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U.S. Medical Billing Service Market - Industry Outlook & Forecast 2021-2026

November 2021 | 162 pages | ID: U4BB920E00D7EN
Arizton Advisory & Intelligence

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In-depth Analysis and Data-driven Insights on the Impact of COVID-19 Included in this US Medical Billing Services Market Report

The US medical billing services market was valued at USD 4.64 billion in 2020 and is expected to reach USD 8 billion by 2026, growing at a CAGR of 9.52% by 2026.

The following factors are going to contribute to the growth of the U.S. medical billing services market.
  • Introduction of Cloud-Based Medical Billing
  • Encouraging Automation in Medical Billing
  • Introduction of Telemedicine Billing
  • Increased Outsourcing of Medical Billing
  • Increasing Healthcare Consolidation
  • Shift Towards Value-based Medical Billing
MARKET OVERVIEW

The medical billing services are used to process, submit, and follow up on health insurance claims to save the staff time. The medical practices were introduced with the new pandemic realities in 2020, in which they had to adjust to the new billing and payment tracking updates. At the same time, the practices were forced to provide the treatments due to the country's shortage of resources as the number of COVID-19 cases surged in the industry. This caused the surge in demand in the medical billing market in the U.S.Medical billing company serves more than 65 EMS agencies with varied call volumes across New York and PA. For instance, MedEx established itself as a leader in Emergency Medical Service (EMS) billing.

KEY HIGHLIGHTS
  • Cloud-based solutions are revolutionizing the US medical billing industry.
  • There are many benefits of cloud-based billing services or medical billing software, such as improves efficiency, cost amortization, and easy access.
  • The evolving needs of the end-users in the industry are driving the demand for medical billing services.
  • The shift towards value-based solutions in the industry is driving healthcare companies to shift towards the latest medical billing techniques.
The study considers a detailed scenario of the present medical billing services market in the US and its market dynamics for the period 2021?2026. It covers a detailed overview of several market growth enablers, restraints, and trends. The report offers both the demand and supply aspects of the market. It profiles and examines leading companies and other prominent ones operating in the market.

U.S. MEDICAL BILLING SERVICES MARKET SEGMENTATION

This research report includes a detailed segmentation by
  • Service Type
  • End User
  • System Type
U.S. MEDICAL BILLING SERVICE MARKET SEGMENTS
  • In 2020, the light service medical billing segment accounted for 65.56% of the US medical billing service market. The light service companies majorly perform the work of reviewing rather than maintaining the entire process first-hand. They have skilled professionals in place to handle the billing process.
  • The open system is largely preferred, as they are accessible by the healthcare providers and can be shared with other third-party companies to process the cases file for claims. Many physician groups, many hospitals prefer using this as they usually outsource their medical billing process as it is more user-friendly.
  • Hospitals and healthcare systems are the biggest end users in the medical billing service market in the US. The evolving needs of the hospitals and health systems drive the constant demand.
Segmentation by Service Type
  • Light Service
  • Full Service
  • Boutique Service
Segmentation By System Type
  • Open
  • Closed
  • Isolated
Segmentation By End User
  • Hospital & Health Systems
  • Physician Groups
  • Home Healthcare Providers
  • Telemedicine Providers
  • Hospice Providers
VENDOR ANALYSIS
  • The key companies in the industry are Kareo, Athenahealth, Practice Fusion, CareCloud, and eClinicalWorks
  • Vendors are coming up with an integrated technology platform, a high-quality provider network, and sophisticated consumer engagement strategies.
  • The shift towards value-based solutions in the medical billing outsourcing market is driving healthcare companies to shift towards the latest medical billing techniques.
  • MedEx established itself as a leader in Emergency Medical Service billing (EMS billing).
KEY VENDORS
  • Kareo
  • Athenahealth
  • Practice Fusion
  • CareCloud
  • eClinicalWorks
OTHER PROMINENT VENDORS
  • 3D Solutions
  • 3Gen Consulting
  • 4D Global
  • 24/7 Medical Billing Services
  • ACP Billing Services
  • AdvancedMD
  • Alaska Billing Services
  • AdvantEdge Healthcare Solutions
  • Allegro Billing
  • AllMeds
  • A-Stat Medical Billing Management
  • Assist Practice Management Services
  • Bay Medical Billing Services
  • California Medical Billing Services
  • ChartLogic
  • Cigna
  • Creosen DBA Medclaims Billing Services
  • Cloud 9 Medical Solutions
  • Coronis Health
  • CureMD
  • DNA Billing
  • DrChrono
  • EHealthSource
  • GE Healthcare
  • Golden West Medical Billing
  • HealthQuist
  • HSCPPA
  • Index Billing
  • MBCT
  • Medmecs Billing Services
  • Medical Billers and Coders
  • MedEx
  • McKesson
  • NXGN Management
  • OMS Partners
  • Park Medical Billing
  • Physicians Management Network (PMN) Inc
  • Procure billing solutions
  • Physicians’ Professional Management Corporation
  • Preferred Billing Solutions
  • Promantra
  • PUREDI
  • Resolutions Billing & Consulting
  • Right Medical Billing
  • Superior Medical Management
  • Twin Peaks Medical Billing
  • TriMed Billing Services
  • Valletta Group
  • Vitruvian Medpro
  • Waystar
KEY QUESTIONS ANSWERED:

