Medical Billing Companies & Consultants in Lyndhurst, NJ

PGM Billing, whose legal name is Physicians Group Management, is a revenue cycle and claims processing company headquartered in Lyndhurst, New Jersey. Founded in 1981, it has never been sold to an outside owner. Its client roster spans every U.S. state. Customers include single-doctor offices, sizable groups covering many fields, hospitals, outpatient providers, newly launched labs and high-throughput reference laboratories.

Services and Approach

A practice or lab can hand PGM responsibility for its entire reimbursement process, from building and sending claims to final reporting. Certified coders assign codes, staff pursue rejected claims and file appeals, and the team handles insurer enrollment. PGM presents its billers as an extension of the client's office rather than a remote vendor. Organizations that prefer to keep their billing internal may simply license the company's software. Offerings include:

• Revenue cycle work for physician practices
• Billing for laboratories in clinical, molecular, pathology and toxicology testing
• Code assignment and pre-submission claim review to catch errors
• Handling of rejected claims, including formal appeals
• Credentialing of providers, maintenance of CAQH profiles, Medicare enrollment and revalidation, and setup of electronic remittance and electronic funds transfer
• Patient bills delivered on paper, by text message or by email, along with a web portal for paying online

Technology

PGM develops its own cloud platform, Northstar, with versions for doctors' offices and for labs. Newer releases brought insurance coverage verification, either in batches or instantly, along with billing for surgical anesthetic services, invoicing of lab clients, and automated posting of insurer payment files. In 2026 the company revealed a partnership with RevAIant that adds artificial-intelligence review of claims to its processes. PGM also provides reporting dashboards, integrations with electronic medical record and lab information platforms, and a no-cost web tool that reviews claims for frequent mistakes before submission.

Specialties Served

According to PGM, its work covers upward of 20 medical fields. Among them are allergy practices and those treating immune disorders, providers who deliver sedation for surgery, heart specialists, spinal adjustment clinics, skin care physicians, and acute-care doctors staffing hospital trauma departments. The company also bills for digestive disease specialists, behavioral health providers, kidney care practices, brain and nervous system specialists, cancer treatment centers, bone and joint surgeons, clinics focused on chronic pain, family and internal medicine offices, and urologists. Lab billing is a central part of the business, particularly the heavy flow of small-balance claims that testing facilities produce.

Background

PGM reports processing over 60 million visits and accessions and submitting more than $1 billion in gross charges annually. It cites established relationships with Medicare, Medicaid and the leading private insurers. Over time it added another New Jersey office, followed by a third site in Manhattan, and it bought CMS Billing. Through IPS Systems, it has worked with electronic health record vendors including Amazing Charts, ICANotes and ChiroTouch. The company has been named to the Inc. 5000 and stresses that it carries no private equity investment and devotes itself solely to coding and billing work.