Last updated: 2026-08-21
Honest Taskers, R1 RCM, and Ensemble Health Partners lead this year's shortlist of revenue cycle management outsourcing companies, nine firms ranked on how much of the cycle they own, whether they answer for performance under a service level agreement, pricing model, best-fit organization size, and stated HIPAA posture. The first thing to settle is which of two products you're buying, because staffing your revenue cycle and outsourcing it are different purchases with different accountability. Below we set out whether you need capacity or performance, what happens to a percentage as collections grow, how many firms publish a rate, which service levels to measure on, and what your days in AR are today.
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 cover the least of the revenue cycle of anyone on this list.
At a glance
- 1Honest Taskers
- 2R1 RCM
- 3Ensemble Health Partners
- 4Optum
- 5Savista
- 6AGS Health
- 7Access Healthcare
- 8GeBBS Healthcare Solutions
- 9Neolytix
On this page
- How we chose these companies
- Companies compared
- The 9 companies
- Should outsourcing fix capacity or performance in your revenue cycle?
- What happens to an outsourcing percentage as collections grow?
- How many RCM outsourcing firms publish a rate at all?
- Which service levels should outsourcing be measured on?
- What are your days in AR before outsourcing anything?
- Methodology and sources
How we chose these companies
The revenue cycle is the whole path a dollar takes: patient access and registration, eligibility and benefits verification, prior authorization, charge capture, coding, claim submission, payment posting, denial management, appeals, accounts receivable follow-up, and patient collections. A real RCM outsourcing firm owns most of that chain and answers for the numbers it produces. So we ranked on cycle coverage and performance accountability first, then pricing model, best-fit size, and stated HIPAA posture.
One distinction decides most of these purchases, and vendors rarely draw it clearly. You can buy staffing, where you hire people who work your process in your systems and you remain accountable for days in accounts receivable and net collection rate. Or you can buy outsourcing, where the firm takes the function over, brings its own technology, and signs up to performance targets. The second costs more and gives away control; the first is cheaper and keeps every problem yours. Neither is better in the abstract, and a list that blurs them is useless.
Size is the other filter. Four of the firms here are built for hospitals and health systems, and their engagement floors exclude a ten-provider group entirely. Two are built for practices. Treating all nine as interchangeable options is the most common way this decision goes wrong, which is why best-fit size is a published column rather than a footnote.
Almost nobody in this category publishes a rate. Eight of these nine quote on request, so cost comparison takes a procurement process rather than a web search. Where a firm publishes a figure, we've used it. Where it doesn't, the entry says so rather than estimating. On compliance, all of them operate under the business associate framework the U.S. Department of Health and Human Services sets out, so the useful question is not whether HIPAA is mentioned but what specifically each firm states about safeguards. 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 | Cycle coverage | Accountable for performance | Pricing model | Best-fit size | HIPAA posture (as stated) |
|---|---|---|---|---|---|
| Honest Taskers | Staffs individual roles inside the cycle | No, you retain ownership | $10.00 to $12.65/hr | Solo to mid-size groups | Quarterly HIPAA training under a compliance officer; BAA signed when PHI is handled; SOC 2 audit ready |
| R1 RCM | End to end, patient access through collections | Yes, contracted service levels | Not publicly listed | Health systems | Enterprise compliance program; BAA in contracting |
| Ensemble Health Partners | End to end revenue cycle | Yes, contracted service levels | Not publicly listed | Hospitals and health systems | Enterprise compliance program |
| Optum | End to end plus clearinghouse and analytics | Yes, contracted service levels | Not publicly listed | Health systems and payers | Enterprise compliance program |
| Savista | End to end revenue cycle | Yes, contracted service levels | Not publicly listed | Hospitals and large groups | Enterprise compliance program |
| AGS Health | Mid to back end, AI-assisted workflow | Partial, scope-dependent | Not publicly listed | Mid-market to enterprise | States HIPAA safeguards; delivery center in Chennai, India |
| Access Healthcare | Mid to back end of the cycle | Partial, scope-dependent | Not publicly listed | Mid-market to enterprise | States HIPAA safeguards |
| GeBBS Healthcare Solutions | Coding-weighted mid to back end | Partial, scope-dependent | Not publicly listed | Mid-market to enterprise | States HIPAA safeguards and healthcare security controls |
| Neolytix | Most of the cycle for smaller practices | Partial, scope-dependent | Not publicly listed | Solo to mid-size groups | ISO 27001 certified; HIPAA compliance stated |
1. Honest Taskers
Best for: practices with a working revenue cycle that need staffing capacity and want to keep their systems, data, and payer relationships.