1. How big is the U.S. medical billing service market?
2. How many medical billing vendors are there in the US?
3. Who are the key players in the U.S. medical billing service market?
4. What market segments are covered in the medical billing service research report?
5. What is the impact of COVID-19 on the US medical billing service market?
6. Who is the leading Vendor in Emergency Medical Services (EMS) Billing market in the U.S.?
1 RESEARCH METHODOLOGY

2 RESEARCH OBJECTIVES

3 RESEARCH PROCESS

4 SCOPE & COVERAGE

4.1 Market Definition
  4.01.01 Inclusions
  4.01.02 Exclusions
  4.01.03 Market Estimation Caveats
4.2 Base Year
4.3 Scope Of The Study
  4.03.01 Market Segmentation By Service Type
  4.03.02 Market Segmentation By System Type
  4.03.03 Market Segmentation By End-User

5 REPORT ASSUMPTIONS & CAVEATS

5.1 Key Caveats
5.2 Currency Conversion
5.3 Market Derivation

6 MARKET AT A GLANCE

7 INTRODUCTION

7.1 Overview
  7.01.01 Impact Of Covid-19 On Medical Billing

8 MARKET OPPORTUNITIES & TRENDS

8.1 Introduction Of Cloud-Based Medical Billing
8.2 Encouraging Automation In Medical Billing
8.3 Introduction Of Telemedicine Billing

9 MARKET GROWTH ENABLERS

9.1 Increased Outsourcing Of Medical Billing
9.2 Increased Healthcare Consolidation
9.3 Shift To Value-Based Medical Billing

10 MARKET RESTRAINTS

10.1 Rising Prevalence Of Medical Billing Errors
10.2 Change In Government Compliance & Shift To Value-Based Reimbursement
10.3 Lack Of Medical Billing Transparency

11 MARKET LANDSCAPE

11.1 Market Overview
11.2 Market Size & Forecast
11.3 Five Forces Analysis
  11.03.01 Threat Of New Entrants
  11.03.02 Bargaining Power Of Suppliers
  11.03.03 Bargaining Power Of Buyers
  11.03.04 Threat Of Substitutes
  11.03.05 Competitive Rivalry

12 SERVICE

12.1 Market Snapshot & Growth Engine
12.2 Market Overview
12.3 Light Service
  12.03.01 Market Overview
  12.03.02 Market Size & Forecast
12.4 Full Service
  12.04.01 Market Overview
  12.04.02 Market Size & Forecast
12.5 Boutique Service
  12.05.01 Market Overview
  12.05.02 Market Size & Forecast

13 SYSTEM

13.1 Market Snapshot & Growth Engine
13.2 Market Overview
13.3 Open System
  13.03.01 Market Overview
  13.03.02 Market Size & Forecast
13.4 Closed System
  13.04.01 Market Overview
  13.04.02 Market Size & Forecast
13.5 Isolated System
  13.05.01 Market Overview
  13.05.02 Market Size & Forecast

