logo-new
Appointment Get Free Trail
  • 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 Arizona. 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.

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 Arizona based practice. Ready to outsource your billing needs?  We’ll guide you through your receivable account to make sure that your claims are paid. Explore our case studies to see how we’ve helped practices overcome complex billing challenges and improve cash flow.

Best In the Industry

title_line

Shoreline Healthcare Technologies in Arizona exceed 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.

Arizona Healthcare Billing Challenges we solve



advance
Managing the AHCCCS Tribal Billing Complexities

Arizona has one of the largest Native American populations relying on AHCCCS, providers must navigate dual rules the AHCCCS and the tribal/IHS protocols, also the reimbursement rates vary depending on whether the facility is contracted as a 638 tribal clinic, creating an inconsistent expectation. Non-tribal providers must often validate member’s tribal enrollment because eligibility and payer sequence can shift based on it. At Shoreline Healthcare Technologies we maintain a tribal-focused billing playbook specifically for Arizona’s IHS/638 facilities. Our team checks tribal affiliation, coverage sequence, and reimbursement rules upfront, so that the claims go to the right payer the first time. For non-tribal providers, we handle the coordination with IHS, including required documentation and encounter format quirks. By partnering with Shoreline Healthcare Technologies providers experiences reduced AR days, faster payments, fewer rejections and tighter tribal compliance.

Arizona
APEP Enrollment & Revalidation Headaches

Arizona’s APEP portal is strict and suspends enrollment for any tiny errors, which freezes payment from all other AHCCCS plans. Some specialties like BH providers, non-physician practitioners and mobile units require extra documents. They auto-terminates inactive NPIs faster than many states. We at Shoreline helps providers by managing the entire APEP lifecycle from applications, revalidations, updates, and corrections. Our team prevents common pitfalls like license date gaps, taxonomy mismatches, and address formatting issues. So, there is no more payment holds, all claims flow without any interruption maintaining the revenue cycle healthy.

Billing
Solving the ALTCS Billing Confusions

Unlike the other LTC Medicaid programs in the US, the ALTCS members bounce between standard AHCCCS and ALTCS mid-month, and these ALTCS subcontractors have unique billing formats and time-based units, they require different modifiers and encounter codes. We always check for ALTCS vs non-ALTCS eligibility at every single date-of-service, and map codes to the correct ALTCS-specific procedure and modifier setups.

Our team of experts understands the intricacies of the Arizona healthcare landscape and offers guidance to help practices navigate these challenges effectively with our cloud-based RCM solutions that optimize Revenue Cycle Management.

Comprehensive Medical Billing Services for Arizona

title

Specialized Services tailored to meet Arizona’s Medicaid rules and regulations

🩺 Services 📍Arizona Specialization 📈 Typical Improvement ⏱️ Turnaround Time
Medicaid AHCCCS Billing Integration with AHCCCS systems, daily eligibility checks through EVS, tribal/IHS/638 billing alignment, automated claim scrubbing based on AHCCCS encounter rules. +35% Faster reimbursements, clean claims and reduced rejections. 1-2 weeks
Billing for Managed Care Plans Unified billing framework for Arizona’s major with automated payer-specific modifier mapping and prior authorization validation. +20% increase in revenue through cross-payer optimization. 24-48 Hours
Denial Management AI based tools to track and flag denial codes, identify high-risk categories (e.g., long-term care, behavioral health), and automate resubmissions Reduce rate of denial by 75% and with quicker appeals. 5-7 days
Credentialing & Enrollment Full-service credentialing through APEP, AHCCCS MCO onboarding, ALTCS network enrollment, tribal/IHS contracting support, all revalidation needs. Direct payment activation and inclusion in value-based care incentive programs. 45-90 days
Patient Statements & Follow-Up Communicate with patients and give Explanation of Benefits (EOBs) Reduces overdue balances and better 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 Arizona

title

Comprehensive resources specifically designed for Arizona Healthcare Providers to navigate the complex Billing Landscape.

Medicaid Billing Guide

Complete guide to Medicaid billing requirements and policy updates.

Managed Care program rules and guidelines

Specialized billing guidelines for managed care programs.

Revenue Cycle Optimization

Strategies to improve cash flow and reduce denials.

Telehealth and Remote patient Monitoring in Arizona

Arizona’s telehealth and RPM guidelines and regulations.

