Last updated: 2026-08-21
Honest Taskers, Transcure, and Neolytix lead this year's shortlist of medical billing outsourcing companies in the US, seven firms ranked on what each one publishes about its US presence, where the billing work is performed, published pricing, specialty fit, and compliance. The finding worth reading before the list: almost every firm marketed as a US medical billing company is US-headquartered with the production work performed offshore, and only some say so. Below we set out whether compliance requires the work to be performed in the US, what happens when you pay a domestic premium for offshore work, whether the premium can be priced from published rates, which part is subcontracted, and why domestic delivery matters to you.
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 our own delivery is offshore, which is stated in our entry.
At a glance
- 1Honest Taskers
- 2Transcure
- 3Neolytix
- 4Coronis Health
- 5Medusind
- 6Omega Healthcare
- 7AGS Health
On this page
- How we chose these companies
- Companies compared
- The 7 companies
- Does compliance require your billing to be performed in the US?
- What happens when you pay a domestic premium for offshore billing?
- Can you price the domestic billing premium from what firms publish?
- Which part of the billing work is subcontracted, and to whom?
- Why does domestic billing matter to you, in writing?
- Methodology and sources
How we chose these companies
This search is usually driven by one of two things: a belief that US-performed billing is more compliant, or a preference for keeping the work domestic. Both are legitimate, and both run into the same fact, which is that a US address in the footer says nothing about where your claims get worked. So the first column here is what each firm publishes about its US presence, and the second is where the work is performed, kept separate on purpose.
The results are uneven. One firm names three US office locations alongside the size of its billing team. Two publish a US headquarters city and nothing about production. Two publish a US headquarters and then name their offshore delivery locations openly, which is the most honest pattern in this category even though it's the answer a domestic-preference buyer doesn't want. Two publish no location information at all, which is worth treating as an answer rather than a gap.
On the compliance premise, it's worth being direct: HIPAA does not require domestic processing. A business associate agreement, encryption, access controls, and audit trails are the requirements the U.S. Department of Health and Human Services sets out, and none of them mention geography. Offshore delivery raises practical questions about enforcement and jurisdiction that are worth asking, but the compliance argument for onshore work is weaker than it's usually sold as.
What US-performed work does buy you is more mundane and more real: payer familiarity from people who grew up with these plans, live phone calls to payers during business hours, and legal recourse in the same jurisdiction. Weigh those against a price difference that is often substantial, and decide on the actual trade rather than the compliance story. Wage context for the in-house comparison is the U.S. Bureau of Labor Statistics May 2025 Occupational Employment and Wage Statistics, which puts the national median for billing and posting clerks at $23.32 an hour, about $48,500 a year.
Companies compared
| Company | US presence (as stated) | Where the work is performed | Published pricing | Specialty fit named | Compliance (as stated) |
|---|---|---|---|---|---|
| Honest Taskers | US clients, US-based management | Offshore, recruited in the Philippines, Latin America, India and Pakistan | $10.00 to $12.65/hr | US practices, small to mid-size | Compliance officer; HIPAA verified by Accountable; BAA when PHI is accessed; SOC 2 audit ready |
| Transcure | Offices in Texas, New Jersey, Florida | Not separately stated; 1,100+ certified billers and coders | 3% to 5% of monthly collections | Solo through health systems, 40+ specialties | ISO 27001; AAPC-certified billers and coders (company-reported) |
| Neolytix | Headquarters Chicago | Not publicly listed | Not publicly listed | 270+ organizations, 31 specialties, 40 states | ISO 27001 certified; HIPAA compliance stated |
| Coronis Health | US company, city not stated | Not publicly listed | Not publicly listed | Behavioral health, community health centers, hospitals, systems, physician groups | None named |
| Medusind | US company, city not stated | Not publicly listed | Not publicly listed | Physician groups, FQHCs, behavioral health, home health, dental and DSOs, 30+ specialties | Not publicly listed |
| Omega Healthcare | Headquarters Boca Raton, Florida | Hiring stated in Philippines, India, Colombia | Not publicly listed | RCM, care coordination, payer operations | Not stated on its about page |
| AGS Health | Headquarters Washington DC | Delivery center Chennai, India | Not publicly listed | Large systems; Banner Health and Baylor Scott & White named | States HIPAA safeguards; no SOC 2, ISO or HITRUST named |
1. Honest Taskers
Best for: US practices that want US-hours coverage and US-based management at a published hourly rate, and are open to offshore delivery.