14 END-USER

14.1 Market Snapshot & Growth Engine
14.2 Market Overview
14.3 Hospital & Health Systems
  14.03.01 Market Overview
  14.03.02 Market Size & Forecast
14.4 Physician Groups
  14.04.01 Market Overview
  14.04.02 Market Size & Forecast
14.5 Home Health Providers
  14.05.01 Market Overview
  14.05.02 Market Size & Forecast
14.6 Telemedicine Providers
  14.06.01 Market Overview
  14.06.02 Market Size & Forecast
14.7 Hospice Providers
  14.07.01 Market Overview
  14.07.02 Market Size & Forecast
14.8 OTHERS
  14.08.01 Market Overview
  14.08.02 Market Size & Forecast

15 COMPETITIVE LANDSCAPE

15.1 Competition Overview
15.2 Market Share Analysis
  15.02.01 Kareo
  15.02.02 athenahealth
  15.02.03 Practice Fusion
  15.02.04 CareCloud
  15.02.05 eClinicalWorks

16 KEY COMPANY PROFILES

16.1 KAREO
  16.01.01 Business Overview
  16.01.02 Product Offerings
  16.01.03 Key Strategies
  16.01.04 Key Strengths
  16.01.05 Key Opportunities
16.2 ATHENAHEALTH
  16.02.01 Business Overview
  16.02.02 Product Offerings
  16.02.03 Key Strategies
  16.02.04 Key Strengths
  16.02.05 Key Opportunities
16.3 PRACTICE FUSION
  16.03.01 Business Overview
  16.03.02 Product Offerings
  16.03.03 Key Strategies
  16.03.04 Key Strengths
  16.03.05 Key Opportunities
16.4 CARECLOUD
  16.04.01 Business Overview
  16.04.02 Product Offerings
  16.04.03 Key Strategies
  16.04.04 Key Strengths
  16.04.05 Key Opportunities
16.5 ECLINICALWORKS
  16.05.01 Business Overview
  16.05.02 Product Offerings
  16.05.03 Key Strategies
  16.05.04 Key Strengths
  16.05.05 Key Opportunities

