Last updated: 2026-08-21
Honest Taskers, Optum, and R1 RCM lead this year's shortlist of healthcare RCM outsourcing companies, nine firms sorted first by the buyer they're built for, then on cycle coverage, contracted accountability, pricing model, and stated HIPAA posture. Health systems and ten-provider practices are shopping in two different markets here, and most lists in this category pretend otherwise. Below we set out whether you are outsourcing the whole cycle or one function, what happens when the real gap was seats, over how many years to cost it, whether a firm takes work at your size, and which scope document every vendor should get.
Disclosure: Honest Taskers publishes this list and appears at position 1. We're judged on the same five published criteria as every other company here, and we're a staffing alternative to RCM outsourcing rather than an RCM firm.
At a glance
- 1Honest Taskers
- 2Optum
- 3R1 RCM
- 4Savista
- 5Ensemble Health Partners
- 6Omega Healthcare
- 7Access Healthcare
- 8AGS Health
- 9Neolytix
On this page
- How we chose these companies
- Companies compared
- The 9 companies
- Are you outsourcing the whole cycle or one function?
- What happens when you outsource accountability but the gap was seats?
- Over how many years should RCM outsourcing be costed?
- Does the outsourcing firm take work at your size?
- Which single scope document should go to every outsourcing vendor?
- Methodology and sources
How we chose these companies
Search "healthcare RCM outsourcing" and you get one list containing vendors whose smallest engagement is a hospital system alongside vendors who will bill for a single physician. Those firms never compete for the same contract, so ranking them against each other on features tells you nothing. We sorted by best-fit buyer first, then compared cycle coverage, whether accountability is contracted under service levels, pricing model, and stated HIPAA posture.
The second thing worth establishing early is what you're buying. Outsourcing means the firm takes the function, brings its technology, and signs up to numbers. Staffing means you hire people into your own process and remain accountable for the outcome. A practice with a working billing process and three unfilled seats has a hiring problem, and buying an outsourcing contract to solve it means paying for accountability it doesn't need while giving up systems it already runs well.
Delivery location turned out to be one of the more revealing columns. Several firms in this category are US-headquartered with the actual production work performed in India, the Philippines, or Colombia, and the honest ones publish it. That's not a mark against them, since offshore delivery is why the price works, but you should know where your claims are being handled and under what safeguards before you sign, not after.
Pricing is the least transparent part of this market. Eight of the nine publish nothing at all, which means the only way to compare is a procurement process with a common scope document. Every firm operates under the business associate framework the U.S. Department of Health and Human Services sets out, so the question worth asking is which specific safeguards a firm will commit to in writing. For what the same work costs locally, the U.S. Bureau of Labor Statistics May 2025 Occupational Employment and Wage Statistics puts billing and posting clerks at a median $23.32 an hour, roughly $48,500 a year.
Companies compared
| Company | Built for | Cycle coverage | Contracted accountability | Delivery location (as stated) | Pricing model |
|---|---|---|---|---|---|
| Honest Taskers | Solo to mid-size groups | Staffs individual cycle roles | No, you retain ownership | Philippines, Latin America, India and Pakistan recruiting, US managed | $10.00 to $12.65/hr |
| Optum | Health systems and payers | End to end plus clearinghouse and analytics | Yes, contracted service levels | Not publicly listed | Not publicly listed |
| R1 RCM | Health systems | Patient access through collections | Yes, contracted service levels | Not publicly listed | Not publicly listed |
| Savista | Hospitals and large groups | End to end revenue cycle | Yes, contracted service levels | Not publicly listed | Not publicly listed |
| Ensemble Health Partners | Hospitals and health systems | End to end revenue cycle | Yes, contracted service levels | Not publicly listed | Not publicly listed |
| Omega Healthcare | Mid-market to enterprise | RCM, care coordination, payer operations, health data | Partial, scope-dependent | US headquarters in Boca Raton; hiring in Philippines, India, Colombia | Not publicly listed |
| Access Healthcare | Mid-market to enterprise | Mid to back end of the cycle | Partial, scope-dependent | Not publicly listed | Not publicly listed |
| AGS Health | Mid-market to enterprise | Coding, claims, AR, denials, prior auth, credentialing | Partial, scope-dependent | US headquarters Washington DC; delivery center Chennai, India | Not publicly listed |
| Neolytix | Solo to mid-size groups | Most of the cycle at practice scale | Partial, scope-dependent | Not publicly listed; headquarters Chicago | Not publicly listed |
1. Honest Taskers
Best for: practices whose revenue cycle works and whose actual problem is unfilled seats.
