According to the Pennsylvania Insurance Department’s 2024 report, over 2.02 million insurance claims were denied out of 14.9 million filed. This places the state’s denial rate at 13.6%, which is 4% above the national average. The financial implications are significant because denied claims can delay revenue by 30 to 90 days. This, in turn, increases re-billing costs by up to 18% and leads to an average annual loss of $100,000 to $300,000 for mid-sized practices.
In such complicated circumstances, the most intelligent decision a Pennsylvania-based provider can make is to focus on patient care and outsource medical billing services. The following top 10 medical billing companies in Pennsylvania for 2025 have been carefully selected based on their track record in reducing claim denials and delivering consistent financial results.
Top 10 Medical Billing Companies in Pennsylvania
The following is the list of the top 10 medical billing companies in Pennsylvania in 2025:
1. Transcure
2. Medwave Billing and Credentialing
3. Nextus Billing Solutions
4. Alpha Billing Solutions, LLC
5. AK Medical Billing Services
6. TJ Billing
7. CBS Medical Billing
8. Medheave
9. Medical Billing and Coding Solutions
10. Mediclaim Inc
Let’s explore these best medical billing companies in Pennsylvania one by one and find out how they can help achieve your practice’s financial goals in 2025.
1. Transcure
Transcure is not currently based in Pennsylvania, but has become a trusted medical billing partner with its 12 years of experience in the industry. The company operates from two central locations: Farmers Branch, Texas, and Woodbridge, New Jersey. Furthermore, Transcure is becoming a prominent name in the medical billing space by expanding its services to all the U.S. states and dealing with medical practices of all types and sizes.
Transcure offers a comprehensive suite of medical billing services that includes patient eligibility verification, medical coding, electronic claim submission, denial management, and payment posting. The company becomes your most reasonable choice for your practice’s medical billing needs in Pennsylvania, with 24/7 customer support that matches your time zone. Furthermore, Transcure’s in-house advanced billing tools, like RPA, which automates your billing, and the Trans Capture App for capturing charges, make billing seamless and hassle-free.
Key Differentiators:
- 1100+ Trained small practices Medical Billers and Coders
- ICD-10, CPT, HCPCS Proficiency
- Expertise in 40+ small practices software & EHRs
- Smooth Billing Software Transition & Integration in Workflows
- HIPAA Compliant & ISO27001 Certified Medical Billing Company
- Accounts Receivable Recovery within Just 24 Days
- Reduces Your Expenses by 25%
- Daily, Weekly, & Monthly Claim Status Reporting
2. Nextus Billing and Credentialing
Nextus Billing Solutions is a prominent name among the best medical billing companies in Pennsylvania. Established in 2015, the company works from two main locations: Philadelphia, PA, and Boca Raton, FL. Its dedicated focus is on behavioral health practices for billing and practice management services, and currently operates a staff of 51-200 individuals.
Another unique focus of Nextus Billing Solutions is its technological innovation with products like Cereus. This exclusive software is intelligent, interprets years of data, and forecasts insurance payments while eliminating traditional guesswork. With this technology, you can make informed, data-driven decisions, allowing your business to achieve better financial success.
Key Differentiators:
- HIPAA-compliant Solutions
- Comprehensive RCM services
- 10+ Years of Billing Experience
- 99% first-pass claim approval rate
- Cereus-powered data analytics and reporting
3. Medwave Billing and Credentialing
Medwave Billing and Credentialing Company is another important name in our list of medical billing companies in Pennsylvania. The company was founded in 2000 and is located in Cranberry Township, PA. Furthermore, the current staff ranges from 11 to 50 people. These are qualified individuals in medical billing and credentialing for practices of multiple types and sizes.
Medwave caters to 21 medical specialties, and a few prominent ones are skilled nursing facilities, genetic testing, and sleep study labs. The company has been using advanced billing software, including HL7 integration and robotic process automation. HL7 allows easy integration of data across multiple interfaces, and with robotic process automation, patient data can be retrieved easily from electronic health records and claim status tracking.
Key Differentiators:
- 25 years in the medical billing industry
- 21+ medical specialties
- Credentialing and billing experts in PA
- HIPAA-compliant processes
- Future-oriented technology-driven billing expertise
4. Alpha Billing Solutions, LLC
Based in the Pittsburgh area, Alpha Billing Solutions is a medical billing company with 16 years of experience in the healthcare industry. The company specializes in medical billing services for mental healthcare providers and also provides credentialing and consulting services to mental health professionals.
Alpha Billing Solutions stands out because of its transparent pricing. Their website clearly shows they charge $190 per insurance payer for provider credentialing. Furthermore, their consulting fee is $460 per hour. There’s also an initial registration fee of $200 for solo practices and $300 for group practices. Afterwards, a small percentage of the monthly income will be charged.
Key Differentiators:
- Full suite of medical billing services
- Verified review with 5-star ratings
- More than a decade of billing expertise
- Transparent pricing with no hidden charges
- Dedicated accounts manager facility
5. AK Medical Billing Services
The company was founded and run by Kurt and Andrea Tesche, a husband-and-wife team currently located in Leechburg, Pennsylvania. Both utilized their medical billing experience and developed custom-made billing services for practices of different types and sizes.
