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Unlock Maximum Reimbursements and Optimize Your Medi-Cal Billing with Shoreline Healthcare Technologies

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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 California. 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 California based practice. Ready to outsource your billing needs? We’ll guide you through your account receivables account to make sure that your claims get paid.

Best In The Industry

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Shoreline Healthcare Technologies in California 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.

Challenges, Meet Solutions - Your Financial Prescription Awaits

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In the complex world of Medi-Cal billing, your practice’s financial health is just as crucial as the care you offer your patients. Unlike the other US States, California presents a unique set of challenges with more than 15 million Medi-Cal beneficiaries, strictest regulatory frameworks, and complex payer systems, due to which the providers often struggle to keep up their revenue cycles healthy. We at Shoreline Healthcare Technologies, help providers navigate these unique billing challenges with our cloud-based RCM solutions that optimize Revenue Cycle Management.

Navigating the Managed Care Plans

California is one of the largest managed care states in US adding layers of complexity like plan-specific portal, authorization process, and claims submission rules. They have varying filing limits from 180 days to 90 days. Providers often struggle to keep up with these varying payer mix. We at Shoreline Healthcare Technologies have consolidated the claim workflows into one unified system with automated eligibility and SOC verifications and ensure compliance with both state & federal rules, resulting in quicker claims submission and improved cash flow.

Managing the No Surprises Act + California layering

California has its own surprise-billing laws layered on the federal NSA; providers must prepare both documentation for patient protection and evidence for IDR when disputing payments. We at Shoreline Healthcare Technologies helps providers to navigate this complex intersection of the federal No Surprises Act (NSA) and California’s surprise billing laws like AB 72 and AB 716. We use automatic billing platforms to determine the applicable regulations apply to each claim, get patient consent and disclosure forms, and ensure accurate cost-sharing and modifier usage. We also manage open negotiations and independent dispute resolutions (IDR) on behalf of providers, maintaining full audit trails and documentation for compliance.

Telehealth coding and parity

California has expanded telehealth access earlier than many states and utilization of telehealth have always remained high. The payer rules for telehealth CPT/HCPCS codes, place-of-service, modifier usage and parity for reimbursement differ across Medi-Cal and Commercial payers. With this variability the correct code selection and documentation become critical for physicians. Shoreline Healthcare Technologies helps providers stay compliant with the latest telehealth policies with automated billing codes, modifiers, and place-of-service updates in line with California’s evolving regulations. All telehealth claims are submitted accurately and reimbursed at parity with in-person visits, minimizing denials and revenue loss while keeping providers audit-ready.

Comprehensive Medical Billing Services for California

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Our comprehensive suite of services is tailored to meet California’s Medicaid rules and regulations

🩺 Services 📍 California Specialization 📈 Typical Improvement ⏱️ Turnaround Time
Medi-Cal Billing Virtual Assistant for Front end management and patient communication, Real-time eligibility verification with Electronic claim submission. Real-time eligibility verification and electronic claim submission +35% Faster reimbursements 1-2 weeks
Billing for Managed Care Plans Unified billing systems across various plans. +20% increase in revenue 24-48 Hours
Denial Management AI tools to track denial patterns and flag them Reduce denial rates by 75% 5-7 days
Credentialing California State licensing, Medi-Cal provider Enrollment, Managed care enrollment through PAVE. Direct payment from Medi-Cal and value-based incentives. 45-90 days
Patient Statements & Follow-Up Clear Explanation of EOB and Patient communication Help reduce overdue balances. 1-2 weeks

California Medical Billing Resources

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

Medi-Cal Billing Guide

Complete guide to Medi-Cal 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 California

California’s telehealth and RPM guidelines and regulations.

Serving Healthcare Providers Across California

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From Alameda to Yuba, we provide comprehensive medical billing services statewide across all 58 counties.

Southern California

Imperial, Kern, Los Angeles, Orange, Riverside, San Bernardino, San Luis Obispo, Santa Barbara, San Diego, Ventura.

San Francisco Bay Area

Alameda, Contra Costa, Marin, Monterey, Napa, San Benito, San Francisco, San Mateo, Santa Clara, Santa Cruz, Solano, Sonoma.

Central Valley & Sierra Nevada

Alpine, Amador, Calaveras, Colusa, Fresno, Glenn, Inyo, Kings, Madera, Mariposa, Merced, Mono, San Joaquin, Stanislaus, Tulare, Tuolumne.

Northern California

Butte, Del Norte, El Dorado, Humboldt, Lake, Lassen, Mendocino, Modoc, Nevada, Placer, Plumas, Sacramento, Shasta, Sierra, Siskiyou, Sutter, Tehama, Trinity, Yolo, Yuba.

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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

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FAQs about Medical Billing Services in California.

Q1. What is the process for checking recipient eligibility for Medi-Cal program?

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Providers can check the recipient’s eligibility by the Medi-Cal Eligibility Verification System (EVS) that can be accessed via

  • ✔ Medi-Cal Provider Portal
  • ✔ Automated Voice Response System (AVRS) at 1-800-456-2387
  • ✔ Point of Service (POS) device (swipe patient’s BIC card)

Q2. What is the timely filing limit for Medi-Cal claims?

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All Original Medi-Cal claims should be filed within 6 months from the month in which the service was rendered. For e.g. if the service is rendered on March 13 the claim must be submitted prior to September 30 to avoid denials or payment reductions.