Serving Healthcare Providers Across Arizona

title

From Apache to Yavapai, we provide comprehensive medical billing services across all 15 Arizona counties.

South Carolina Map
Northern Arizona:

Apache, Coconino, Mohave, Navajo, Yavapai

Central Arizona:

Gila, Maricopa, Pinal

Southern Arizona:

Cochise, Graham, Greenlee, Pima, Santa Cruz

Western Arizona:

La Paz, Yuma

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 Arizona

Q1. How can Providers check the patient’s eligibility for Arizona Medicaid programs in real time?

+

The Eligibility can be checked by:

  • ✓ Online using the AHCCCS Portal
  • ✓ AHCCCS Provider Portal (ProviderConnect)
  • ✓ 270/271 EDI transactions
  • ✓ Verifying the MCO portals (for members assigned to managed care)

Q2. What is the timely filing limit for Medicaid claims in Arizona?

+

All original Medicaid claims should be submitted within six months from the date of service. For MCOs the period may vary between 6-12 months depending on the plan.

Q3. Does AHCCCS require providers to enroll before billing MCO plans?

+

Yes. Even though MCOs contract separately, it is mandatory to enroll in the AHCCCS via the APEP portal. Termination with the AHCCCS also results in termination of the contract with individual managed care organizations resulting in claim denials.

Q4. What happens if an emergency service is performed without prior authorization?

+

Emergency services do not require PA in Arizona, but documentation of medical necessity must be clear. Plans may still request clinical justification during post-payment review.

Q5. Does Arizona Medicaid follow Medicare NCCI edits?

+

Yes, but they also have additional state-specific edits, that differs between fee-for-service, managed care plans, ALTCS and other tribal programs.

Q6. How can Shoreline Healthcare Technologies help Arizona providers?

+

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.

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.

Arizona Licensed

Licensed to operate in Arizona

Medical Billing Glossary

title

Essential Terms for Understanding Arizona’s Medical Billing Landscape

Arizona Health Care Cost Containment System (AHCCCS)

+

Arizona’s state Medicaid program that contracts with various Managed Care Organizations (MCOs) to deliver services. It acts as the primary rule-setter, for determining the coverage, establishing the medical necessity, prior authorization rules, and reimbursement methodologies (including encounter reporting).

AHCCCS Provider Connect

+

The new online portal of Arizona that is used for provider enrollment & revalidation, demographic updates, license & credential verification, managing affiliations and submitting documents for AHCCCS review. Billing teams can use this portal to ensure provider files remain active and compliant, preventing payment holds and enrollment-related claim denials.

American Indian Health Program (AIHP)

+

The fee-for-service Medicaid program for the American Indian and Alaska Native members, all claims are directed to AHCCCS without any MCOs involvement.

AHCCCS Provider Enrollment Portal (APEP)

+

The legacy system of Arizona used to complete new provider enrollment, submit revalidations, update provider data and track application status Although AHCCCS Provider Connect is replacing it, APEP still plays a role in verifying historical applications and managing transitions.

Children’s Rehabilitative Services (CRS)

+

The specialized AHCCCS program for children with qualifying medical conditions such as congenital anomalies or chronic illnesses.

Electronic Medicare Crossover Reconciliation (EMCR)

+

An AHCCCS process that reconciles Medicare crossover claims to ensure secondary Medicaid payment is accurate and timely. It is important for providers seeing dual-eligible patients as they automate receipt of Medicare adjudicated claims, ensures cost-sharing amounts match Medicare decisions and prevents duplicate billing errors. If Medicare data is incomplete or mismatched, AHCCCS will reject the crossover, triggering additional billing steps.

Quality Management Portal (QM Portal)

+

The system used by providers and MCOs to track the quality metrics, compliance reports, corrective action plans, healthcare-acquired conditions and performance measures tied to value-based payments.

Tribal Arizona Long Term Care System (TRIBAL ALTCS) Program

+

The long-term care system for the Native Americans, they have specific protocols and operates under the 638 authorities. Encounter reporting is mandatory and prior authorization rules differ from non-tribal ALTCS

Our Top-Notch Medical Billing Features

Our Services

title

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

AI Center

Testimonials

title

We Care

title

From electronic health records, billing services and practice management tools – Shoreline has you covered! In addition to being an 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 Arizona 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 Arizona -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 Arizona support team