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| Company | Tier | ICP | ★ | Scale / Headcount | Backing | Conf. | Notes |
|---|---|---|---|---|---|---|---|
| Clarity RCM Acq Target | S1 | Derm | ★★★ | 200+ practices $1B+ managed |
Bootstrapped | Med | #1 SERP derm billing. Derm-only since 2017. ClarityOS AI layer building. PRIMARY THREAT. |
| Inga Ellzey Acq Target | S1 | Derm | ★★★ | 325+ providers 85 practices · 32 states |
Founder-owned | Med | Derm-only since 1978. ACQUISITION TARGET — Inga Ellzey = named target. Watch job postings + revenue signals. |
| PGM Billing Acq Target | S1 | Derm | ★★★ | — | Private | Low | Founded 1981. Nationwide derm leader. Long-tenured client relationships. |
| ADSC / ADS RCM Acq Target | S1 | Derm | ★★★ | — | Private | Low | Founded 1977. MedicsPremier platform — oldest derm-specific billing system in the market. |
| DermatologyBilling365 Acq Target | S1 | Derm | ★★★ | — | Private | Low | Derm-only, Mohs focus. Strong AEO citation presence — appears in top-10 Perplexity sources for derm billing queries. Traditional organic footprint is low (DFS: 20 kw, 3 ETV May '26) — visibility is AI-citation-driven, not rank-driven. Monitor AEO, not SERP position. |
| Derm Care Billing Consultants | S1 | Derm | ★★★ | — | Private | Low | NYC. AMBA-certified derm coders. |
| Dermatology RCM LLC Acq Target | S1 | Derm | ★★★ | — | Private | Low | Medium-to-large practice focus. |
| Miami RCM Acq Target | S1 | Derm | ★★★ | — | Private | Low | FL-based, Mohs focus. |
| AnnexMed | S1 | Derm | ★★ | ~977 employees | Bootstrapped | Med | 7 locations, offshore delivery (India). Derm primary + multi-specialty. |
| Practolytics | S1 | Derm | ★★ | 1,400+ providers 5M+ claims/yr · 31 states |
Private | Med | Active derm vertical marketing. |
| MBW RCM | S1 | Derm | ★★ | 500+ employees | Private | Med | Aggressive derm marketing. BPO-of-BPOs model. |
| MedCare MSO | S1 | Derm | ★★ | $107M revenue | Private | Med | Derm-founded. Publishes self-ranking listicles — SEO competitor. |
| Medisys Data Solutions | S1 | Derm Plastics | ★★ | $65M revenue | Private | Med | Active derm + plastics content marketing. |
| Medical Billers & Coders (MBC) | S1 | Derm | ★★ | — | Private | Low | Offices in Chicago, NYC, Dallas, Houston — every Auctus target state. |
| TruBridge Litigation | S1 | Derm | ★★ | Public NASDAQ:TBRG | Public | High | Schweiger Dermatology (170+ locations) is a named client. Revenue scale unknown for RCM segment. |
| Dermatology Billing Solutions (DermBSI) Acq Target | S1 | Derm | ★★★ | — | Private | Low | FL boutique, derm-only. |
| Track A — Plastics (In-Network) | |||||||
| Nextech | S2 | Plastics Derm ENT | ★★★ | 11,000+ physicians | TPG Capital $1.4B (2023) | High | #1 plastics EHR. RCM white-labeled to Assembly Health. Lock-in risk. New PE = switching window possible. |
| Assembly Health | S3 + E2 | Plastics Derm ENT | ★★★ | 132 LI · 1,600+ claimed 3,000+ physician groups · +1,670% YoY headcount |
Shore Capital | Med | Powers Nextech RCM Services. Expanding derm/ophtho/ortho. Headcount spike = roll-up activity. Source: LinkedIn. |
| Quantum Medical Billing Acq Target | S1 | Plastics Derm | ★★★ | — | Private | Low | Pure plastics origin. Founded by Dr. Janevicius's billing team, Chicago. Geographic overlap. |
| SybridMD | S1 | Plastics | ★★ | — | Private | Low | Reconstructive + cosmetic plastics coding depth. |