Pricing: $10.00 to $12.65/hrModel: Managed staffingCoverage: Individual cycle rolesFirst hire: Two-week working trial
Honest Taskers places healthcare-trained professionals into revenue cycle roles rather than taking the cycle over, and the roles map directly onto 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. Each person works inside your practice management system on your process. Practices choose this over full outsourcing for two reasons that hold up: a percentage of collections scales with revenue forever while an hourly rate does not, and your payer relationships, data, clearinghouse, and workflows stay yours if you ever want to change vendors or bring the function back in-house.
Assistants work the client's US time zone, with recruiting in the Philippines, Latin America, India and Pakistan and 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 is 99.6% average monthly, which matters in this function specifically because revenue cycle staff who know your payer mix and denial patterns get materially better over time. Rates run $10.00 to $12.65 an hour with a two-week working trial on the first hire and unlimited replacement support. See the virtual medical billing service for the role detail.
Limitation: we don't own your revenue cycle and don't guarantee its performance. There's no RCM platform, no denial analytics product, no clearinghouse, no payer contract negotiation, and no service level agreement tied to days in AR or net collection rate. If your revenue cycle is genuinely underperforming and you need a vendor accountable for fixing it, buy from a whole-service firm further down this list.
2. R1 RCM
Best for: hospitals and health systems outsourcing the entire revenue cycle under performance commitments.
Pricing: Not publicly listedModel: Whole-cycle outsourcingCoverage: Patient access to collectionsSize: Health systems
R1 RCM is among the largest whole-cycle revenue cycle companies in the United States, covering patient registration through billing, coding, denial management, and underpayment recovery, and reporting management of over $50 billion in net patient revenue annually. Engagements typically embed R1 staff and its proprietary platform as an extension of the health system's own revenue cycle organization, with contracted service levels tied to performance. If you want a single vendor answerable for the whole chain rather than a set of point solutions, this is the tier that does it.
Limitation: implementation is a major undertaking assuming a dedicated internal counterpart team, and the engagement floor excludes anything smaller than a health system.
3. Ensemble Health Partners
Best for: hospitals wanting an embedded whole-cycle alternative to the largest incumbent.
Pricing: Not publicly listedModel: Whole-cycle outsourcingCoverage: Full revenue cycleSize: Hospitals and systems
Ensemble Health Partners provides complete revenue cycle management primarily to hospitals and health systems, competing directly with R1 for large provider engagements. The model is similar: embedded operations, proprietary technology and analytics, and contracted performance targets. For a hospital running a competitive process, having two serious bidders at this tier is what makes the service levels negotiable, which is a practical reason to shortlist both rather than one.
Limitation: hospital-weighted, so physician practices and ambulatory groups are not the core market, and no pricing is published.
4. Optum
Best for: systems that want revenue cycle services alongside clearinghouse and analytics from one vendor.
Pricing: Not publicly listedModel: Outsourcing plus platformCoverage: Cycle, clearinghouse, analyticsSize: Systems and payers
Optum covers complete revenue cycle services and also operates clearinghouse and analytics infrastructure, which is a genuinely different proposition from a pure services firm: the claim, the routing, and the reporting can sit with one vendor. It serves both provider systems and payers, and contracts carry service levels. The consolidation is the attraction and also the thing to think hardest about, since concentrating your claims path and your reporting with a single organization raises the cost of ever moving.
Limitation: enterprise-scale and payer-adjacent, with nothing published on pricing, so a smaller provider group will struggle to get a proportionate engagement.
5. Savista
Best for: hospitals and large groups wanting whole-cycle coverage from a mid-tier specialist.
