QBS

What QBS does

QBS (Quality Billing Service, Inc.) is a privately held, Poughkeepsie, New York-headquartered consulting firm that has provided healthcare revenue cycle services to providers since 1987. The company operates three interconnected service lines: Accounts Receivable Management (hospital and professional medical billing, denial resolution, underpayment recovery, legacy AR wind-down, and supplemental staffing), Advisory Services (interim management, operational performance metrics, quality and productivity monitoring, EHR technology planning and implementation including Epic and Cerner, and workflow optimization), and Eligibility Advocacy Services (multilingual Medicaid, Marketplace, SSI/SSD, and long-term-care enrollment support delivered by Certified Application Counselors). Its technology stack centers on a proprietary HIPAA-compliant accounts receivable management system that ingests client data, runs follow-up and appeal protocols, and includes technology solutions for continual monitoring of self-pay populations to identify newly available insurance coverage.\n\nQBS generates revenue through professional services fees tied to revenue cycle management engagements, denial recovery, and consulting under flexible, tailored contract terms. It targets hospitals and health systems, multi-specialty physician practices, outpatient laboratories, and home health agencies, primarily in the Northeast and tri-state area, with one source referencing broader nationwide reach. The go-to-market model is direct enterprise sales emphasizing direct senior leadership access, supported by industry credibility through Healthcare Financial Management Association (HFMA) involvement, including Hudson Valley chapter leadership and Gold Sponsorship of the Annual Institute, as well as Dutchess County Regional Chamber of Commerce membership. The company maintains 101-250 employees and operates from a single office in Poughkeepsie, NY, with no disclosed subsidiaries, parent entities, acquisitions, or external funding rounds in the source material.

Name

QBS

Legal name

Quality Billing Service, Inc.

Website

https://qualitybillingservice.com

Company type

Private

Founded year

1987

Operating status

Operating

Headcount range

101–250 employees

Short description

QBS is a privately held healthcare revenue cycle consulting firm serving hospitals, physician practices, laboratories, and home health agencies primarily in the Northeast US through medical billing, accounts receivable management, denial resolution, advisory services, and Medicaid eligibility advocacy.

Ownership category

akta.pro rank

Product category

Healthcare Revenue Cycle Management

NAICS

Other Scientific and Technical Consulting Services (54169), Computer Systems Design and Related Services (54151)

SIC

Services-Health Services (8000), Services-Engineering, Accounting, Research, Management (8700)

akta.pro primary industry

Claims Management, Scrubbing & Clearinghouse (HLACACAB)

akta.pro secondary industries

Medical Coding, Billing & Clinical Documentation Support (BPAAAFAD), Patient Access, Registration & Intake (Front-End RCM) (HLACACAE)

Keywords

• Revenue cycle management
• Medical billing services
• Accounts receivable management
• Denial resolution services
• Medicaid enrollment services

Headquarters

HQ city

Poughkeepsie

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure

Revenue model

1. Revenue Cycle Management Services: QBS generates revenue through professional services fees for accounts receivable management, medical billing, and revenue cycle consulting provided to healthcare organizations. Services are offered under flexible contract terms tailored to client needs. The company operates as a privately-owned entity serving healthcare providers since 1987.

Go-to-market motion1 record

Distribution channels1 record

Marketing channels4 records

Core offering

QBS is a healthcare revenue cycle services firm that helps hospitals, physician practices, laboratories, and home health agencies recover unpaid claims, resolve denials, and improve revenue cycle performance. Its offering is organized into three service lines — Accounts Receivable Management (hospital A/R, professional billing, denial resolution, supplemental staffing, legacy A/R wind-down, underpayment recovery), Advisory Services (interim management, operational performance metrics, quality and productivity monitoring, technology planning and implementation, workflow optimization), and Eligibility Advocacy Services (Medicaid, SSI/SSD, long-term care, and marketplace enrollment support by Certified Application Counselors). Services are delivered through a proprietary HIPAA-compliant A/R management system with Epic and Cerner EHR proficiency.