| Microwize Technology | S2 | Plastics | ★★ | — | Private | Low | Hybrid EHR + billing, 30+ yrs, plastics-specific. |
| ClaimCare | S1 | Plastics Derm | ★★ | — | Private | Low | Derm + plastics explicit, bundling/global period expertise. |
| FC Billing / MyFC Billing | S1 | Plastics Derm | ★★ | — | Private | Low | Plastics + reconstructive focus, 99% accuracy claim. |
| Track A — Plastics OON / IDR | |||||||
| HaloMD Litigation | S1 | OON Plastics | ★★★ | #1 IDR filer nationally $1B+ annual collections |
Founder-owned (LaRoque) | Med | 84% IDR win rate, contingency model. 4 active BCBS RICO suits. Positioning: "HaloMD without the lawsuits." |
| CollectionPro Acq Target | S1 | OON Plastics | ★★★ | 10K+ appeals handled | Private | Med | Provider-side OON specialist, NYC. |
| No Surprise Bill Acq Target | S1 | OON | ★★★ | — | Private | Low | NSA/IDR identity. Closest ideological competitor to Auctus OON play. |
| MAC Services Acq Target | S1 | OON Plastics | ★★★ | — | Private | Low | 98% success rate, 100% post-award collection. Proprietary AI arbitration software. Surgical specialty focus. |
| MD Capital Advisors | S1 | OON | ★★★ | 66 employees Founded 2008 · New York |
Private | Med | Full legal name: M&D Capital Premier Billing, LLC. Strong OON/NSA/IDR focus. Direct Auctus OON comp. Source: LinkedIn. |
| Practice With Ease | S1 | OON | ★★ | — | Private | Low | OON + legal partner model. |
| IDR Dynamics | S1 | OON | ★★ | — | Private | Low | Spun out of NYX Health IDR team. Federal IDR advisory + submission mgmt. |
| Howard Healthcare Group | S1 | OON Plastics | ★★ | — | Private | Low | OON billing for private plastics practices, uses network of attorneys at their expense. |
| Gottlieb & Greenspan LLC | Law | OON | ★★★ | Tens of thousands of NSA filings | Law firm | Med | NJ/NY/CT + federal. James Greenspan = nationally quoted NSA expert. |
| Cohen Howard LLP | Law | OON Plastics | ★★★ | $150M+ recovered | Law firm | Med | NJ OON law firm specifically for plastic/reconstructive surgeons. "Cohen and Howard" John mentioned. |
| Minevich Law Group | Law | OON | ★★ | — | Law firm | Low | NY-based, all 50 states federal IDR. |
| Track A — ENT | |||||||
| Currence Physician Solutions ENT Market Open | S1 | ENT | ★★★ | 40+ yr history | ENT Partners / Candescent PE (May 2025) | High | ENT-exclusive. NOW CAPTIVE inside ENT Partners DSO rollup. Independent ENT RCM market is OPEN. Act now. |
| ENT Billing Associates Acq Target | S1 | ENT | ★★★ | — | Private | Low | ENT-ONLY since 1999. AAO-HNS recognized. 26-year pure-play. Primary remaining ENT competitor. |
| Smart RCM Solutions | S1 | ENT | ★★ | — | Private | Low | ENT-focused denial reduction. |
| ProMD Medical Billing | S1 | ENT Derm | ★★ | — | Private | Low | ENT primary, national reach. FL base. |
| Pro-MBS | S1 | ENT | ★★ | 400 staff | Private | Med | ENT subspecialty depth (allergy, audiology, sinus). |
| Capture Billing | S1 | ENT | ★★ | — | Private | Low | Real ENT operational background, Virginia. |
| BSI Medical Billing | S1 | ENT | ★★ | — | Private | Low | 30+ yrs, AAPC-certified ENT coders. |
| Eminence RCM | S1 | ENT | ★★ | — | Private | Low | ENT CPT/modifier specialization. |
| Track A — Multi-ICP | |||||||
| Precision Practice Management Being Acquired | S1 | Derm Plastics ENT | ★★ | — | Being acquired by Vee Healthtek | Med | CENTC-certified ENT coders. Derm + plastics + ENT. Acquisition = watch for client disruption. |
