Find the patients your market is missing
Identify ZIP codes and populations with high estimated hospice need and low utilization.
Protect revenue.Grow with confidence.
ClaimIQ turns market, claims and clinical data into clear growth and risk priorities for hospice leaders.
NATIONWIDE HOSPICE INTELLIGENCE
See where hospice need is growing, where revenue is at risk, and what to do next.
See risk before it becomes loss
Surface cap, billing, utilization and compliance concerns earlier.
Stop reviewing every chart
Prioritize the records most likely to need clinical, billing or compliance attention.
Know exactly where to grow and what to fix
Get source-linked findings your leadership team can act on immediately.
CURRENT INSIGHTS
What hospice leaders should be watching now
Regulatory context reviewed July 11, 2026. Each item links to its official source.
Get the monthly compliance briefSEPT 30
FY2026 hospice cap year closes
Model the direction of the cap position before the reporting window begins.
CMS sourceACTIVE
HOPE submission timeliness
CY2026 submissions shape future payment performance and deserve an active review cadence.
CMS sourcePROPOSED
Claims-based SSVI measures
Proposed measures would make variation across claims more visible. Proposed is not final.
CMS sourceProposed rules are not final requirements. Verify current obligations with official sources and qualified advisors.
HOW CLAIMIQ WORKS
Screen. Verify. Monitor.
Each stage has a clear purpose, from the first signal to the next informed decision.
Find the signals that deserve attention.
Review cap, claims, quality and survey patterns with source context kept visible.
Connect each signal to the evidence.
Reconcile PS&R, MCReF, billing detail and supporting records before drawing conclusions.
Keep the claims picture current.
Track supported changes over time so the team can act before deadlines tighten.
WHY CLAIMIQ
Explainable by design. Restrained by principle.
Billers manage claims going out. ClaimIQ examines the patterns those claims form together without replacing your EHR, biller, compliance team, accountant or counsel.
- Visible inputsSources, windows and assumptions remain attached.
- Human reviewSignals prioritize records; qualified people reach conclusions.
- Clear boundariesPublic first, provider-authorized when separately scoped.
DECISION MOMENTS
Claims intelligence for the moments that matter
Claims data can show where to look. Clinical, legal, accounting and compliance conclusions remain with the qualified people reviewing the complete record.
Before filing season
Aggregate-cap reconstruction
Reconcile PS&R, MCReF, beneficiary shares and payment detail before a planning estimate becomes a surprise.↗Before chart review
Claims-pattern triage
Prioritize the episodes and records behind live-discharge, long-stay, level-of-care and visit patterns.↗When time is short
Urgent notice support
Organize a reproducible data pack for your compliance team or counsel during a payment-review window.↗Between reports
Ongoing monitoring
Refresh the measures with each supported import so changes surface while there is still time to investigate.↗Before a transaction
Buyer and exit readiness
Give owners and advisors a structured view of cap, claims and survey posture before diligence begins.↗After a survey
Survey-to-claims mapping
Connect cited themes to billing sequences, orders, plans of care, visit records and corrective-action evidence.↗SERVICES
Choose the review scope your team needs.
Every engagement is scoped around your data, priorities and review timeline.
PUBLIC-DATA SCREEN
Risk Snapshot
A one-page, source-linked view of cap, claims, quality and survey signals.- No PHI required
- Sources and caveats included
- Practical review questions
PROVIDER-DATA REVIEW
Cap and Claims Review
A scoped reconstruction and claims-pattern review based on provider-authorized data.- PS&R and MCReF reconciliation
- Episode and pattern drill-down
- Advisor-ready analysis packet
REPEATABLE VISIBILITY
Monitoring
Recurring tracking aligned to your supported data refresh cadence.- Cap utilization direction
- Claims-pattern movement
- Exception-focused review queue
Contact ClaimIQ for a tailored quote based on scope, timing and data availability.
MONTHLY, SOURCE LINKED
Stay ahead of hospice claims and cap changes.
A concise briefing on aggregate cap, claims-based measures, survey patterns and practical review questions.
Get the compliance brief
FOR ATTORNEYS, BILLERS AND CONSULTANTS
Add the data layer without giving up the client relationship.
White-label or referral. ClaimIQ organizes cap and claims-pattern analysis; you keep the client, the call and the professional judgment.
Partner with ClaimIQSTRAIGHT ANSWERS
Questions a skeptical operator should ask
Review the method, inputs, assumptions and boundaries before acting on any result.
We already have a biller. Is this the same thing?
No. Billers manage claims going out. ClaimIQ looks across accumulated claims to surface aggregate patterns and cap exposure. The two functions are complementary.
Does a Risk Snapshot mean something is wrong?
No. Public data cannot determine whether an individual claim is supported or whether a patient was eligible. A Snapshot shows which signals may be worth verifying. If nothing needs attention, you will know that too.
Do you need PHI to begin?
No. The initial screen uses public sources. Provider-authorized data is requested only for a separately scoped review after handling terms are established.
Is the public cap number official?
No. It is a planning screen. Actual aggregate-cap liability and filing requirements depend on provider-authorized information, the applicable methodology and the MAC process.
START WITH A CLEAR SCOPE
Bring clarity to your next claims decision.
Tell us what you need reviewed. ClaimIQ will confirm the scope, required data, timing and quote.
Contact for a quote Clear scope · Source-linked work · Human review