Product overview

QBS operates as a unified revenue cycle management platform organized into three interconnected service lines. The core Accounts Receivable Management suite handles unpaid claims through six specialized sub-products: Hospital AR Management, Professional Medical Billing, Denial Resolution, Legacy AR Wind-Down, Supplemental Staffing, and Underpayment Recovery—all supported by a proprietary A/R management system. Advisory Services provides consulting and transformation support through five sub-products including Interim Management, Operational Performance Metrics, Quality and Productivity Monitoring, Technology Planning & Implementation (covering Epic and Cerner EHR systems), and Workflow Optimization. The Eligibility Advocacy Services (EAS) program offers Medicaid enrollment support through four sub-products: Enrollment Support and Guidance, Long Term Care Enrollment Assistance, Eligibility Search & Verification, and SSI/SSD Enrollment Support, all delivered by Certified Application Counselors. The three service lines interconnect to provide comprehensive end-to-end revenue cycle support from claims submission through Medicaid eligibility.

Differentiator

Problem solved

Functional benefit

Products and services

• Accounts Receivable Management Core service specializing in accounts receivable management and recovery of hospital, physician, and other provider unpaid accounts receivables, including data import into QBS's proprietary A/R management system, follow-up protocols, appeal procedures, and customized reporting for healthcare providers.
• Hospital AR Management Partners with hospitals and health systems to address third-party insurance accounts receivable through cost-effective outsource strategies that enhance cash flow, appeal denied revenue, and provide detailed A/R reports.
• Professional Medical Billing Medical billing service with claims submission expertise across academic medical centers, physician practices, outpatient laboratories, and clinical settings including emergency medicine, hospice, mental health, orthopedics, and rehabilitation.
• Denial Resolution Manages, resolves, and recovers denied and underpaid insurance claims through extensive research, appeals submitted to insurance carriers, and diligent follow-up to avoid loss of client revenue.
• Supplemental Staffing Provides trained staffing support to healthcare providers experiencing unexpected staffing shortages or requiring temporary assistance for special projects to maintain operational excellence.
• Legacy AR Wind-Down Assists providers with legacy AR liquidation projects during system conversions, helping hospitals and health systems transition to new platforms while maintaining sufficient cash flow.
• Underpayment Recovery Reviews previously paid claims to evaluate claim accuracy and third-party reimbursement, analyzing paid claims and initiating recovery efforts when underpayment is identified.
• Advisory Services Revenue cycle transformation services including technology planning and implementation support, workflow optimization, operational performance metrics, workforce analysis, and interim management for healthcare providers.
• Interim Management Provides strategic support, stability, and organization during loss of key management positions in revenue cycle teams while permanent replacements are recruited.
• Operational Performance Metrics Completes operational assessments and develops performance metrics to evaluate revenue cycle performance, identifying bottlenecks and workflow inefficiencies across referrals, scheduling, registration, eligibility verification, claims submission, and AR follow-up.
• Quality and Productivity Monitoring Analyzes productivity and work quality throughout the revenue cycle to improve resource allocation, evaluate staff assignments and productivity standards, and create a culture of accountability.
• Technology, Planning and Implementation Supports organizations with strategic planning, technology selection, and onboarding for EHR implementations such as Epic and Cerner, including needs analysis, goal definition, system testing, end-user training, and implementation monitoring.
• Workflow Optimization and Redesign Reviews current-state staff workflow and system utilization, often including front-to-back revenue cycle analysis, to redesign processes and capture optimal revenue while leveraging systems and efficiencies.
• Eligibility Advocacy Services (EAS) Multilingual guidance program for Medicaid-eligible patients delivered by trained Certified Application Counselors (CACs) who advocate for patients with state Health Plan Marketplaces and Department of Social Services throughout the application process.
• Enrollment Support and Guidance Trained and certified multilingual staff communicate with uninsured patients and provide support through the Medicaid and Marketplace application process, collaborating with clients to design programs addressing uninsured populations.
• Long Term Care Enrollment Assistance EAS team assists with long-term care enrollment support, guiding patients and families through application requirements throughout the enrollment process.
• Eligibility Search and Verification Continual screening of self-pay populations using technology solutions to identify insurance coverage, uncover primary and secondary coverage not identified at time of service, and initiate billing to third-party insurance.
• SSI/SSD Enrollment Support and Guidance Assists with SSI/SSD enrollment support, with employees trained and familiar with application requirements to guide patients and families throughout the Social Security Disability Insurance and Supplemental Security Income application process.