Pricing: $10.00 to $12.65/hrUS presence: US management and clientsDelivery: OffshoreFirst hire: Two-week working trial
Honest Taskers is included first with the geography stated plainly rather than blurred: clients are US practices, management is US-based, and the billers themselves are recruited in the Philippines, Latin America, India and Pakistan. What you get domestically is the part that usually matters day to day, which is coverage in your own time zone on your own schedule, accountability to a US-based team, and a Customer Success contact who works your hours. A placed biller handles charge entry, claim submission, payment posting, denial follow-up, accounts receivable work, insurance verification, and patient balance queries inside your systems.
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 is 99.6% average monthly. Rates run $10.00 to $12.65 an hour with a two-week working trial on the first hire. See the virtual medical billing service for scope.
Limitation: if your requirement is genuinely that claims be worked on US soil, this isn't it, and no amount of US management changes that. Buy from a firm that publishes US-performed delivery instead.
2. Transcure
Best for: practices wanting named US offices, a published rate, and a full outsourced service.
Pricing: 3% to 5% of monthly collectionsUS presence: Texas, New Jersey, FloridaScale: 1,100+ certified billers and codersCompliance: ISO 27001
Transcure publishes the most specific US footprint on this list, naming offices in Texas, New Jersey, and Florida, and it's also the only firm here publishing a rate, at 3% to 5% of monthly collections. Scope spans billing, coding, audits, MIPS reporting, eligibility verification, and credentialing for practices from solo through health systems across 40 or more specialties, with more than 1,100 certified billers and coders reported, ISO 27001 certification, and AAPC-certified staff. Between the named offices and the published price it's the easiest firm here to evaluate before a sales call.
Limitation: it names US offices but doesn't separately state where the billing work is performed, so ask directly rather than inferring it from the office list.
3. Neolytix
Best for: smaller US practices wanting a Chicago-headquartered firm with tiers built for their size.
Pricing: Not publicly listedUS presence: Headquarters ChicagoCoverage: Billing, coding audit, credentialingCompliance: ISO 27001 certified
Neolytix publishes a Chicago headquarters and reports serving 270 or more organizations across 31 specialties and 40 states, with explicit small-practice and mid-market tiers, covering revenue cycle management, billing, coding audit, credentialing and provider enrollment, licensing, and virtual assistants. It is ISO 27001 certified and states HIPAA compliance, which is a stronger disclosure than most of the firms below it manage. The 40-state spread is the relevant detail for a US buyer, since it implies familiarity with many state Medicaid programs.
Limitation: where the work is performed isn't published, and neither is pricing, so both need asking.
4. Coronis Health
Best for: US behavioral health organizations and community health centers.
Pricing: Not publicly listedUS presence: US company, city not statedCoverage: Billing, coding, RCM, ARCompliance: None named
Coronis Health provides medical billing and coding, revenue cycle management, and claims and accounts receivable follow-up, and names behavioral health, community health centers, hospitals, health systems, and physician groups among its clients. For US buyers the segment fit is the argument rather than the geography: community health center and behavioral health billing are governed by rules a generalist firm will get wrong, and this is a firm that treats them as core.
Limitation: it publishes no location detail, no pricing, and no named certification, so nothing about its delivery model can be verified before contact.
5. Medusind
Best for: US practices in segments with unusual claim mechanics, including dental and FQHCs.
Pricing: Not publicly listedUS presence: US company, city not statedCoverage: Medical and dental billing, coding, credentialingSpecialties: 30+
Medusind names physician groups, federally qualified health centers, behavioral health, home health, dental practices and dental service organizations across 30 or more specialties, and handles medical and dental billing, coding and credentialing, accounts receivable follow-up, and payment posting. Running medical and dental billing under one vendor is genuinely useful for US groups that do both, since the alternative is two contracts and two reporting formats.
Limitation: pricing, delivery location, and certifications are all unpublished, which for a location-driven search is the least helpful combination.
6. Omega Healthcare
Best for: US organizations wanting a domestic headquarters with the offshore footprint stated openly.
Pricing: Not publicly listedUS presence: Boca Raton, FloridaDelivery: Philippines, India, Colombia hiringCoverage: RCM and care coordination
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: revenue cycle management, care coordination including nurse triage and remote patient management, health data curation, payer operations, and drug access. The disclosure pattern is the reason it earns a place on a US-focused list: it tells you the headquarters is domestic and the production is not, which is exactly the distinction this search needs and which several firms above it leave unanswered.
Limitation: its about page publishes no headcount, no pricing, and no HIPAA statement or named certification, so compliance detail has to be requested.
7. AGS Health
Best for: US health systems comfortable with a published offshore delivery model.
Pricing: Not publicly listedUS presence: Headquarters Washington DCDelivery: Chennai, IndiaCoverage: Coding, claims, AR, denials
AGS Health states a US headquarters in Washington DC and a delivery center in Chennai, India, covering coding, claims, accounts receivable, denials, prior authorization, provider enrollment and credentialing, and clinical documentation improvement with an AI-assisted workflow, and it names clients including Banner Health and Baylor Scott & White. It's ranked last here purely on the US question, since a firm publishing a single offshore delivery center is the furthest thing on this list from domestic processing, and that's the criterion this article sorts on.