AK Medical Billing Solutions offers primary medical billing services, including patient eligibility verification, claim submission, denial management, payment posting, AR recovery, and credentialing. A review of the testimonials on their page shows that they specialize in behavioral health, psychiatric, and mental health practices.
Key Differentiators:
- Part of Goodfirms’ top 20 medical billing companies in Pennsylvania
- Tailor-made billing services
- Quick turnaround
- Maximum collection potential
- Market competitive pricing
6. TJ Billing
TJ Billing is a woman-owned medical billing company in Pennsylvania. The company has been in the U.S. medical billing space for more than 15 years. Furthermore, TJ Billing specializes in chiropractic, physical therapy, and podiatry and has its headquarters in Lafayette Hill, PA. They have a small but dedicated and certified team of coders, delivering timely results.
The company uses cloud-based systems, medical billing tools, and practice management software to submit and process claims accurately. Furthermore, TJ Billing follows the latest industry guidelines and federal/state laws.
Key Differentiators:
- Specialty-focused billing solutions
- HIPAA-complaint operations
- Technologically advanced systems
- More than a decade of billing experience
- Detailed financial status reporting
7. CBS Medical Billing
Under the leadership of founder Erin Cammarata, the company embodies the proper American work ethic and values in the medical billing domain. Its professional billers and coders operate from offices in Exeter and Portsmouth, NH, but they offer billing services in more than 25 states, including Pennsylvania.
CBS Medical Billing and Consulting is a professional resource that can handle the medical billing needs of your practice, of any type and size. The company offers medical billing, revenue cycle management, and practice management support. Primary billing services include compliance audits, claims remittance, and detailed reporting.
Key Differentiators:
- Specialization in Orthotics & Prosthetics (O&P)
- 99% Audit Pass Rate
- U.S.-Based Certified Team
- Comprehensive Practice Management Support
- Transparent and Competitive Pricing
8. Medheave
Medheave Healthcare Services LLC is a healthcare IT company that provides practices with dedicated practice management services and revenue cycle management. The company has been around for more than a decade and has positive reviews from its clients on the internet. It has been operating professionally by ensuring compliance with the new guidelines, like HIPAA 5010, and ICD-10 codes.
Medheave offers tailor-made medical billing services in Pennsylvania to practices of all types and sizes. Primary services are billing, coding, prior authorization, virtual medical assistant, credentialing, and denial management services. Furthermore, the company operates across all central U.S. states and offers custom solutions for all medical specialties, including mental health, podiatry, internal medicine, and family practice.
Key Differentiators:
- Customized Reporting & Analytics
- Expert Data Scientists
- Comprehensive RCM Services
- Advanced Technology Integration
- High First Submission Pass Rate
9. Medical Billing and Coding Solutions
Another excellent name on the list of top medical billing companies in Pennsylvania in 2025 is Medical Billing and Coding Solutions, founded in 2004 and located in Bala Cynwyd, PA. The company is familiar with the medical billing challenges in Pennsylvania, such as extensive billing paperwork, high regulatory compliance costs, errors in codes, and poor documentation.
The Medical Billing and Coding Solutions company offers comprehensive medical billing services for hospitals and other healthcare units. It supports its clients from the initial setup to ongoing support. The company firmly believes that you need to get paid faster, and it is only possible by simplifying the billing process with coding accuracy. Their medical billing services include organized charge entry, billing, collections, payment posting, faster claim submission, and financial statements and reports.
Key Differentiators:
- Comprehensive Billing Services
- Streamlined Electronic Invoicing
- Customized Billing Processes
- Experienced Team
- Real-Time Financial Monitoring
10. Mediclaim, Inc.
Mediclaim is the only name on the list of medical billing companies in Pennsylvania that has been working for the longest time in the medical billing industry, with more than 30 years of service. They are located in Philadelphia and are experts in medical billing services such as charge entry, payment posting, denial correction, resubmission, secondary billing, tertiary billing, patient billing, and telephone support for patients.
The company can help your practice with medical billing for specialties such as podiatrists, allergists, neurologists, gastroenterologists, pediatrics, and pain management. The company also claims to have generated 485 million dollars for its clients since 1990. Furthermore, Mediclaim promises advantages for your organization, including enhanced control, higher revenues, improved safety, compliance with changing regulations, reducing coding errors, and excellent patient satisfaction support around the clock.
Key Differentiators:
- Over 30 Years of Experience
- Comprehensive Billing Services
- Specialization in Multiple Specialties
- Significant Revenue Generation
- Personalized Service Approach
Conclusion
With Pennsylvania’s denial rate for claims far higher than the rest of the country, outsourcing to the appropriate medical billing company is a wise decision. The companies listed here excel in 2025 at lowering denials, simplifying revenue cycle management, and achieving quantifiable gains in cash flow. Whether you’re a solo mental health clinic or a multi-specialty healthcare organization, working with one of these leading medical billing companies in Pennsylvania can enable you to remain patient-centered while becoming more financially secure.