Pricing: $10.00 to $12.65/hrModel: Managed staffingCoverage: Individual cycle rolesFirst hire: Two-week working trial
Honest Taskers staffs revenue cycle roles rather than taking the cycle over, which makes it the right first stop for the large share of buyers in this search who don't need an outsourcing contract. The roles line up with cycle stages: insurance verification specialists on eligibility and benefits, prior authorization specialists chasing approvals, medical billers on charge entry through payment posting and accounts receivable follow-up, medical coders on abstraction and code assignment, patient intake coordinators on registration, and medical collection specialists on patient balances. People work inside your practice management system, on your workflow, in your US time zone, with recruiting in the Philippines, Latin America, India and Pakistan under US-based management.
Compliance runs on quarterly HIPAA and data privacy training led by a dedicated compliance officer, a Business Associate Agreement signed where the professional will access PHI, remote work screening covering a dedicated password-protected computer with VPN and antivirus requirements, and a security environment described as SOC 2 audit ready, with HIPAA compliance verified by Accountable. Reported retention of 99.6% average monthly matters here specifically, because a biller who has learned your payer mix and denial patterns is worth substantially more in month twelve than in month one. Rates run $10.00 to $12.65 an hour, with a two-week working trial on the first hire, unlimited replacement support, and roughly two weeks to onboard. See the virtual medical billing service for role detail.
Limitation: we take no responsibility for your collection performance, and there's no platform, clearinghouse, denial analytics product, or service level agreement tied to days in AR. If your cycle is underperforming rather than understaffed, buy from a whole-service firm on this list.
2. Optum
Best for: systems consolidating revenue cycle services, clearinghouse, and analytics with one vendor.
Pricing: Not publicly listedModel: Outsourcing plus platformCoverage: Cycle, clearinghouse, analyticsBuilt for: Systems and payers
Optum ranks second here because its scope is the widest in the category: complete revenue cycle services plus the clearinghouse the claims travel through and the analytics used to judge the result. For a health system that wants one contract and one accountable party across the whole claims path, that is a materially different offer from a services-only firm. It serves payers as well as providers, and engagements carry contracted service levels.
Limitation: concentrating services, claims routing, and reporting with one organization raises the cost of ever moving, and nothing is published on pricing.
3. R1 RCM
Best for: health systems handing over the entire cycle under performance commitments.
Pricing: Not publicly listedModel: Whole-cycle outsourcingCoverage: Patient access to collectionsBuilt for: Health systems
R1 RCM is among the largest complete revenue cycle firms in the United States, covering patient registration through billing, coding, denial management, and underpayment recovery, and reporting management of more than $50 billion in net patient revenue annually. Its engagements embed R1 staff and technology inside the system's own revenue cycle organization, which is a deeper operational change than a back-office contract and is the reason its results tend to be discussed as transformation rather than throughput.
Limitation: implementation assumes a dedicated internal counterpart team, and the engagement floor rules out anything below health-system scale.
4. Savista
Best for: mid-sized hospitals and large groups wanting whole-cycle coverage without being a giant vendor's smallest client.
Pricing: Not publicly listedModel: Whole-cycle outsourcingCoverage: Full revenue cycleBuilt for: Hospitals and large groups
Savista provides complete revenue cycle management to hospitals and large provider groups under contracted service levels, sitting a tier below the biggest firms on scale. That position is the practical argument for it: a mid-sized hospital is likely to get a more proportionate engagement and more senior attention than it would at the bottom of a much larger portfolio, which in this category tends to matter more than feature lists.
Limitation: no published pricing, fewer public reference points than the largest firms, and an engagement floor still well above a single practice.
5. Ensemble Health Partners
Best for: hospitals running a competitive process at the top tier.
