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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 Connecticut. 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 Connecticut 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 Healthcare Technologies in Connecticut 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.

Connecticut Billing Challenges we solve



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Managing the HUSKY Program Tier Complexity

Connecticut’s HUSKY Health umbrella includes four coverage groups A, B, C, and D and each has its own eligibility rules, cost-sharing, and managed care involvement. Providers frequently struggle with this cross-tier billing transitions, since they must match the claim to the correct program ID number and service coverage rules. We at Shoreline Healthcare Technologies makes sure that every claim aligns with the right HUSKY category avoiding denials and getting the maximum reimbursements.

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Correcting Access Health CT Integration Errors

Connecticut’s Access Health CT have integrated the Medicaid and Marketplace applications under one system. While this benefits patients, it creates complex billing verification issues. Access Health CT and DSS often display asynchronous eligibility updates, causing incorrect eligibility verification. Billing Staffs must always check both the Access Health CT and DSS’s EVS (Eligibility Verification System) before every claim submission to avoid eligibility-based denials. Our billing specialists perform dual verification checks across both systems daily. We maintain a retroactive eligibility tracker, which identifies patients who gained coverage after service delivery and automatically triggers rebilling. Shoreline’s compliance team ensures proper documentation for retroactive eligibility submissions, avoiding timely filing denials.

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Staying Ahead of DSS Policy Bulletins and Retroactive Updates

The Connecticut DSS issues Policy Transmittals and Provider Bulletins frequently sometimes several in a month that retroactively alter fee schedules or documentation rules. Providers often must rebill or adjust previously paid claims to stay compliant and missing these bulletins can lead to recovery audits or take-backs. We at Shoreline Healthcare Technologies maintains an automated bulletin tracker that scans DSS’s Provider Bulletin Index daily. We also perform retroactive reprocessing to recover underpayments from previously billed claims. We help providers to stay compliant with every DSS transmittal, without missing reimbursement opportunities due to outdated codes or rates.

We at Shoreline Healthcare Technologies provide personalized support tailored to the unique needs of Connecticut providers. Our team of experts understands the intricacies of the Connecticut 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 Connecticut

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Specialized Services tailored to meet Connecticut Medicaid rules and regulations

🩺 Services 📍Connecticut Specialization 📈 Typical Improvement ⏱️ Turnaround Time
Medicaid & HUSKY Health Billing Support Expertise in Expertise in HUSKY A, B, C, D claims, coding, and resubmission protocols. 40% reduction in Medicaid claim denials. 1-2 weeks
Eligibility & Enrollment Management Real-time checks through DSS EVS and Access Health CT to prevent eligibility-based rejections. Near 98% accuracy in eligibility verification before claim submission. Instant to 24 hours
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 Connecticut

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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 Connecticut

Connecticut’s telehealth and RPM guidelines and regulations.

Serving Healthcare Providers Across Connecticut

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From Fairfield to Windham, we provide comprehensive medical billing services across all 8 Connecticut counties.

South Carolina Map
Southwestern / Coastal:

Fairfield

South Central / Coastal:

New Haven, Middlesex

Southeastern / Coastal:

New London

Central / North Central:

Hartford, Tolland

Northwestern:

Litchfield

Northeastern:

Windham

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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 Connecticut

Q1. What happens when a patient has another insurance besides Medicaid?

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If a patient has another health plan, Medicaid acts as the payer of last resort. Providers must first bill the primary insurance and then submit the balance to Medicaid. Always include the primary payer’s Explanation of Benefits (EOB) with the Medicaid claim.

Q2. What are the services that usually needs prior authorization?

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Services like image tests, therapy sessions, durable medical equipment (DME), and surgeries needs prior approval. Check the CHNCT portal for the list of all procedures that requires pre-approval.

Q3. What are the categories of HUSKY Program?

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HUSKY A covering people with low-income adults, children and pregnant women.

HUSKY B children under 19 whose families earn too much for Medicaid but still need affordable coverage.

HUSKY C people with disabilities, elderly or blind.

HUSKY D low-income adults in the age of 19-64 without dependent children.

Q4. How can providers enroll themselves to bill for Connecticut Medicaid?

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Providers can submit their enrollment through the Connecticut Medical Assistance Program (CMAP) portal. The process includes submitting licenses, NPI information, and supporting documents for DSS approval. Once approved, providers receive a CMAP ID that must be used on all claims.

Q5. How can Shoreline Healthcare Technologies help providers in Connecticut?

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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 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.

Connecticut Licensed

Licensed to operate in Connecticut

Medical Billing Glossary

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Essential Terms for Understanding the Colorado’s Medical Billing Landscape

Access Health CT

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The official health insurance marketplace of Connecticut where residents can apply and manage their health coverage through various private health plans, Medicaid, and CHIP Program.

Consumer Assessment of Healthcare Providers and Systems (CAHPS)

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The survey program in Connecticut used to collect feedback from patients about their healthcare experiences by which the state and health plans can improve their service quality.

Connecticut’s Program for Health Insurance Assistance, Outreach, Information and Counseling (CHOICES)

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The free counseling service that helps older adults and people with disabilities to understand the various options available in Medicare, Medicaid, and other private health insurance programs in the state of Connecticut.

Connecticut Home Care Program for Elders (CHCPE)

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The program for providing in-home care and support to the residents of age 65 and above who might otherwise need nursing home care.

Connecticut Medical Assistance Program (CMAP)

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The online system for managing the Medicaid claims, provider enrollment, and reimbursements for healthcare services provided in Connecticut.

HUSKY Health

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HUSKY Health is Connecticut’s Medicaid program. It includes coverage for children, parents, adults, and seniors under different groups known as HUSKY A, B, C, and D.

MED Connect

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MED-Connect is a program that allows people with disabilities to work and at the same time keep up their Medicaid coverage. Participants can earn income without losing health benefits.

Money Follows the Person (MFP)

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MFP is a program that helps people who are living in nursing homes or long-term care facilities move back to their own homes or community settings, with services and supports arranged by the state.

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 Healthcare Technologies in Connecticut 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 Connecticut -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 Connecticut support team