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  • 1-855-838-1370
  • 445 Main Street, 2nd Floor, #1, Saco, ME 04072
  • Mon to Fri 9:00AM to 06:00PM EST
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Shoreline Medical Billing Company is a proud Maine-based company that offers end to end revenue cycle management services to physicians and Medical billing companies in Colorado. 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 Colorado 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

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Shoreline Medical Billing Company in Colorado 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.

Colorado Billing Challenges we solve



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Managing the Complex Medicaid Structure

Unlike many states, Colorado’s Medicaid program operates through regional organizations (RAEs) with each having their own claim processes, pre-authorization requirements, and performance reporting rules. This decentralized system often confuses billing staff, leading to delayed or denied claims. We at Shoreline maintains real-time RAE-specific billing workflows, tracking regional rule updates, and integrating with payer-specific edits directly into our billing system. Our experts handle the complete RAE submissions end-to-end with precision and accuracy.

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Medicaid Expansion & Eligibility Verification Delays

Providers in Colorado have faces constant fluctuations in patient eligibility and frequent coverage lapses, especially for transient populations or seasonal workers. These gaps cause claim rejections and payment losses. We at Shoreline Medical Billing Company perform real-time eligibility checks across Medicaid, Medicare, and other private payers before every claim submission. Our system alerts any coverage changes instantly, preventing denials even before they occur.

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Overcoming the Behavioral and Mental Health Billing Barriers

Billing for mental health services comes with unique rules like bundled codes, telehealth coverage, and concurrent billing limits. We are specialized in behavioral health billing and understands all the claim formatting processes, service modifiers, and parity requirements. Our audit-ready processes ensure compliance while maximizing the behavioral health reimbursement.

We at Shoreline Medical Billing Company provide personalized support tailored to the unique needs of Colorado providers. Our team of experts understands the intricacies of the Colorado 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 Colorado

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Specialized Services tailored to meet Colorado Medicaid rules and regulations

🩺 Services 📍Colorado Specialization 📈 Typical Improvement ⏱️ Turnaround Time
Medicaid & RAE Billing Support Expertise in Colorado’s Regional Accountable Entities (RAEs), region-specific edits, coding, and resubmission protocols. 40% reduction in Medicaid claim denials. 1-2 weeks
Behavioral & Mental Health Billing Compliant with BHASO billing rules, bundled codes, and telehealth coverage per state parity laws. 30% increase in approved behavioral health claims. 48 hours claim processing window.
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. 5-7 days
Credentialing & Enrollment Supports provider enrolment revalidation, and credentialing. Ensures active status and timely reimbursements. 45-90 days
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 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 Colorado

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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 Colorado

Colorado’s telehealth and RPM guidelines and regulations.

Serving Healthcare Providers Across Colorado

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From Adams to Yuma, we provide comprehensive medical billing services across all 64 Colorado counties.

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Denver Metro/Central Colorado:

Adams, Arapahoe, Broomfield (City & County), Clear Creek, Denver (City & County), Douglas, Gilpin, Jefferson, Park

Northeast Colorado:

Boulder, Cheyenne, Elbert, Kit Carson, Larimer, Lincoln, Logan, Morgan, Phillips, Sedgwick, Washington, Weld, Yuma

Western Slope / Northwest Colorado:

Delta, Eagle, Garfield, Grand, Gunnison, Jackson, Hinsdale, Lake, Mesa, Moffat, Montrose, Pitkin, Rio Blanco, Routt, Summit

Southeast Colorado:

Baca, Bent, Crowley, Custer, El Paso, Fremont, Huerfano, Kiowa, Las Animas, Otero, Prowers, Pueblo, Teller

Southwest/South Central Colorado:

Alamosa, Archuleta, Chaffee, Conejos, Costilla, Dolores, La Plata, Mineral, Montezuma, Ouray, Rio Grande, Saguache, San Juan, San Miguel

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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 Colorado

Q1. How can Colorado providers ensure clean claims on the first submission?

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All clean claims depend on accurate RAE-specific coding, eligibility checks through the Health First Colorado portal, and pre-authorization verifications. By Partnering with a local billing expert like Shoreline Medical Billing company providers can have 95% of First Pass Claims with electronic scrubbing for both state and federal compliance before submission.

Q2. What are the timely filing limits for claim submissions in Colorado?

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The standard timely filing limit is 120 days from the date of service. However, secondary claims or retroactive eligibility adjustments may have different windows.

Q3. What is BHASO billing, and why is it important in Colorado?

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BHASO (Behavioral Health Administrative Services Organization) billing applies to mental and behavioral health services under Colorado Medicaid. It has its own billing codes, documentation requirements, and service limitations

Q4. How Does Medicaid reimburse telehealth for behavioral health services?

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All mental health services delivered virtually are reimbursed at the same rate as in-person visits, provided the claims are submitted with proper modifiers (like 95) and documentation.

Q5. How can Shoreline Medical Billing Company help providers in Colorado?

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We at Shoreline Medical Billing Company 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

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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.

Colorado Licensed

Licensed to operate in Colorado

Medical Billing Glossary

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Essential Terms for Understanding the Colorado’s Medical Billing Landscape

Acentra Prior Authorization Request (Acentra PAR)

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The online system used for obtaining prior authorizations approval by Colorado Medicaid providers. They can submit and track prior authorization requests for services, medications, or procedures using this system, before rendering the service.

Colorado Benefits Management System (CBMS)

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The central database of the state of Colorado that processes applications and manages eligibility for Medicaid, CHP+, and other public programs. CBMS checks whether an applicant’s income and personal information meet state and federal guidelines for health coverage.

Child Health Plan Plus (CHP+)

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CHP+ program offers low-cost health coverage to children and pregnant women having family’s income little high to qualify for Medicaid, however they might still need financial help from insurance. CHP+ includes doctor visits, hospital stays, dental, vision, and prescription benefits.

Colorado Access

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Colorado Access is one of the RAEs operating in the state of Colorado that helps to manage Medicaid benefits for members in particular area. They ensure that members get appropriate and timely care through their provider network coordinating with medical, behavioral, and community-based services.

Health First Colorado

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The official name of the Medicaid program in Colorado that provides free or low-cost health coverage to children, adults, seniors, and individuals with disabilities who fulfils certain eligibilities.

Colorado Department of Health Care Policy & Financing (HCPF)

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It administers Medicaid (Health First Colorado) and CHP+ programs in Colorado. They regulate the delivery of Medicaid services and reimbursements across the state. They are responsible for developing the coverage policies, managing provider enrolment and maintains compliance.

Program Eligibility and Application Kit (PEAK)

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The online self-service portal where the residents of Colorado can apply for Medicaid, CHP+, and for other benefits like food assistance etc. They can even check eligibility, upload documents, renew coverage, and manage benefits without visiting an office.

Regional Accountable Entity (RAE)

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RAEs are responsible for managing the local healthcare delivery under Medicaid. They coordinate with the physical and behavioral health services, work with providers to improve outcomes, and ensure members receive quality care within their region. The state of Colorado is divided into several such RAEs.

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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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 Company in Colorado 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 Colorado-specialized billing services.

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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 Colorado support team