Limitation: built for health systems rather than practices, and it names no SOC 2, ISO or HITRUST certification.
Does compliance require your billing to be performed in the US?
No. The business associate framework requires an agreement, safeguards, access controls and audit trails, and none of those is a map reference. For compliance, location matters less than most buyers assume. The business associate framework requires an agreement, safeguards, access controls, and audit trails. It doesn't require domestic processing, and a US firm with weak controls is a bigger exposure than an offshore firm with strong ones. If compliance is your reason, buy on the controls and the agreement rather than the map.
For practical performance, more than the price difference suggests in some cases. Payer phone calls happen during US business hours, and a team already inside those hours works them live rather than queueing them overnight. State Medicaid programs carry local quirks that domestic staff pick up faster. If your denial volume is high and payer-specific, that daily overlap has real value.
For cost, the gap is the whole reason offshore delivery dominates this category. A hybrid arrangement is what many practices end up with in practice: domestic oversight and patient-facing contact, offshore claim processing and posting. That's not a compromise so much as the shape the market has settled into, which is why so many "US" billing companies are structured exactly that way.
What happens when you pay a domestic premium for offshore billing?
You buy a US address rather than US work, which is the first of the risks here and the one the marketing in this category is built on.
- Treating a US address as evidence about where the work happens.
- Assuming domestic processing satisfies compliance by itself, when the agreement and controls are what count.
- Paying a domestic premium for work that is subcontracted offshore anyway.
- Offshore teams unable to reach payers by phone within US business hours.
- Enforcement and jurisdiction questions that a business associate agreement alone doesn't settle.
- Coder credentials unverified regardless of where the coder sits.
- Patient-facing collections handled by staff your patients struggle to understand or reach.
- Vendors that answer the location question vaguely, which is itself information.
- Percentage pricing that rises with revenue whatever the delivery model.
Can you price the domestic billing premium from what firms publish?
No, because five of the seven quote on request. Two publish figures, 3% to 5% of monthly collections for a full outsourced service, and $10.00 to $12.65 an hour for staffing. The other five quote on request, which in a location-driven search means you cannot price the domestic premium from public information at all.
When you do get quotes, insist that each vendor state where the work is performed alongside the number, because otherwise you'll compare a domestic quote against an offshore one and conclude the domestic firm is overpriced when it may simply be selling something different. The premium for genuinely US-performed billing is real and worth paying where live payer contact and state program familiarity drive your recovery, and hard to justify where the work is routine posting and submission. Ask for the price both ways from any firm that can offer both. Rates move, so confirm before you sign.
Which part of the billing work is subcontracted, and to whom?
Ask in writing, separately from where the company is headquartered, and work down the rest of this list from there.
- Where the work is performed, in writing, separate from where the company is headquartered.
- Whether any part of the work is subcontracted, and to whom.
- A signed BAA plus the named safeguards behind it.
- Which credentials the coders hold, wherever they sit.
- Whether payer calls happen live during US business hours.
- State Medicaid experience for the states you bill.
- Who contacts your patients about balances, and from where.
- Pricing quoted with the delivery model attached.
- Exit terms and data export format.
Why does domestic billing matter to you, in writing?
Write the reason down before you shop, then test it against the actual requirement, because compliance, payer contact and preference lead to different shortlists.
- Decide why domestic delivery matters to you, and write the reason down.
- Test it against the actual requirement: is it compliance, payer contact, or preference?
- Ask every vendor the location question in writing, early.
- Ask whether any work is subcontracted, and where.
- Request pricing with the delivery model stated alongside it.
- Check coder credentials and state program experience.
- Consider a hybrid split: domestic patient contact, offshore processing.
- Pilot one stage and measure recovery, not activity.
- Review at 90 days against the baseline you recorded first.
Methodology and sources
We verified each company at its own website on August 21, 2026, recording what it publishes about its US presence, what it publishes about where the work is performed, published pricing, named specialty and client-type fit, and stated compliance. These first two were recorded separately on purpose, because a headquarters address is not a delivery location. Business associate requirements come from the U.S. Department of Health and Human Services, which sets no geographic requirement on processing. Figures a company reports about itself are labeled company-reported, and anything unpublished is marked "not publicly listed" rather than estimated. GeBBS Healthcare Solutions was reviewed and left out because its site blocks automated retrieval and nothing could be verified from source.
Related billing guides
For what a placed biller owns day to day, see our virtual medical billing page.
If offshore access to patient data is the concern, our guide on whether offshore virtual assistants can access PHI covers the rules.