| Medusind | S1 | Derm Plastics | ★★ | 3,125–4,000 employees Miami HQ · $1.1B+ payments · 25yr derm |
Alpine Investors (2023) | Med | Active acquisition platform (acquired AVA Billing 2023). PE roll-up in progress. |
| TriumpHealth | S1 | Derm Plastics | ★★ | — | Private | Low | Derm + plastics + ASC. |
| Track A — Large Multi-Specialty (Low ICP focus) | |||||||
| Coronis Health Litigation | E2 | Derm Plastics ENT | ★ | 10,000+ employees | Veritas Capital | High | Covers all specialties. Generalist breadth. Monitor as acquirer — 3 acquisitions under Veritas. |
| CareCloud Litigation | S5 | Derm Plastics | ★ | ~$112M revenue Public · NASDAQ:CCLD |
Public | High | Has derm/plastics modules but not focused. EMR/PM + bundled billing. |
| Track A — EMR/PM Captive Billing (S2) — Switching Windows Active | |||||||
| ModMed Switching Window | S2 | Derm Plastics ENT | ★★★ | 40,000+ providers $5.3B valuation |
Clearlake Capital (Apr 2025 from Warburg) | High | Dominant derm/plastics/ENT EHR. Biggest structural lock-in risk. AI Scribe layer building. NEW PE — switching window now open. |
| AdvancedMD Switching Window | S2 | Derm Plastics ENT | ★★ | 40,000+ providers | Francisco Partners (Q4 2024 from Global Payments) | High | Multi-specialty. Same switching window dynamic as ModMed. |
| Ezderm | S2 | Derm | ★★★ | — | Serent Capital (2024) | High | Derm-only EHR + RCM bundle. Lock-in risk. New PE 2024. |
| Greenway Health | S2 | Derm Plastics ENT | ★ | 1,203 employees $350M revenue · Founded 1977 |
Private | Med | EHR/PM platform, not pure RCM. Multi-specialty. Source: LinkedIn. |
| Track B2 — AI-RCM Platforms (ProCode Competitive Set) | |||||||
| Amperos Health Freshly Funded | E1 | Derm | ★★★ | $21M Series A Apr 2026 · Bessemer |
Bessemer Venture Partners | High | AI-native denial management. Derm as named vertical. Raised 1 month after ProCode launch. FASTEST MOVING. Watch closely. |
| Enter Health | E1 | Derm Plastics ENT | ★★ | 16 employees $9.9M total · Founded 2013 · SF |
VC-backed | Med | AI coding + contract AI. Private practice focus. Closest software model to ProCode. Source: LinkedIn. |
| Agent AI | E1 | Derm Plastics ENT | ★★ | 16 employees $5.8M seed · Founded 2023 · LA |
VC-backed | Med | AI workflow automation for billing. +217% YoY. 2023-vintage. Source: LinkedIn. |
| Nanonets Health | E1 | Derm | ★★ | $42M parent funding Accel-backed |
Accel (via Nanonets parent) | Med | Well-funded parent. Derm-specific RCM page explicit. |
| iMagnum Healthcare | E1 | Derm | ★★ | — | Bootstrapped | Low | 25-year incumbent embedding AI fast. Derm explicit, CodeEaseHCC product. |
| Max AI | E1 | Derm | ★★ | ~15 employees | Undisclosed | Low | Agentic swarm architecture, derm-focused, founded 2025, Ann Arbor MI. Direct shot at offshore/traditional RCM. No disclosed raise but derm ICP = watch closely. |
| Taiga (Bayes AI) | E1 | Derm Plastics ENT | ★★ | 2 founders | YC Spring 2026 | Low | AI-native full-stack billing (coding → claims → denials → patient billing). Multi-specialty horizontal play — no ICP focus yet. Physician-founder narrative mirrors Rinova. Watch for specialty pivot. |
| Rinova AI | E1 | Plastics Derm | ★★ | Pre-institutional | Pre-seed | Low | Physician-founded. Private practice agentic billing. Same narrative as ProCode. |
| Camber Health | E1 | Plastics Derm | ★★ | $50M Series A | a16z | High | Behavioral → surgical specialty expansion. a16z signal = watch for productization down-market. |
