to the address on our contact page.

If you're comparing billers for a surgery center, book a discovery call. Our ranking of ASC billing companies covers the wider field.