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 Idaho. 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 Idaho 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

Shoreline Healthcare Technologies in Idaho 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.

Idaho Billing Challenges we solve

Keeping Up with Idaho’s Frequent Medicaid Manual Updates

Idaho Medicaid updates its provider manuals and bulletins more often without a long transition period. Code sets, documentation rules, or prior auth criteria change without broad alerts. Shoreline Healthcare Technologies protects providers by monitoring every Idaho Medicaid bulletin and updates billing rules instantly. We keep training your staff when new rules affect front-end processes and adjust authorization workflows, documentation needs, and code sets to catch missed revenue, so that providers aren’t blindsided by sudden reimbursement cuts or new requirements.

Managing Idaho’s Aggressive Eligibility Re-Determinations and Mid-Cycle Coverage Flips

Idaho performs aggressive eligibility redeterminations, more than many states. As a result, patients may fall in and out of active Medicaid status mid-treatment plan. Long-term therapy, maternity care, dental care, and chronic-condition treatment plans get interrupted financially. Providers must constantly verify eligibility before every single visit or might risk rendering uncompensated care. We at Shoreline Healthcare Technologies provides real-time eligibility checks before every appointment and gives automatic alerts when a patient’s coverage changes mid-plan. We provide guidance to staff on how to update authorizations when eligibility resets and clean-up “lost” claims that became unpaid because of coverage flip without warning thereby stabilizing the cash flow.

Solving Idaho’s Telehealth Geographic Restrictions

Idaho’s huge frontier areas affect Medicaid payment. Though, Telehealth billing is allowed, some originating-site rules are different in frontier counties. Providers must document whether the patient’s home location is in a qualifying area as they get updated yearly. Mistakes in these geography rules might lead to silent denials, without any clear rejections. Telehealth claims get denied in Idaho just because a ZIP code isn’t logged correctly. We at Shoreline uses location-validation tools to ensure the patient’s home qualifies under Idaho’s frontier guidelines, applies the correct POS codes and modifiers for allowed rural scenarios. This removes the guesswork and protects revenue from unnecessary telehealth denials.

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

Specialized Services tailored to meet Idaho Medicaid rules and regulations

🩺 Services	📍Idaho Specialization	📈 Typical Improvement	⏱️ Turnaround Time
End-to-End Medical Billing	Routing physical health claims to Idaho Medicaid with payer-specific edit logic.	20–35% reduction in denials, faster payment cycles across multiple plans.	1-2 Weeks
Eligibility & Coverage Verification	Real-time checks tailored for Idaho’s frequent redeterminations and mid-cycle coverage flips.	15–30% drop in eligibility-related write-offs	Instant + daily auto-refresh
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
Telehealth Billing	Applies Idaho’s frontier-area telehealth geography rules, eligible ZIP codes, modifiers, and POS	25–40% fewer telehealth denials	Same-day telehealth claim processing.
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 Idaho

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 Idaho

Idaho’s telehealth and RPM guidelines and regulations.

Serving Healthcare Providers Across Idaho

From Ada to Washington, we provide comprehensive medical billing services across all 44 Idaho counties.

Northern Idaho:

Benewah, Bonner, Boundary, Kootenai, Shoshone

North Central Idaho:

Clearwater, Idaho, Latah, Lewis, Nez Perce

Southwestern Idaho:

Ada, Adams, Boise, Canyon, Elmore, Gem, Owyhee, Payette, Valley, Washington

South Central Idaho:

Blaine, Camas, Cassia, Gooding, Jerome, Lincoln, Minidoka, Twin Falls

Southeastern Idaho:

Bannock, Bear Lake, Bingham, Caribou, Franklin, Oneida, Power

Eastern Idaho:

Bonneville, Butte, Clark, Custer, Fremont, Jefferson, Lemhi, Madison, Teton

Savings Estimation Calculator

Practice Type/Speciality

No. of Physicians

Monthly Patient Volume

% of Insurance Pay Patient

% of Self Pay Patient

Frequently Asked Questions

FAQs about Medical Billing Services in Idaho

Q1. How do Healthy Connections referrals affect billing?

Patients in Healthy Connections need coordinated care through their assigned PCP. If a referral is missing or outdated, claims get denied even if the service is covered. This hits specialties like ENT, cardiology, orthopedics, etc.

Q2. How can providers prevent losses during Idaho’s Medicaid redetermination cycles?

To avoid losses providers can run eligibility checks at every encounter, flag high-risk patients (new moms, members with gaps, waiver kids) and update PAs when eligibility category changes.

Q3. How can providers reduce denials caused by the Idaho Gainwell MMIS system?

✔ Check the weekly Medicaid bulletins because Idaho updates rules often.
✔ Use an Idaho-specific claim scrubber to catch state-unique edits.
✔ Make sure the place-of-service codes and modifiers match Idaho’s rules (especially for telehealth).
✔ Verify NDC numbers and units for all drug and injection claims.
✔ Re-check patient eligibility on the actual date of service.
✔ Watch out for top recurring denial codes and fix the patterns early.