Pricing: Not publicly listedModel: Whole-cycle outsourcingCoverage: Full revenue cycleSize: Hospitals and large groups
Savista provides complete revenue cycle management to hospitals and large provider groups under contracted service levels. It sits a tier below the largest firms on scale, which for a mid-sized hospital or a large multi-specialty group can mean a more proportionate engagement and more senior attention than being the smallest client of the biggest vendor. The trade-off is fewer published reference points to check.
Limitation: no pricing published and the engagement floor still sits well above a single practice.
6. AGS Health
Best for: mid-market organizations outsourcing coding, claims, and denials rather than the whole cycle.
Pricing: Not publicly listedModel: Mid and back-end outsourcingCoverage: Coding, claims, AR, prior authSize: Mid-market to enterprise
AGS Health covers the middle and back end of the cycle, including coding, claims, accounts receivable, denials, prior authorization, provider enrollment and credentialing, and clinical documentation improvement, with an AI-assisted workflow. It names large clients including Banner Health and Baylor Scott & White, and it publishes its delivery footprint plainly, with a US headquarters in Washington DC and a delivery center in Chennai, India. Buying the back end alone rather than the whole cycle is often the right first outsourcing step, since it targets the work that is genuinely volume-driven.
Limitation: built for health systems, so a small practice is unlikely to be the right fit, and it names no SOC 2, ISO or HITRUST certification.
7. Access Healthcare
Best for: mid-market and enterprise buyers outsourcing high-volume back-end processing.
Pricing: Not publicly listedModel: Mid and back-end outsourcingCoverage: Claims, AR, denialsSize: 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 belongs on a shortlist where the problem is throughput on claims and accounts receivable rather than redesigning patient access, and where you want to keep the front end of your cycle in-house.
Limitation: partial cycle coverage with no pricing published, so the accountability boundary has to be drawn carefully in the statement of work.
8. GeBBS Healthcare Solutions
Best for: organizations whose main gap is coding capacity rather than the whole cycle.
Pricing: Not publicly listedModel: Coding-weighted outsourcingCoverage: Coding, AR, denialsSize: Mid-market to enterprise
GeBBS Healthcare Solutions is coding-weighted across the middle and back end, and states HIPAA safeguards alongside healthcare security controls. Where coding backlogs are the binding constraint, and where the alternative is recruiting credentialed coders into a tight market, a coding-led outsourcer is a more direct fix than a full RCM engagement. Ask specifically which specialties its coders hold credentials in.
Limitation: its site blocks automated retrieval, so its published claims could not be read from source for this list and should be confirmed directly.
9. Neolytix
Best for: solo and small practices that want most of the cycle handled at practice scale.
Pricing: Not publicly listedModel: Practice-scale outsourcingCoverage: Most of the cycleSize: Solo to mid-size groups
Neolytix covers most of the revenue cycle for smaller organizations, including billing, coding audit, credentialing and provider enrollment, licensing, and virtual assistants, and it 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. For a practice that wants outsourcing rather than staffing but cannot meet an enterprise engagement floor, this is the tier that will take the work.
Limitation: no published pricing, so comparing it on cost takes a quote, and minimums start at one full-time equivalent.
Should outsourcing fix capacity or performance in your revenue cycle?
Capacity is a staffing problem and performance is an outsourcing one, and staffing a broken process only runs it faster. Staffing the cycle costs a published hourly rate, keeps your systems and payer relationships, and leaves the outcome yours. It suits practices whose process works and whose problem is hands. The risk is that staffing a broken process just runs it faster.
Full outsourcing hands over the function, the technology, and the accountability, usually as a percentage of collections. It suits organizations whose revenue cycle genuinely underperforms and who want someone answerable under a service level agreement. The costs are real: percentage pricing rises with your revenue forever, your data lives in their platform, and exit is a project rather than a decision.
There is a middle route most buyers overlook, which is outsourcing one stage rather than the cycle. Coding, prior authorization, or accounts receivable follow-up can each go out on their own, which contains the risk and tests the vendor on a scope you can measure. Several firms here sell exactly that. Start with the stage where your metrics are worst, and expand only once the numbers move.
