Sustainable Medical Billing buys Smrtdo, adds first Latin American operations
What's the deal? Scottsdale-based Sustainable Medical BillingDealroom has a profile for this one. Try Dealroom → has acquired Smrtdo Medical BillingDealroom has a profile for this one. Try Dealroom →, an international outsourcing provider with operations in Nicaragua and Colombia. The deal, announced October 21, 2026, adds more than 300 team members and establishes Sustainable's first nearshore Latin American operations. Terms were not disclosed.
Who's who? Sustainable provides revenue cycle management (RCM) for US hospitals and physician practices, covering billing, coding, credentialing, and prior authorisation. Headquartered in Managua, Smrtdo runs medical billing and coding for US providers alongside broader back-office work in accounting, administration, and customer service.
The expansion: The acquisition gives Sustainable a nearshore delivery platform in Latin America, complementing its existing US operations. "The addition of more than 300 talented team members and our first nearshore operations in Latin America expands our ability to serve clients," said chief executive officer Michael Johnson.
What changes? Smrtdo's leadership will stay in current roles, and both companies will keep working with existing teams. Founder Lenin Lemus said joining Sustainable lets his team "build on the capabilities and relationships we have developed over the years."
Why now? The deal extends an acquisition-led run for Sustainable, which bought Pettigrew Medical in March 2025, took over MedEvolveDealroom has a profile for this one. Try Dealroom →'s RCM services business in September 2025, and acquired eyecare-focused RevCycle PartnersDealroom has a profile for this one. Try Dealroom → in July 2026. Each has widened its reach into new specialties and capabilities.
The signal: The broader RCM market has seen a steady run of deals — 116 M&A and private-equity transactions tracked across 2021–2026 — as firms chase scale and add technology or services. Sustainable's purchase is another step in that consolidation, though available reporting does not independently verify the terms or closing, and no price is disclosed.
Read more: issuewire.com
Image credit: Ken Lund
