Claim Services Inc.

Claim Services Inc. specializes in resolving coordination of benefits (COB) issues and Medicare-related claim denials for hospitals and health systems. The company provides outsourced claim resolution services that address denied or delayed payments, focusing on patient engagement and insurance verification to reduce accounts receivable days and prevent write-offs.

The company's service portfolio centers on three primary areas: COB solutions that engage directly with patients and insurers, comprehensive Medicare compliance services including MSP audits and questionnaire completion, and additional claim denial resolution for accident details, subrogation forms, and creditable coverage certificates. They offer after-hours and Saturday calling services to improve patient contact rates and claim resolution speed, with account resolution typically completed within 30 days.

Since developing their Medicare Secondary Payer audit methodology in 2010, Claim Services has identified over $3 million in health plan payments subject to take-backs for client hospitals. The company also provides MSP training and seminars for patient access and billing staff at hospitals and industry events nationwide.

Choose Claim Services if your hospital faces persistent COB denials impacting cash flow, needs Medicare compliance expertise to avoid contractor audits, or seeks to reduce business office workload without adding staff. Their specialized focus on patient engagement for claim resolution and documented track record in MSP compliance make them suitable for facilities prioritizing these specific revenue cycle pain points.

Expect a managed services approach where their team acts as an extension of your business office, handling patient outreach and insurance coordination directly. Their after-hours availability and 30-day resolution commitment suggest an operationally focused engagement rather than technology-driven automation.

Claim Services operates exclusively in the hospital revenue cycle space, with particular emphasis on Medicare compliance and coordination of benefits issues unique to healthcare billing. Their services address highly specific regulatory requirements including Medicare Secondary Payer rules, MSP questionnaire completion, and Common Working File updates that have no application outside healthcare.

The company's team demonstrates deep understanding of payer-provider dynamics, Medicare contractor audit processes, and the patient access challenges specific to hospital registration and billing workflows. Their training programs cover healthcare-specific compliance topics and billing practices relevant only to hospital business offices.

Mid-sized to large hospitals and health systems experiencing claim denial rates above industry benchmarks, particularly those with significant Medicare populations or complex COB scenarios. Organizations seeking to outsource specific denial categories rather than entire revenue cycle functions, and facilities that value compliance-focused services with measurable ROI in reduced write-offs and accelerated cash collection.