Segments3 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature3 records

Partnerships

Two partnerships are on record, tiered minor and core.

• Dutchess County Regional Chamber of CommerceminorOthersQBS is a member of the Dutchess County Regional Chamber of Commerce, participating in local business networking and community engagement activities.
• HFMA (Healthcare Financial Management Association)coreStrategic or Co-development PartnerQBS is an active participant and supporter of HFMA. Leadership team member Christina Santullo serves as President of the Hudson Valley HFMA Chapter. QBS was a Gold Sponsor of the Chapter's Annual Institute. The company and its staff regularly take advantage of educational opportunities offered locally, regionally and nationally through HFMA.

Scale indicators2 records

Recent moves6 records

Expansion highlights5 records

Broad incumbents

• R1 RCM: R1 RCM is one of the largest US healthcare revenue cycle management firms, serving hospitals and health systems with end-to-end RCM, coding, and patient access solutions. It is a scaled, publicly-traded incumbent competing for the same hospital and health system buyers that QBS serves, but with a national footprint and significantly broader product portfolio.
• Optum (UnitedHealth Group): Optum, a division of UnitedHealth Group, operates one of the largest healthcare RCM, billing, and coding services platforms in the US alongside its payer and analytics businesses. It directly competes for enterprise hospital RCM contracts and offers the scale, capital, and technology investment that mid-sized firms like QBS cannot match.
• Waystar: Waystar provides cloud-based revenue cycle technology including claims management, denial resolution, patient estimation, and analytics to hospitals and health systems. It competes in the same claims management and denial resolution categories as QBS but via a SaaS platform model rather than QBS's services-led approach.
• Experian Health: Experian Health provides revenue cycle management, eligibility verification, claims management, and patient access solutions to hospitals, physician practices, and labs. Its eligibility search and patient access offerings directly overlap with QBS's Eligibility Advocacy Services and AR management product lines.

Direct peers

• Aspiron (formerly known as nThrive): Aspiron provides end-to-end revenue cycle management, including A/R recovery, denial resolution, underpayment recovery, and advisory services, to hospitals and health systems. Its service portfolio closely mirrors QBS's three service lines (AR Management, Advisory, Eligibility/Patient Access) and serves similar enterprise healthcare buyers.
• Healthrise: Healthrise provides outsourced revenue cycle management, EHR implementation support, and workflow optimization services to hospitals and physician practices. It is a closely comparable mid-sized RCM services peer to QBS, with overlapping service lines in AR management and advisory.
• Coronis Health: Coronis Health offers end-to-end medical billing, RCM, coding, and credentialing services to hospitals, physician groups, labs, and home health agencies. It targets the same customer segments as QBS with comparable service lines in professional billing, AR management, and specialty billing.
• Advantmed: Advantmed provides risk-adjustment, coding, and revenue cycle solutions to health plans, hospitals, and physician groups. It overlaps with QBS in physician billing and coding, denial resolution, and quality-focused RCM services.
• AviCode (now part of CorroHealth): AviCode (now part of CorroHealth) provides medical coding, clinical documentation improvement, and RCM support to hospitals and health systems. It directly competes with QBS's coding and denial resolution services for hospital and health system clients.

Emerging players

• AKASA: AKASA is an AI-native revenue cycle automation company serving hospitals and health systems with autonomous coding, claim status, and AR follow-up capabilities. It represents the emerging AI-driven competitive vector that could pressure traditional RCM services firms like QBS in the medium term.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/quality-billing-service-inc

Revenue estimate

Valuation estimate

Number of profiles

Profiles9 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about QBS