| Humata Health | E1 | Plastics Derm | ★★ | $25M Series A | BCBS VC | High | Strong prior auth pedigree. Surgical PA workflows. Relevant for plastics/derm auths. |
| Waystar | S5 | Derm Plastics ENT | ★ | Public $968M IPO · 1M+ providers |
Public | High | AI claims automation. Medium threat if they add managed RCM for small practices. Currently platform-only. |
| AKASA | E1 | Derm Plastics ENT | ★ | $200M+ | a16z | High | GenAI prior auth + coding. Hospital-only today. No private practice path. 18-36mo window before they come down-market. |
| Track B1 — PE Roll-ups (Acquisition Threat + Competition) | |||||||
| EqualizeRCM | E2 | Derm Plastics ENT | ★★ | — | Pilot Wall Group | Med | Active acquirer. Named derm explicitly via MRG acquisition. |
| Vee Healthtek | E2 | Derm Plastics ENT | ★★ | 1,177 employees Founded 2000 · Plano TX · 7 countries |
TA Associates $250M | Med | 1-2 acquisitions/yr. Acquiring Precision Practice Management. Ambulatory focus. Source: LinkedIn. |
| Omega Healthcare | E2 | Derm Plastics ENT | ★★ | 20,000+ employees | Goldman Sachs + Everstone | High | Scale + derm named = serious roll-up threat. 40 specialties. |
| Infinx Healthcare | E2 | Derm Plastics ENT | ★★ | — | KKR + Norwest | Med | Targeting $25-75M specialty billing companies for acquisition. Auctus is in their acquisition range. |
| Nimble Solutions / National Medical | E2 | Plastics ENT | ★★ | — | Aquiline Capital | Med | Surgical RCM roll-up. ENT/plastics overlap. ASC focus. |
| Ensemble Health Partners | E2 | Derm Plastics ENT | ★ | 3,510 employees $794M revenue · Founded 2014 · Cincinnati |
Golden Gate Capital · Public: ENSB | High | Large generalist. Monitor as potential acquirer. Source: LinkedIn + public disclosures. |
| AGS Health | S5 | Derm Plastics ENT | ★★ | 4,035 employees $100M revenue · Founded 2011 · 16 countries |
Private | Med | 15,000 total staff claimed. Multi-specialty generalist with derm ICP. Source: LinkedIn. |
| Cosentus | E2 | Derm Plastics ENT | ★★ | 169 employees Founded 1999 · Irvine CA · Non-PE |
Non-PE (roll-up behavior) | Med | 25+ yrs. Recently acquired Alta Management Solutions. Roll-up behavior without PE backing. Source: LinkedIn. |
| GetixHealth Litigation | E2 | Derm Plastics ENT | ★ | — | H.I.G. Capital | Low | New PE backing, acquisitions expected. |
| Advantum Health | E2 | Derm Plastics ENT | ★ | — | Fulcrum Equity | Low | Active bolt-on acquirer. Multi-specialty coding/billing. |
| PPM Platforms with Embedded Billing (Market Compression) | |||||||
| ADCS / Ameriderm | PPM | Derm | ★★ | 80+ independent derm practices | Harvest Partners | Med | DSO buying billing companies as practice acquisition hook. Compresses independent billing market from top down. |
| ENT Partners | PPM | ENT | ★★ | — | Candescent PE | Med | Acquired Currence (May 2025). Uses captive billing as loss-leader to onboard ENT practices into DSO network. |
| ⚠️ Payer-Side Enemy Infrastructure (Know, Don't Compete) | |||||||
| Claritev (ex-MultiPlan) Litigation | Payer | OON | — | Controls 80%+ OON repricing | Public (Antitrust MDL pending) | High | Works AGAINST providers. Antitrust MDL pending. Enemy infrastructure — know their moves. |
| Zelis Litigation | Payer | OON | — | — | Private (Antitrust suit) | High | OON pricing for payers. Works AGAINST providers. Antitrust suit from major payers. |