Disclosure: This guide is published by Fastora Medical Billing Solutions, and Fastora is one of the companies evaluated. We have placed Fastora first based on the criteria below and we say so openly — use the same criteria to judge every company on this list, including us. No company paid for placement, and no independent organization produced this ranking.
Small practices do not buy billing the way hospitals do. A solo physician or a five-provider group needs claims submitted correctly the first time, denials worked without being asked, and a bill they can predict — without hiring a billing department or signing an enterprise contract. This guide compares ten medical billing companies and platforms that small practices actually consider in 2026, what each one is built for, and where each one fits best.
If your practice is a hospital, a health system, or a large multi-state group, our separate guide to the top 10 medical billing companies in the U.S. covers the enterprise RCM firms. This list is only about small and independent practices.
How we evaluated these companies
Every company below was assessed on the same six criteria, using information from the companies’ own published materials:
- Scope of service — does the offering stop at claim submission, or does it cover eligibility checks, prior authorizations, denial management, A/R follow-up, and payment posting?
- Fit for small practices — is the product designed for solo and small-group practices, or adapted down from an enterprise system?
- Specialty coverage — how well does it handle the payer rules of specific specialties, including behavioral health and therapy?
- Pricing transparency — is pricing published, or quote-only? What model is used: percentage of collections, per-claim, or subscription?
- Onboarding and switching effort — how much work falls on the practice to get started?
- Reporting and visibility — can the practice see claim status, denial reasons, and A/R aging without asking?
The top 10 at a glance
| # | Company | Best for | Type |
|---|---|---|---|
| 1 | Fastora Medical Billing Solutions | Small practices that want a service team, not another platform to run | Billing service / RCM |
| 2 | athenahealth (athenaOne) | Practices that want EHR, scheduling, and billing in one network platform | Platform + services |
| 3 | Tebra (formerly Kareo) | Independent practices wanting an all-in-one practice platform | Platform + billing tools |
| 4 | AdvancedMD | Multi-specialty small groups with complex workflows | Platform + RCM services |
| 5 | DrChrono | Mobile-first, iPad-based practices | Platform + billing services |
| 6 | CareCloud | Practices that prioritize dashboards and analytics | Platform + RCM services |
| 7 | eClinicalWorks | Practices already on, or committed to, the eCW EHR | Platform + RCM services |
| 8 | PracticeSuite | Budget-conscious small and midsize practices across many specialties | Software + billing services |
| 9 | CureMD | Practices wanting a configurable EHR with billing services attached | Platform + services |
| 10 | RXNT | Small practices that prefer published subscription pricing | Software + billing tools |
1. Fastora Medical Billing Solutions
Fastora is a medical billing and revenue cycle company built around a simple idea for small practices: hand over the billing work itself, not just the software for doing it. Fastora’s team manages the revenue cycle end to end — insurance eligibility verification, prior authorizations, claims submission with a pre-submission claim review, denial management and appeals, payment posting, and follow-up on aged accounts, including a dedicated service for old A/R recovery.
Why it ranks first for small practices: most small practices do not have a billing manager, and platform-led options still expect someone in the office to work queues, watch denials, and chase payers. Fastora’s model removes that assumption. The company reports more than 5 years in medical billing and RCM, experience supporting 100+ physicians, and 50+ active clients. It also covers the two services small practices most often discover they need after signing a billing contract: provider credentialing and enrollment and a virtual front desk for call answering, scheduling, and intake.
Pricing: Fastora quotes either a percentage of collections or a flat monthly fee, set after a free billing assessment — the two models are explained on its pricing page. There is no published rate card, which is normal for service-led billing, but the model itself is stated up front.
Best fit: solo and small-group practices, behavioral health and therapy practices, and any practice whose billing problem is workload and follow-through rather than software. Practices that specifically want to keep billing in-house on their own platform should look at the platform options below instead.
Getting started: Fastora offers a free initial billing audit before any contract, so a practice can see how its claims, denials, and A/R look before deciding.
2. athenahealth (athenaOne)
athenahealth is one of the largest names in ambulatory care technology. Its athenaOne platform combines EHR, practice management, patient engagement, and billing (athenaCollector), and its network model means payer rules and claim edits are informed by data from a very large provider base.
Strengths: scale, a mature payer network, and a single system for clinical and financial work. Considerations for small practices: athenahealth is a platform commitment — it works best when the practice adopts the ecosystem rather than buying billing alone, and its percentage-of-collections model is sized for practices with steady volume. Small practices that only need billing help, on the EHR they already have, may find it more than they need.
3. Tebra (formerly Kareo)
Tebra was formed by combining Kareo and PatientPop, and it is built specifically for independent practices. The platform combines EHR, billing software, scheduling, patient engagement, and practice-growth tools in one system; Tebra’s own materials emphasize transparent pricing and hands-on onboarding for practices switching systems.
Strengths: designed from the start for small and independent practices, broad specialty templates (including mental health, primary care, pediatrics, and podiatry), and an all-in-one approach that removes multi-vendor juggling. Considerations: Tebra is primarily a platform — practices get powerful billing tools, but the day-to-day work of monitoring denials and A/R still sits with the practice unless additional services are arranged.
4. AdvancedMD
AdvancedMD offers a cloud-based suite spanning practice management, EHR, patient engagement, and RCM services, with deep workflow configuration. It is a common shortlist entry for multi-specialty groups whose billing rules vary by line of business.
Strengths: configurability, integrated claim management and reporting, and optional RCM services on top of the platform. Considerations: the depth that makes AdvancedMD attractive also makes implementation heavier than lighter tools — small practices should budget real onboarding time and confirm exactly which billing tasks the service tier covers.