Q3. How does Share of Cost (SOC) affect Medi-Cal claims?

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The Share of Cost (SOC) is the out-of-pocket amount a Medi-Cal recipient must pay each month before the Medi-Cal coverage begins. It is like a deductible. The SOC amount is based on the recipient’s income level. And claims submitted before the SOC is met will be denied stating “Recipient Not Eligible.”

Q4. What’s the difference between Medi-Cal Fee-for-Service and Managed Care?

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Under Fee-for-Service (FFS) providers can bill directly the DHCS for each service. Whereas with Managed Care programs providers contract with a specific plan and bill the plan, not the DHCS.

Q5. How can providers enroll as Medi- Cal Provider?

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Providers can enroll themselves to serve the Medi-Cal Patients by applying through the secure online portal PAVE maintained by the Department of Health Care Services (DHCS). Once approved, they receive a Medi-Cal Provider ID, allowing them to bill DHCS and contract with Medi-Cal Managed Care Plans (MCPs)

Q6. How can Shoreline Healthcare Technologies help California providers?

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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 Medi-cal specific rules.

Compliance & Certifications

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Your data security and compliance are our top priorities.

HIPAA Compliant

Full HIPAA compliance with regular audits

AAPC Certified

Certified Professional Billing Staffs.

California Licensed

Licensed to operate in California

Medical Billing Glossary

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Essential Terms for Understanding California’s Medical Billing Landscape.

Benefits Identification Card (BIC):

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The Plastic Identity card issued by Medi-Cal to all its beneficiaries that contains the member’s ID number, which providers use for eligibility verification and billing.

Medi-Cal:

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The Medicaid program of California providing health insurance and healthcare services to low-income individuals like seniors, people with disabilities, children in foster care and pregnant women. It is jointly funded by the state and federal government.

Medi-Cal Subscription Service (MCSS):

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It is free email update service from the California Department of Health Care Services (DHCS). It sends subscribers the official updates about Medi-Cal policies, billing, and coding changes.

Provider Application and Validation for Enrollment (PAVE) Portal:

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The secure online portal of California where providers can apply for Medi-Cal enrollment, revalidate, and update their information.

Share of Cost (SOC):

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The fixed dollar amount per month, based on income for Medi-Cal beneficiaries who have income slightly above the “no-cost Medi-Cal” limit. They must pay or “meet” their Share of Cost only after which the Medi-Cal will start paying for covered services.

Treatment Authorization Request (TAR):

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The formal request submitted by a healthcare provider to Medi-Cal (or a Medi-Cal Managed Care Plan) to get prior authorization for certain medical services, procedures, drugs, or equipment before they are provided.

Our Services

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

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Testimonials

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My first time in solo practice I was very concerned about my ability to manage "the business side" of medicine. The personalized care and guidance this group provided to me and my staff were really a life saver. They always had quick turnaround on any questions I sent in, and were very knowledgeable for problem solving on the fly! I never feel like just a number, as I might have with a large corporation. quote

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Family Medicine Centre in Maine
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“We use Shoreline Medical Billing for all our billing needs, the support is second to none! They are always up to date with coding updates which helps to ensure timely billings and prompt payments. I highly recommend Shoreline Medical Billing for your billing needs.”

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Nephrology Group in New Hampshire
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I have been using Shoreline Medical Billing for almost 2 years, and I could not be more pleased with their service. They really care about my business. With all the complexities of medical billing, we needed a professional partner to help us. Shoreline delivered.


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Pain Management in New Jersey
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We switched to Shoreline Medical Billing. Our claims are getting paid, and we are getting friendly, knowledgeable service. We highly recommend Shoreline.


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★ ★ ★ ★ ★
Internal Medicine & Nephrology in Georgia
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I’m a small pediatric OT practice and have been with Shoreline for several years now. They have made it so easy for me to keep my focus on patient care by being so knowledgeable and so efficient with all aspects of my billing. When I do have questions, they are always available and able to help quickly. Couldn’t be happier!

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Peds OT Clinic in Maine
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Thanks so much for working so hard to help my company:) It sound cheesy, but having a biller I could trust changed my life by giving me the headspace/time to focus on clinical work, scale my business and sleep better at night. I've had quite a few people ask about you on Facebook Messenger from my posts. Overall, the feedback I've heard back from everyone is that you guys are very responsive and helpful. quote

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Nurse Practitioner Group in Washington
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Hi, following up on our conversation about Shoreline. I did let them know that I had some concerns and they were very understanding. They have been very responsive and proactive in their billing process, reports and communication. It has been very good. Thank for recommending them.

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Nurse practitioner in Delaware
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Before Shoreline, billing was a constant headache. Now, our reimbursements are faster, and I’m no longer chasing unpaid claims. Their team handles everything so efficiently, it’s one less thing I need to worry about.



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Internal Medicine in Arizona

We Care

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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 medical billing services in California understands how to navigate today’s complex healthcare revenue environment.

Ready to Optimize Your Medical Billing?

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

Get Your Free Consultation

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Contact Information

  • 4 Scammon Street, Suite 19-343, saco, ME 04072
  • 1-855-838-1370
  • info@shorelinemb.com
  • M-F, 9am - 5pm EST
Why work with us?
  • ✔ 40% average denial rate reduction
  • ✔ California Care billing specialists
  • ✔ 24-48 hour claim turnaround
  • ✔ Dedicated California support team