17 OTHER PROMINENT VENDORS

17.1 3D SOLUTIONS
  17.01.01 Business Overview
  17.01.02 Product Offerings
17.2 3GEN CONSULTING
  17.02.01 Business Overview
  17.02.02 Product Offerings
17.3 4D GLOBAL
  17.03.01 Business Overview
  17.03.02 Product Offerings
17.4 24/7 MEDICAL BILLING SERVICES
  17.04.01 Business Overview
  17.04.02 Product Offerings
17.5 ACP BILLING SERVICES
  17.05.01 Business Overview
  17.05.02 Product Offerings
17.6 ADVANCEDMD
  17.06.01 Business Overview
  17.06.02 Product Offerings
17.7 ADVANTEDGE HEALTHCARE SOLUTIONS
  17.07.01 Business Overview
  17.07.02 Product Offerings
17.8 ALASKA BILLING SERVICES
  17.08.01 Business Overview
  17.08.02 Product Offerings
17.9 ALLEGRO BILLING
  17.09.01 Business Overview
  17.09.02 Product Offerings
17.10 ALLMEDS
  17.10.01 Business Overview
  17.10.02 Product Offerings
17.11 A-STAT MEDICAL BILLING MANAGEMENT
  17.11.01 Business Overview
  17.11.02 Product Offerings
17.12 ASSIST PRACTICE MANAGEMENT SERVICES
  17.12.01 Business Overview
  17.12.02 Product Offerings
17.13 BAY MEDICAL BILLING SERVICES
  17.13.01 Business Overview
  17.13.02 Product Offerings
17.14 CALIFORNIA MEDICAL BILLING
  17.14.01 Business Overview
  17.14.02 Product Offerings
17.15 CHARTLOGIC
  17.15.01 Business Overview
  17.15.02 Product Offerings
17.16 CIGNA
  17.16.01 Business Overview
  17.16.02 Product Offerings
17.17 CREOSEN DBA MEDCLAIMS BILLING SERVICES
  17.17.01 Business Overview
  17.17.02 Product Offerings
17.18 CLOUD 9 MEDICAL SOLUTIONS
  17.18.01 Business Overview
  17.18.02 Product Offerings
17.19 CORONIS HEALTH
  17.19.01 Business Overview
  17.19.02 Product Offerings
17.20 CUREMD
  17.20.01 Business Overview
  17.20.02 Product Offerings
17.21 DNA BILLING
  17.21.01 Business Overview
  17.21.02 Product Offerings
17.22 DRCHRONO
  17.22.01 Business Overview
  17.22.02 Product Offerings
17.23 EHEALTHSOURCE
  17.23.01 Business Overview
  17.23.02 Product Offerings
17.24 GENERAL ELECTRIC
  17.24.01 Business Overview
  17.24.02 Product Offerings
17.25 GOLDEN WEST MEDICAL BILLING
  17.25.01 Business Overview
  17.25.02 Product Offerings
17.26 HEALTHQUIST
  17.26.01 Business Overview
  17.26.02 Product Offerings
17.27 HSCCPA
  17.27.01 Business Overview
  17.27.02 Product Offerings
17.28 INDEX BILLING
  17.28.01 Business Overview
  17.28.02 Product Offerings
17.29 MBCT
  17.29.01 Business Overview
  17.29.02 Product Offerings
17.30 MEDMECS BILLING SERVICES
  17.30.01 Business Overview
  17.30.02 Product Offerings
17.31 MEDICAL BILLERS AND CODERS
  17.31.01 Business Overview
  17.31.02 Product Offerings
17.32 MEDEX MEDICAL BILLING
  17.32.01 Business Overview
  17.32.02 Product Offerings
17.33 MCKESSON
  17.33.01 Business Overview
  17.33.02 Product Offerings
17.34 NXGN MANAGEMENT LLC
  17.34.01 Business Overview
  17.34.02 Product Offerings
17.35 OMS PARTNERS
  17.35.01 Business Overview
  17.35.02 Product Offerings
17.36 PARK MEDICAL BILLING
  17.36.01 Business Overview
  17.36.02 Product Offerings
17.37 PMN
  17.37.01 Business Overview
  17.37.02 Product Offerings
17.38 PROCURE BILLING SOLUTIONS
  17.38.01 Business Overview
  17.38.02 Product Offerings
17.39 PHYSICIANS’ PROFESSIONAL MANAGEMENT CORPORATION
  17.39.01 Business Overview
  17.39.02 Product Offerings
17.40 PREFERRED BILLING SOLUTIONS
  17.40.01 Business Overview
  17.40.02 Product Offerings
17.41 PROMANTRA
  17.41.01 Business Overview
  17.41.02 Product Offerings
17.42 PUREDI
  17.42.01 Business Overview
  17.42.02 Product Offerings
17.43 RESOLUTIONS BILLING & CONSULTING
  17.43.01 Business Overview
  17.43.02 Product Offerings
17.44 RIGHT MEDICAL BILLING
  17.44.01 Business Overview
  17.44.02 Product Offerings
17.45 SUPERIOR MEDICAL MANAGEMENT
  17.45.01 Business Overview
  17.45.02 Product Offerings
17.46 TWIN PEAKS MEDICAL BILLING
  17.46.01 Business Overview
  17.46.02 Product Offerings
17.47 TRIMED BILLING SERVICES
  17.47.01 Business Overview
  17.47.02 Product Offerings
17.48 VALLETTA GROUP
  17.48.01 Business Overview
  17.48.02 Product Offerings
17.49 VITRUVIAN MEDPRO
  17.49.01 Business Overview
  17.49.02 Product Offerings
17.50 WAYSTAR
  17.50.01 Business Overview
  17.50.02 Product Offerings