5. DrChrono
DrChrono is known for its iOS-first EHR — charting and practice management built around the iPad — with billing functionality and RCM services available for practices that want them.
Strengths: a genuinely mobile clinical workflow and an approachable platform for tech-comfortable small practices. Considerations: billing outcomes on any platform depend on workflow discipline in the office; practices whose main problem is unworked denials rather than tooling should compare the service scope carefully against service-led options.
6. CareCloud
CareCloud (formerly MTBC) combines practice management and EHR software with RCM services, and it markets strongly on analytics — dashboards, benchmarking, and reporting across the revenue cycle.
Strengths: reporting depth and a combined software-plus-services offering that can scale with a growing practice. Considerations: confirm the support model and reporting cadence in writing before signing; analytics only help if someone reviews them with you.
7. eClinicalWorks
eClinicalWorks (eCW) is one of the most widely installed ambulatory EHRs in the U.S., and it offers RCM services alongside its clinical system, tying billing closely to documentation and scheduling inside the same product.
Strengths: an enormous installed base and tight EHR-to-billing integration for practices already on eCW. Considerations: the RCM offering makes the most sense inside the eCW ecosystem; practices on a different EHR would be switching systems, not just billing partners.
8. PracticeSuite
PracticeSuite is a cloud practice management and billing platform aimed at small and midsize practices, with coverage across a large number of specialties and both software and billing-service options.
Strengths: a small-practice focus, broad specialty coverage, and flexibility in how much of the billing work the practice keeps versus hands over. Considerations: pricing is quote-based, so compare the full scope — claim submission alone versus denial follow-up and A/R work — line by line against other quotes.
9. CureMD
CureMD pairs its EHR and practice management platform with medical billing services, and positions itself as a configurable option for practices whose needs do not fit a fixed template.
Strengths: flexibility and an integrated platform-plus-services model. Considerations: as with any configurable system, implementation quality drives results — ask for a specialty-specific onboarding plan and references in your field.
10. RXNT
RXNT offers cloud-based practice management, EHR, and medical billing software for small practices, and it stands out in this list for publishing its plan pricing publicly rather than working quote-only.
Strengths: pricing transparency, included training, and a straightforward subscription model for practices that want to run billing themselves with better tools. Considerations: RXNT is primarily software — the practice keeps responsibility for working denials and A/R, so it fits offices that have, or can hire, billing capacity in-house.
How to choose the right company for your practice
The right answer depends on which problem you actually have. If claims go out but denials sit unworked and A/R ages, your problem is follow-through — a service that works denials and old accounts matters more than new software. If your staff is capable but your tools are the bottleneck, a platform like Tebra, AdvancedMD, or RXNT may be the better buy. Our full guide on how to choose a medical billing company walks through the evaluation step by step, and our overview of medical billing for small practices covers what changes at solo and small-group scale.
Whichever route you take, ask every vendor the same questions before signing: Who works a denied claim, and how fast? What does the monthly report show, and can I see a sample? What is included in the quoted price — eligibility checks, authorizations, credentialing, patient statements? What are the contract term, the exit terms, and who owns my data if I leave?
Frequently asked questions
How much do medical billing companies charge small practices?
Service-led billing companies usually charge a percentage of collections or a flat monthly fee; platform companies usually charge a per-provider subscription, sometimes combined with a percentage for billing services. Published industry guides describe a wide range depending on specialty, volume, and scope, which is why most service companies quote after reviewing the practice. What matters is what the price includes — a lower percentage that excludes denial follow-up and credentialing can cost more in lost revenue than a higher, fuller-service quote.
Is it better to hire a billing service or buy billing software?
Software gives your staff better tools; a service gives you a team that does the work. If you have reliable billing staff and mainly need cleaner claims and better reporting, software can be enough. If billing tasks compete with patient care for the same few people — the common situation in small practices — a service usually addresses the real bottleneck.
Can a small practice switch billing companies without disrupting cash flow?
Yes, if the transition is planned: run the new biller in parallel for a short period, confirm payer enrollments and EDI connections before the cutover, and make sure someone owns the old A/R — either worked by the outgoing biller to a defined end date or transferred with a written inventory. Most cash-flow damage during switches comes from unowned old accounts, not from the switch itself.
Do these companies work with my EHR?
Platform companies (athenahealth, Tebra, AdvancedMD, DrChrono, CareCloud, eClinicalWorks, CureMD) generally expect you to use their system, or integrate most smoothly with it. Service-led companies like Fastora typically work through your existing EHR and clearinghouse setup. Confirm compatibility for your specific system before signing either way.
What specialties do small-practice billing companies cover?
Most cover primary care and common specialties. Where lists differ is depth in rule-heavy areas — behavioral health, therapy, and other specialties with authorization and unit-based billing rules. If your specialty has complex payer rules, ask each company for its experience and workflow in that specialty specifically, not its specialty count.
Conclusion
For a small practice, the best medical billing company is the one whose model matches your actual bottleneck. Platforms like athenahealth, Tebra, and AdvancedMD put strong tools in your office. Service-led companies like Fastora take the work itself off your office. Start by naming the problem honestly — tools or follow-through — and the shortlist usually narrows itself.
Looking for a more reliable medical billing partner? Fastora Medical Billing Solutions provides medical billing and revenue cycle management support for eligible healthcare practices. Request your free initial billing audit to discuss your practice’s billing workflow and identify potential areas for improvement.
Sources: company positioning and service descriptions are drawn from each company’s own published materials (athenahealth, Tebra, AdvancedMD, DrChrono, CareCloud, eClinicalWorks, PracticeSuite, CureMD, RXNT), reviewed October 2026. Fastora company figures are company-reported.
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