logo-new
Appointment Get Free Trial
  • 1-855-838-1370
  • 445 Main Street, 2nd Floor, #1, Saco, ME 04072
  • Mon to Fri 9:00AM to 06:00PM EST
doctor_image_in_collab

Shoreline Healthcare Technologies is a proud Maine-based company that offers end to end revenue cycle management services to physicians and Medical billing companies  in Wisconsin. Our goal is to help them manage their business in a way where they can focus on patient care and operations, not paperwork! By providing great services at reduced costs, we have been able to keep our customers since our inception in 2015. Explore our case studies to see how we’ve helped practices overcome complex billing challenges and improve cash flow.

As a medical billing outsourcing company, we have helped our clients grow their business by providing them with the resources they need to succeed while maintaining a competitive edge in today’s industry. We offer timesaving, cost-effective revenue cycle management services to your Wisconsin-based practice. Ready to outsource your billing needs? We’ll guide you through your receivable account to make sure that your claims are paid.

Best In the Industry

title_line

Shoreline Healthcare Technologies in Wisconsin exceeds customer expectations and we are proud of our history, but more importantly we are focused on the future. We have grown in recent years by continuing to invest in technology and people while maintaining a commitment to excellent service and innovation. We have the best customer service and one of the highest success rates for reimbursement, so you know your money will be going where it belongs - back into your pocket.

Wisconsin Billing Challenges we solve



georgia_expertise

Stabilize eligibility volatility with proactive verification


The state of Wisconsin have not yet expanded its Medicaid program under the ACA, which has resulted in frequent eligibility fluctuations, especially for adults near income thresholds. Patients often move in and out of eligibility within short timeframes creating higher rate of recoupments after payment. This instability forces providers to absorb unpaid services. We at Shoreline Healthcare Technologies have integrated the real-time eligibility checks on daily basis during appointment scheduling and at the point-of-care. We conduct patient financial counseling workflows to capture their liabilities and payment authorizations upfront. This helps organizations to have fewer retroactive denials and write-offs, with reduced patient-balance and improvement in the first-pass acceptance rate.

georgia_streamlined

Automate BadgerCare Plus with Wisconsin specific configurations


The BadgerCare Plus program is divided into multiple benefit plan for children, parents/caretakers, pregnant women, childless adults, and certain waiver-based populations each with different coverage rules and service limitations. The same CPT code may be payable for one eligibility group but denied for another. This makes automated rules engines less reliable without Wisconsin-specific configuration. At Shoreline Healthcare Technologies we have Wisconsin-configured rules engine that maps CPT/HCPCS and modifiers to BadgerCare eligibility classes (children, parents, pregnant, waiver populations). This helps to reduce the category-based denials.

georgia_transparantreporting

Protect the Reimbursement rate through specialty-aware coding


Specialties like behavioral health, pediatrics, and long-term care experiences lower reimbursement and have lesser chances for negotiation. Shoreline Healthcare Technologies have specialty coding teams who are well versed in Wisconsin specific fee schedules, bundling rules, and common denial triggers. Partnering with us organizations can improve their financial stability and reduce the revenue leakage.

We at Shoreline Healthcare Technologies provide personalized support tailored to the unique needs of Wisconsin providers. Our team of experts understands the intricacies of the Wisconsin billing landscape and offers guidance to help practices navigate these challenges effectively with our cloud-based RCM solutions for an optimized Revenue Cycle Management.