18 REPORT SUMMARY

18.1 Key Takeaways
18.2 Strategic Recommendations

19 QUANTITATIVE SUMMARY

19.1 Market By Service Type
19.2 Market By System Type
19.3 Market By End-User

20 APPENDIX

20.1 Abbreviations

LIST OF EXHIBITS

Exhibit 1 Segmentation of US Medical Billing Service Market
Exhibit 2 Market Size Calculation Approach 2020
Exhibit 3 Medical Billing Process
Exhibit 4 Impact of Introduction of Cloud-Based Medical Billing
Exhibit 5 Impact of Encouraging Automation in Medical Billing
Exhibit 6 Impact of Introduction of Telemedicine Billing
Exhibit 7 Usage of Telemedicine Prior and Following COVID-19 Pandemic
Exhibit 8 Impact of Increased Outsourcing of Medical Billing
Exhibit 9 Impact of Increased Healthcare Consolidation
Exhibit 10 Share of Physicians Affiliated with Healthcare Systems
Exhibit 11 Impact of Shift to Value-based Medical Billing
Exhibit 12 Shift to Alternative Payment Methodologies in US Healthcare Landscape
Exhibit 13 Impact of Rising Prevalence of Medical Billing Errors
Exhibit 14 Statistics of Medical Billing Errors in US
Exhibit 15 Challenges in Medical Fillings
Exhibit 16 Impact of Change in Government Compliance & Shift to Value-based Reimbursement
Exhibit 17 Impact of Lack of Medical Billing Transparency
Exhibit 18 US Medical Billing Service Market 2020–2026 ($ billion)
Exhibit 19 US Medical Billing Service Market by Service Type
Exhibit 20 US Medical Billing Service Market by System Type
Exhibit 21 US Medical Billing Service Market by End-User
Exhibit 22 Five Forces Analysis 2020
Exhibit 23 Incremental Growth by Service 2020 & 2026
Exhibit 24 US Medical Billing Service Market by Service
Exhibit 25 US Medical Billing Service Market by Service Type: Incremental Growth
Exhibit 26 US Medical Billing Service Market by Service Type: Absolute Growth
Exhibit 27 US Medical Billing Light Service Market: Incremental & Absolute Growth
Exhibit 28 US Medical Billing Light Service Market 2020–2026 ($ billion)
Exhibit 29 US Medical Billing Full Service Market: Incremental & Absolute Growth
Exhibit 30 US Medical Billing Full Service Market 2020–2026 ($ billion)
Exhibit 31 US Medical Billing Boutique Service Market: Incremental & Absolute Growth
Exhibit 32 US Medical Billing Boutique Service Market 2020–2026 ($ billion)
Exhibit 33 Incremental Growth by System 2020 & 2026
Exhibit 34 US Medical Billing Service Market by System
Exhibit 35 US Medical Billing Service Market by System Type: Incremental Growth
Exhibit 36 US Medical Billing Market Service by System Type: Absolute Growth
Exhibit 37 US Open Medical Billing Service Market 2020–2026 ($ billion)
Exhibit 38 US Open Medical Billing Service Market: Incremental & Absolute Growth
Exhibit 39 US Closed Medical Billing Service Market: Incremental & Absolute Growth
Exhibit 40 US Closed Medical Billing Service Market 2020–2026 ($ billion)
Exhibit 41 US Isolated Medical Billing Service Market 2020–2026 ($ billion)
Exhibit 42 US Isolated Medical Billing Service Market: Incremental & Absolute Growth
Exhibit 43 Incremental Growth by End-user 2020 & 2026
Exhibit 44 US Medical Billing Service Market by End-User
Exhibit 45 US Medical Billing Service Market by End-User: Incremental Growth
Exhibit 46 US Medical Billing Service Market by End-User: Absolute Growth
Exhibit 47 US Medical Billing Hospital & Health Systems Market: Incremental & Absolute Growth
Exhibit 48 US Medical Billing Hospital & Health Systems Market 2020–2026 ($ billion)
Exhibit 49 US Physician Groups Medical Billing Market: Incremental & Absolute Growth
Exhibit 50 US Physician Groups Medical Billing Service Market 2020–2026 ($ billion)
Exhibit 51 US Home Health Providers Medical Billing Market: Incremental & Absolute Growth
Exhibit 52 US Home Health Providers Medical Billing Market 2020–2026 ($ billion)
Exhibit 53 US Telemedicine Providers Medical Billing Service Market: Incremental & Absolute Growth
Exhibit 54 US Telemedicine Providers Medical Billing Service Market 2020–2026 ($ billion)
Exhibit 55 US Hospice Providers Medical Billing Market: Incremental & Absolute Growth
Exhibit 56 US Hospice Providers Medical Billing Service Market 2020–2026 ($ billion)
Exhibit 57 US Other Medical Billing Service Market: Incremental & Absolute Growth
Exhibit 58 US Other Medical Billing Service Market 2020–2026 ($ billion)
Exhibit 59 CareCloud Revenue 2018 to 2020 ($ million)