Pricing: Not publicly listedModel: Whole-cycle outsourcingCoverage: Full revenue cycleBuilt for: Hospitals and systems
Ensemble Health Partners provides complete revenue cycle management to hospitals and health systems with embedded operations, proprietary technology, and contracted performance targets, competing directly for the engagements R1 pursues. Shortlisting both is the practical move rather than a hedge, because at this tier the service levels themselves are what gets negotiated, and a single bidder has little reason to move on them.
Limitation: hospital-weighted, so ambulatory and physician-practice buyers are outside the core market, and no pricing is published.
6. Omega Healthcare
Best for: mid-market organizations wanting revenue cycle work alongside care coordination and payer operations.
Pricing: Not publicly listedModel: Outsourced servicesCoverage: RCM, care coordination, payer operationsDelivery: Philippines, India, Colombia hiring
Omega Healthcare states a US headquarters in Boca Raton, Florida and recruits in the Philippines, India, and Colombia, and its service lines run wider than billing alone: revenue cycle management, care coordination including nurse triage and remote patient management, health data curation, payer operations, and drug access and affordability. For an organization whose gaps sit on both sides of the revenue and care line, that breadth is the argument, and the multi-country footprint is published rather than implied.
Limitation: its about page publishes no headcount, no pricing, and no named certification or HIPAA statement, so the compliance detail has to be requested directly.
7. Access Healthcare
Best for: buyers whose problem is throughput on claims and accounts receivable.
Pricing: Not publicly listedModel: Mid and back-end outsourcingCoverage: Claims, AR, denialsBuilt for: Mid-market to enterprise
Access Healthcare works the middle and back end of the revenue cycle at volume, with scope-dependent accountability rather than service levels covering the whole engagement, and states HIPAA safeguards. It fits where the front end of your cycle is fine and the backlog is in claims and accounts receivable, which is a narrower and more measurable purchase than a full engagement, and easier to unwind if it doesn't work.
Limitation: partial coverage means the accountability boundary has to be drawn carefully in the statement of work, and no pricing is published.
8. AGS Health
Best for: organizations outsourcing coding, denials, and credentialing rather than the whole cycle.
Pricing: Not publicly listedModel: Mid and back-end outsourcingCoverage: Coding, claims, AR, prior auth, credentialingDelivery: Chennai, India
AGS Health covers the middle and back end with an AI-assisted workflow spanning coding, claims, accounts receivable, denials, prior authorization, provider enrollment and credentialing, and clinical documentation improvement. It names large clients including Banner Health and Baylor Scott & White, and it publishes its footprint plainly: US headquarters in Washington DC, delivery center in Chennai, India. Credentialing sitting alongside coding in one scope is genuinely useful for groups adding providers while also fighting a coding backlog.
Limitation: built for health systems, so a small practice is unlikely to fit, and it names no SOC 2, ISO or HITRUST certification.
9. Neolytix
Best for: solo and small practices that want outsourcing but can't meet an enterprise engagement floor.
Pricing: Not publicly listedModel: Practice-scale outsourcingCoverage: Most of the cycleBuilt for: Solo to mid-size groups
Neolytix handles most of the revenue cycle for smaller organizations, including billing, coding audit, credentialing and provider enrollment, licensing, and virtual assistants, and reports serving 270 or more organizations across 31 specialties and 40 states with explicit small-practice and mid-market tiers. It is ISO 27001 certified and states HIPAA compliance. It appears last here not on quality but because the ranking is sorted by the buyer each firm is built for, and it sits at the opposite end of that range from the firms above it.
Limitation: no published pricing, so comparison takes a quote, and minimums start at one full-time equivalent.
Are you outsourcing the whole cycle or one function?
Three tiers of buyer get three different answers, and the tier decides before any vendor does. A hospital or health system buying whole-cycle outsourcing is choosing among four firms here, and the decision turns on contracted service levels, implementation capacity, and how much internal counterpart resource you can commit. Run a competitive process, because at this tier the terms move and a single bidder's terms don't.
A mid-market group is usually better served outsourcing one stage than the whole cycle. Coding, denials, prior authorization, or accounts receivable each go out on their own, which contains the risk, keeps the front end in-house, and gives you a scope you can measure inside a quarter. Three firms here sell exactly that.