What happens to an outsourcing percentage as collections grow?
It keeps rising long after the work stops scaling with it, which is the first of the contract risks here.
- Percentage-of-collections pricing that keeps rising as you grow, long after the work stops scaling with it.
- Service levels written around activity, such as claims touched, rather than outcomes like days in AR and net collection rate.
- Data held in the vendor's platform, which makes transition costs the real switching barrier.
- Accountability gaps where the vendor owns the back end and blames the front end, or the reverse.
- Coding decisions made offshore without visible credentials, which is a compliance exposure rather than a saving.
- Engagement floors that quietly make a small group the least important client in the portfolio.
- Auto-renewal and long notice periods that turn a disappointing year into a three-year commitment.
- Implementation cost and internal effort, which are routinely understated at the point of sale.
- Patient-facing collections handled in your name by people you never hear, which becomes your reputation.
How many RCM outsourcing firms publish a rate at all?
One of nine, which is the single most useful fact about this market. Honest Taskers publishes $10.00 to $12.65 an hour for staffing. Everyone else quotes on request, and the two common structures are a percentage of net collections or a per-transaction fee, with implementation and technology charges layered on top.
To compare the models, convert everything to cost per dollar collected across a full year. A percentage of collections looks cheap when volume is low and becomes the largest line in the practice once revenue climbs, because the fee grows with your success and the vendor's cost of serving you doesn't. Hourly staffing behaves in reverse and is cheapest at scale, but it comes with no accountability for the result. Whichever way you go, ask for the baseline the vendor will be measured against and get it written down before signing, because a service level agreement with no agreed starting point cannot be enforced. Rates and models move, so confirm before you buy.
Which service levels should outsourcing be measured on?
Days in AR, clean claim rate, denial rate and net collection rate against an agreed baseline, rather than activity counts like claims touched.
- A written scope naming every cycle stage the vendor owns and every stage you keep.
- Service levels tied to days in AR, clean claim rate, denial rate, and net collection rate, with an agreed baseline.
- The pricing model modelled at your current volume and at twice it.
- Whether your data stays exportable, and in what format, at any point in the contract.
- Where the work is performed, and which credentials the people doing coding hold.
- A signed BAA and the specific safeguards behind it rather than a HIPAA logo.
- Named references at your size and in your specialty, not the vendor's largest client.
- Notice period, exit assistance, and what transition help costs.
- Who talks to your patients about money, and in whose name.
What are your days in AR before outsourcing anything?
Measure that alongside clean claim rate, denial rate and net collection rate, because it is both your baseline and your negotiating position.
- Measure your current days in AR, clean claim rate, denial rate, and net collection rate. This is your baseline and your negotiating position.
- Decide whether the problem is capacity or performance, because that answer picks staffing or outsourcing for you.
- Shortlist by best-fit size before anything else, so you don't run a process with vendors who won't take the work.
- Ask each firm to price at your volume and at double it.
- Get the scope boundary in writing, stage by stage.
- Check where the work happens and what credentials the coders hold.
- Negotiate exit terms and data portability while you still have room to negotiate.
- Pilot one cycle stage where you can measure the result within 90 days.
- Review against your baseline at 90 days and again at a year.
Methodology and sources
We verified each company at its own website on August 21, 2026, recording cycle coverage, whether performance accountability is contracted, pricing model, stated best-fit organization size, and stated HIPAA posture. Business associate requirements come from the U.S. Department of Health and Human Services. Pricing in this category is almost never published, so "not publicly listed" is the accurate answer rather than an omission, and any figure a company reports about itself is labeled company-reported. GeBBS Healthcare Solutions blocks automated retrieval, so its entry rests on what it states in materials we could reach and should be confirmed directly. Conifer Health was reviewed and left out because nothing could be verified from source at the time of writing.
Related billing and coding guides
If staffing rather than outsourcing is the likely answer, our virtual medical billing page sets out what a placed biller owns.
If coding capacity is the binding constraint, our virtual medical coder page covers credentials and scope.
Speak with Honest Taskers about staffing your revenue cycle.