Comprehensive Medical Billing Services for Wisconsin

title

Specialized Services tailored to meet Wisconsin Medicaid rules and regulations

🩺 Services 📍Wisconsin Specialization 📈 Typical Improvement ⏱️ Turnaround Time
Managed Care vs. FFS Claim Routing Automated payer-ID resolution to correctly route claims to Wisconsin MCOs or Medicaid FFS 25–40% drop in misrouted claim rejections Claims submitted within 24–48 hours
Eligibility & Coverage Verification Real-time BadgerCare Plus eligibility checks at scheduling and date-of-service and retro-eligibility monitoring Reduction in eligibility-related denials by 30–45% Instant/ Within 24 hours
Charge Capture Management Audits encounter documentation to ensure all billable services are captured. Increases net reimbursement per visit 48 hours
Timely Filing Management Tracks filing and rebilling deadlines for original, corrected, and appeal claims Significant reduction in late-filing write-offs Ongoing, automated
Denial Management AI based tools to track and flag denial codes and root-cause analysis tailored for Medicaid claim categories, identifies high-risk categories and automate resubmissions. Reduce rate of denial by 75% and with quicker appeals. 7–14 days for backlog cleanup; ongoing daily follow-up
Patient Statements & Follow-Up Communicate with patients and give Explanation of Benefits (EOBs). Includes text/email payment reminders and online payment options. Reduces overdue balances and increases the collection rates. 1-2 weeks
Audit & Compliance Support Conducts Audit Review and mock audits, including documentation, encounter verification, and claim reconciliation. Minimizes risk of penalties and supports successful audits. Ongoing, depending on audit schedule

Medical Billing Resources for Wisconsin

title

Comprehensive resources specifically designed for Medicaid Providers to navigate the state’s complex Billing Landscape.

Medicaid Billing Guide

A Complete guide covering all billing requirements, policy updates and compliance standards.

Behavioral & Mental Health Billing rules and guidelines

Specialized billing guidelines and documentation procedures for behavioral health programs.

Revenue Cycle Optimization

Best Practices and Strategies to improve cash flow and reduce denials.

Telehealth and Remote patient Monitoring in Wisconsin

Wisconsin’s telehealth and RPM guidelines and regulations.

Serving Healthcare Providers Across Wisconsin

title

From Ashland to Washburn, we provide comprehensive medical billing services across all 72 Wisconsin Counties.

Wisconsin Map
Northern Wisconsin:

Ashland, Barron, Bayfield, Burnett, Douglas, Florence, Forest, Iron, Langlade, Lincoln, Oneida, Polk, Price, Rusk, Sawyer, Taylor, Vilas, Washburn.

Northeast Wisconsin:

Brown, Calumet, Door, Fond du Lac, Green Lake, Kewaunee, Manitowoc, Marinette, Marquette, Menominee, Oconto, Outagamie, Shawano, Sheboygan, Waupaca, Waushara, Winnebago.

West Central Wisconsin:

Adams, Buffalo, Chippewa, Clark, Crawford, Dunn, Eau Claire, Jackson, Juneau, La Crosse, Marathon, Monroe, Pepin, Pierce, Portage, St. Croix, Trempealeau, Vernon, Wood.

South Central Wisconsin:

Columbia, Dane, Dodge, Grant, Green, Iowa, Lafayette, Richland, Rock, Sauk.

Southeast Wisconsin:

Jefferson, Kenosha, Milwaukee, Ozaukee, Racine, Walworth, Washington, Waukesha.

Savings Estimation Calculator
Primary Care
Specialty Clinic
Rural Health
Mental Health
Cardiology
Dermatology
Emergency Medicine
Family Medicine
Internal Medicine
Neurology
Oncology
Orthopedics
Pediatrics
Psychiatry
Radiology
Surgery
Urgent Care
Women's Health

Frequently Asked Questions

title

FAQs about Medical Billing Services in Wisconsin

Q1. How does CSC differ from the traditional behavioral health treatment?

+

CSC uses a multidisciplinary team approach that integrates psychiatric care, therapy, case management, family education, and supports employment or education services.

Q2. Does Shoreline Healthcare Technologies support CSC billing?

+

Yes. Shoreline Healthcare Technologies supports Coordinated Specialty Care (CSC) billing. Our team has experience with the documentation, authorization, and coding requirements that are unique to the CSC programs. We help providers to submit clean claims under the correct service codes and manage prior authorizations and denials specific to CSC.

Q3. Can Shoreline work with small or rural practices in Wisconsin?