Q4. What is the timely filing limit for Medicaid claims in Idaho?

Original Medicaid claims	Within 12 months from the date of service
Adjustments and corrected claims	Within six months from the date of the remittance advice.

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

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

Your data security and compliance are our top priorities.

HIPAA Compliant

Full HIPAA compliance with regular audits

AAPC Certified

Certified Professional Billing Staffs.

Idaho Licensed

Licensed to operate in Idaho

Medical Billing Glossary

Essential Terms for Understanding the Idaho’s Medical Billing Landscape

Estate Recovery Program

The program by which the Idaho Medicaid recovers the cost of certain services from the estate of a member after they pass away. This usually applies to adults who received long-term care, home- and community-based services, or were permanently in nursing facilities. The state may claim against assets like property or bank accounts, but only after the member’s death and only within Idaho’s rules. Families are notified through IDHW, and there are exemptions for surviving spouses, minor children, or situations that would cause hardship.

Healthy Connections

Idaho’s main Medicaid care management program. Members are assigned to a primary care provider who coordinates all care, referrals often matter for billing or PA approval.

Healthy Connections Value Care

Idaho’s version of value-based care, where certain provider groups get paid based on quality, cost savings, and meeting outcomes. It affects reporting, referrals, and care coordination rules.

Idaho Department of Health and Welfare (IDHW)

The state agency for overseeing the Medicaid, behavioral health programs, eligibility determinations, and policy updates. All Idaho Medicaid guidance flows through IDHW.

Katie Beckett Program

A Medicaid eligibility pathway for children with serious medical needs who wouldn’t normally qualify under household income rules. This allows kids to receive services at home without institutional placement.

My Choice Matters

Idaho’s Self-Direction program under Medicaid that lets adults with developmental disabilities or aging-related needs manage their own care instead of relying on agency-directed services. Members (or their authorized representatives) can hire caregivers of their choice, decide on schedules, manage budgets, and select the services that best fit their daily living needs. Idaho Medicaid still oversees the plan, but the individual has far more control over who provides their care and how it’s delivered.

Our Services

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

Testimonials

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.

★ ★ ★ ★ ★

Family Medicine Centre in Maine

“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.”

★ ★ ★ ★ ★

Nephrology Group in New Hampshire

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.

★ ★ ★ ★ ★

Pain Management in New Jersey

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

★ ★ ★ ★ ★

Internal Medicine & Nephrology in Georgia

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!

★ ★ ★ ★ ★

Peds OT Clinic in Maine

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.

★ ★ ★ ★ ★

Nurse Practitioner Group in Washington

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.

★ ★ ★ ★ ★

Nurse practitioner in Delaware

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.

★ ★ ★ ★ ★

Internal Medicine in Arizona

We Care

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 Idaho understands how to navigate today’s complex healthcare revenue environment.

Ready to Optimize Your Medical Billing?

Get your free consultation and discover how much you could save with our Idaho -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 Idaho support team

The Best Medical Billing Company in Idaho - Shoreline

Best In the Industry

Idaho Billing Challenges we solve

Keeping Up with Idaho’s Frequent Medicaid Manual Updates

Managing Idaho’s Aggressive Eligibility Re-Determinations and Mid-Cycle Coverage Flips

Solving Idaho’s Telehealth Geographic Restrictions

Comprehensive Medical Billing Services for Idaho

Medical Billing Resources for Idaho

Medicaid Billing Guide

Behavioral & Mental Health Billing rules and guidelines

Revenue Cycle Optimization

Telehealth and Remote patient Monitoring in Idaho

Serving Healthcare Providers Across Idaho

Northern Idaho:

North Central Idaho:

Southwestern Idaho:

South Central Idaho:

Southeastern Idaho:

Eastern Idaho:

Savings Estimation Calculator

Frequently Asked Questions

Q1. How do Healthy Connections referrals affect billing?

Q2. How can providers prevent losses during Idaho’s Medicaid redetermination cycles?

Q3. How can providers reduce denials caused by the Idaho Gainwell MMIS system?

Q4. What is the timely filing limit for Medicaid claims in Idaho?

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

Compliance & Certifications

HIPAA Compliant

AAPC Certified

Idaho Licensed

Medical Billing Glossary

Estate Recovery Program

Healthy Connections

Healthy Connections Value Care

Idaho Department of Health and Welfare (IDHW)

Katie Beckett Program

My Choice Matters

Our Services

Testimonials

Family Medicine Centre in Maine

Nephrology Group in New Hampshire

Pain Management in New Jersey

Internal Medicine & Nephrology in Georgia

Peds OT Clinic in Maine

Nurse Practitioner Group in Washington

Nurse practitioner in Delaware

Internal Medicine in Arizona

We Care

Ready to Optimize Your Medical Billing?

Get Your Free Consultation

Contact Information

Why work with us?