LIST OF TABLES

Table 1 Key Caveats
Table 2 Currency Conversion 2013?2020
Table 3 Popular Companies Offering Cloud-Based Medical Billing Platforms
Table 4 Services Provided by Different Types of Medical Billing Companies
Table 5 Competitive Structure Analysis of Medical Billing Market in US
Table 6 Kareo: Major Product Offerings
Table 7 athenahealth: Major Product Offerings
Table 8 Practice Fusion: Major Product Offerings
Table 9 CareCloud: Major Product Offerings
Table 10 eClinicalWorks: Major Product Offerings
Table 11 3D Solutions: Major Product Offerings
Table 12 3Gen Consulting: Major Product Offerings
Table 13 4D Global: Major Product Offerings
Table 14 24/7 Medical Billing Services: Major Product Offerings
Table 15 ACP Billing Services: Major Product Offerings
Table 16 AdvancedMD: Major Product Offerings
Table 17 AdvantEdge Healthcare Solutions: Major Product Offerings
Table 18 Alaska Billing Services: Major Product Offerings
Table 19 Allegro Billing: Major Product Offerings
Table 20 AllMeds: Major Product Offerings
Table 21 A-Stat Medical Billing Management: Major Product Offerings
Table 22 Assist Practice Management Services: Major Product Offerings
Table 23 Bay Medical Billing Services: Major Product Offerings
Table 24 California Medical Billing Services: Major Product Offerings
Table 25 ChartLogic: Major Product Offerings
Table 26 Cigna: Major Product Offerings
Table 27 Creosen DBA Medclaims Billing Services: Major Product Offerings
Table 28 Cloud 9 Medical Solutions: Major Product Offerings
Table 29 Coronis Health: Major Product Offerings
Table 30 CureMD: Major Product Offerings
Table 31 DNA Billing: Major Product Offerings
Table 32 DrChrono: Major Product Offerings
Table 33 EHealthSource: Major Product Offerings
Table 34 General Electric: Major Product Offerings
Table 35 Golden West Medical Billing: Major Product Offerings
Table 36 HealthQuist: Major Product Offerings
Table 37 HSCPPA: Major Product Offerings
Table 38 Index Billing: Major Product Offerings
Table 39 MBCT: Major Product Offerings
Table 40 Medmecs Billing Services: Major Product Offerings
Table 41 Medical Billers and Coders: Major Product Offerings
Table 42 MedEx Medical Billing: Major Product Offerings
Table 43 McKesson: Major Product Offerings
Table 44 NXGN Management: Major Product Offerings
Table 45 OMS Partners: Major Product Offerings
Table 46 Park Medical Billing: Major Product Offerings
Table 47 PMN: Major Product Offerings
Table 48 Procure Billing Solutions: Major Product Offerings
Table 49 Physicians’ Professional Management Corporation: Major Product Offerings
Table 50 Preferred Billing Solutions: Major Product Offerings
Table 51 Promantra: Major Product Offerings
Table 52 PUREDI: Major Product Offerings
Table 53 Resolutions Billing & Consulting: Major Product Offerings
Table 54 Right Medical Billing: Major Product Offerings
Table 55 Superior Medical Management: Major Product Offerings
Table 56 Twin Peaks Medical Billing: Major Product Offerings
Table 57 TriMed Billing Services: Major Product Offerings
Table 58 Valletta Group: Major Product Offerings
Table 59 Vitruvian Medpro: Major Product Offerings
Table 60 Waystar: Major Product Offerings
Table 61 US Medical Billing Service Market by Service Type 2020?2026 ($ billion)
Table 62 US Medical Billing Service Market by Service Type 2020?2026 (%)
Table 63 US Medical Billing Service Market by System Type 2020?2026 ($ billion)
Table 64 US Medical Billing Service Market by System Type 2020?2026 (%)
Table 65 US Medical Billing Service Market by End-User 2020?2026 ($ billion)
Table 66 US Medical Billing Service Market by End-User 2020?2026 (%)


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