+

Yes. Shoreline Healthcare Technologies offer customized billing services that are highly effective for rural clinics, independent practices, and community-based providers who lack in-house Medicaid expertise and have limited administrative staff. We provide the complete end-to-end RCM services for all specialities irrespective of their practice size.

Q4. What are the initial processes that Shoreline does on onboarding?

+
  • ➣ Reviews current billing workflows and denial patterns
  • ➣ Confirms Wisconsin Medicaid and MCO enrollment status
  • ➣ Sets up payer-specific claim rules and authorization workflows
  • ➣ Transits claims without disrupting the cash flow

Providers can see an increase in clean claim submission within the first few weeks of onboarding, with measurable performance improvements by partnering with Shoreline Healthcare Technologies.

Q5. What are the factors that influences the process of onboarding?

+
  • ➣ Active status of the provider with Wisconsin Medicaid and other MCOs
  • ➣ Data access (EHR, clearinghouse, payer portals)
  • ➣ Volume of legacy A/R and denied claims
  • ➣ Scope of services (full RCM vs. partial support)

Q6. How can Shoreline Healthcare Technologies help providers in Wisconsin?

+

We at Shoreline Healthcare Technologies handle the entire process of RCM Cycle from patient appointment scheduling to eligibility checks, prior auths, coding, claim submissions, denials, and appeals, till payment processing and patient communication ensuring faster payments and compliance with state specific rules. We also offer analytics and process automation to reduce first pass rejects in state systems and to reconcile managed-care encounter reporting.

Compliance & Certifications

title

Your data security and compliance are our top priorities.

HIPAA Compliant

Full HIPAA compliance with regular audits

AAPC Certified

Certified Professional Billing Staffs.

Wisconsin Licensed

Licensed to operate in Wisconsin

Medical Billing Glossary

title

Essential Terms for Understanding the Wisconsin’s Medical Billing Landscape

BadgerCare Plus

+

Wisconsin’s Medicaid and CHIP program that delivers healthcare coverage to eligible low-income children, parents and caretakers, pregnant individuals, and certain adults who do not have dependent children.

Coordinated Specialty Care (CSC)

+

It is a treatment model with a multidisciplinary team for providing support to young adults who are experiencing early psychosis or other serious mental health conditions.

ForwardHealth

+

It is the healthcare program administered by the Wisconsin Department of Health Services to manage all the operations of Medicaid, BadgerCare Plus, and other health initiatives for the state.

Grant Enrollment, Application and Reporting System (GEARS)

+

The centralized online system used by providers and organizations in the state of Wisconsin to apply, manage, and report the state and federal grants for the public health and behavioral health programs.

IRIS (Include, Respect, I Self-Direct)

+

It is a self-directed long-term care program that allows eligible members to manage their own services and supports rather than enrolling in managed care.

Our Services

title

Shoreline proudly supports physicians, medical groups, and medical billing companies. Following are the revenue cycle management steps we offer.

RCM
Solution

powered by AI

Eligibility Verification
Prior Authorization
Virtual Assistance
Coding ICD-10
Charge Capture
Claims Submission
Claims Audit
Payment Posting
Denial Management
AR Follow Up
Patient Statements
Credit Balance
Credentialing

Testimonials

title

We Care

title

From electronic health records, billing services and practice management tools-Shoreline has you covered! In addition to being industry leader when it comes to pricing, we also provide personalized support for every client, with a team of experts who have worked with physicians and medical groups for years, Shoreline Healthcare Technologies in Wisconsin understands how to navigate today’s complex healthcare revenue environment.

Ready to Optimize Your Medical Billing?

title

Get your free consultation and discover how much you could save with our Wisconsin-specialized billing services.

Get Your Free Consultation

mail_image
Sending...

Contact Information

  • 445 Main Street, 2nd Floor, #1, Saco, ME 04072
  • 1-855-838-1370
  • info@shorelinemb.com
  • M-F, 9am - 5pm EST

Why work with us?
  • 40% average denial rate reduction
  • Local billing expertise
  • 24-48 hour claim turnaround
  • Dedicated Wisconsin support team