A solo or small practice has two real options: practice-scale outsourcing from a firm that will take the work, or staffing the roles and keeping the process. The deciding question is whether your billing underperforms or is simply short-handed. Underperformance needs someone accountable; short-handedness needs people, and paying outsourcing rates to fix a staffing gap is the most expensive way to solve it.
What happens when you outsource accountability but the gap was seats?
You pay for a vendor to own an outcome your own process was already capable of, which heads this list because it is the most expensive way to solve a staffing problem.
- Buying accountability you don't need because the actual gap was unfilled seats.
- Percentage-of-collections pricing that grows with revenue long after the work stops growing with it.
- Service levels written around activity volumes rather than days in AR and net collection rate.
- Delivery location left unpublished, so you learn where your claims are handled after signing.
- Your data living in the vendor's platform, which is the real switching cost.
- Split scope creating a blame boundary between front end and back end.
- Coding performed without visible credentials, which is a compliance exposure rather than a saving.
- Auto-renewal and long notice periods converting a bad year into a multi-year commitment.
- Patient collections conducted in your name by people you never hear.
Over how many years should RCM outsourcing be costed?
Three, not one, because percentage pricing and implementation fees land in different years. Eight of these nine publish no price. Honest Taskers publishes $10.00 to $12.65 an hour for staffing. Everyone else quotes, typically as a percentage of net collections or per transaction, with implementation and technology fees on top.
The comparison that survives contact with a real contract is cost per dollar collected, modelled over three years rather than one. Percentage pricing is gentle at low volume and becomes the practice's largest administrative line as revenue grows, because the fee tracks your success while the vendor's cost of serving you stays roughly flat. Hourly staffing inverts that and gets cheaper per dollar as you grow, at the price of owning every outcome yourself. Either way, insist on a written baseline for the metrics the contract will be judged against, because a service level agreement with no agreed starting point is unenforceable in practice. Terms move, so confirm before you buy.
Does the outsourcing firm take work at your size?
Establish that before anything else, so you are not running a competitive process with vendors who will not bid, and it heads the rest of this list.
- A best-fit size answer before anything else, so you're not running a process with vendors who won't take the work.
- Scope written stage by stage, naming what the vendor owns and what you keep.
- Service levels tied to days in AR, clean claim rate, denial rate, and net collection rate, against an agreed baseline.
- The pricing model modelled at your current volume and at double.
- Where the work is performed, stated in writing.
- Which credentials the people coding your charts hold.
- A signed BAA plus the specific safeguards behind it.
- References at your size and in your specialty.
- Notice period, exit assistance, and data portability terms.
Which single scope document should go to every outsourcing vendor?
One you drafted, sent unchanged to all of them, because comparing quotes written against different scopes is not a comparison.
- Write down your days in AR, clean claim rate, denial rate, and net collection rate today.
- Answer one question honestly: is the cycle underperforming, or just understaffed?
- Filter the market by best-fit size before comparing anything else.
- Draft a single scope document and send the same one to every vendor.
- Ask for pricing at your volume and at twice it.
- Require delivery location and coder credentials in writing.
- Negotiate exit terms and data export while the deal is still open.
- Pilot one stage you can measure within 90 days.
- Review against your written baseline at 90 days and at a year.
Methodology and sources
We verified each company at its own website on August 21, 2026, recording the buyer each is built for, cycle coverage, whether accountability is contracted, stated delivery location, and pricing model. Business associate requirements come from the U.S. Department of Health and Human Services. Pricing is almost never published in this category, so "not publicly listed" is the accurate answer rather than an omission, and any figure a company reports about itself is labeled company-reported. Omega Healthcare's about page states its US headquarters and its hiring locations but publishes no headcount, pricing, or certification, and its compliance detail is held on a separate page we did not treat as verified. GeBBS Healthcare Solutions and Conifer Health were reviewed and left out of this ranking because their material could not be read from source at the time of writing.
Related billing and coding guides
If staffing is the likely answer, our virtual medical billing page sets out what a placed biller owns day to day.
If the constraint is coding capacity, our virtual medical coder page covers scope and credentials.
Speak with Honest Taskers about staffing your revenue cycle.