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  • 445 Main Street, 2nd Floor, #1, Saco, ME 04072
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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 Iowa. 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 Iowa-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 Iowa 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.

Iowa Billing Challenges we solve



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Fragmented Administration Between State Oversight and Managed Care Operations


Iowa operates Medicaid through a hybrid structure where policy authority sits with the state, while claims flow through managed care organizations under the umbrella of Iowa Medicaid Enterprise. Therefore, providers get trapped between the state Medicaid approvals and MCO payment rules that don’t align with each other. We at Shoreline Healthcare Technologies have built a dual-rule adjudication model inside our billing workflow with one mapped to the Iowa Medicaid policy and the other mapped to each MCO’s unpublished payment behavior. So that every claim is scrubbed twice before submission, one against the state coverage law and the other against the real-world MCO denial patterns. This helps to reduce the denial rates considerably.

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

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Specialized Services tailored to meet Iowa Medicaid rules and regulations

🩺 Services 📍Iowa Specialization 📈 Typical Improvement ⏱️ Turnaround Time
End-to-End Medical Billing Full compliance with Iowa Medicaid Enterprise (IME), Iowa Health Link MCOs, FFS claims, and rural billing standards 20–35% reduction in denials, faster payment cycles across multiple plans. Claim submission within 24–48 hours
Iowa Medicaid & MCO Eligibility Verification (ELVS) Real-time ELVS verification, mid-month eligibility change tracking, and Annual Choice MCO switch monitoring 15–30% drop in eligibility-based denials Instant + daily auto-refresh
PDN/PC Billing & Authorization Control Hour-level unit caps, nursing credential validation, physician order & POC enforcement 30%–50% recovery of previously lost PDN revenue 3–5 business days
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 telehealth geography rules, specific 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 Iowa

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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 Iowa

Iowa’s telehealth and RPM guidelines and regulations.

Serving Healthcare Providers Across Iowa

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From Adair to Winnebago, we provide comprehensive medical billing services across all 99 Iowa counties. .

South Carolina Map
Northwest:

Buena Vista, Cherokee, Clay, Dickinson, Emmet, Lyon, O'Brien, Osceola, Palo Alto, Plymouth, Pocahontas, Sioux

North Central:

Butler, Cerro Gordo, Floyd, Franklin, Hancock, Humboldt, Kossuth, Mitchell, Winnebago, Worth, Wright

Northeast:

Allamakee, Black Hawk, Bremer, Buchanan, Chickasaw, Clayton, Delaware, Dubuque, Fayette, Howard, Winneshiek

West Central:

Audubon, Calhoun, Carroll, Crawford, Greene, Guthrie, Harrison, Ida, Monona, Sac, Shelby, Woodbury

Central:

Boone, Dallas, Grundy, Hamilton, Hardin, Jasper, Marshall, Polk (most populous, contains Des Moines), Poweshiek, Story, Tama, Webster

East Central:

Benton, Cedar, Clinton, Iowa, Jackson, Johnson, Jones, Linn, Muscatine, Scott

Southwest:

Adair, Adams, Cass, Fremont, Mills, Montgomery, Page, Pottawattamie, Taylor, Union

South Central:

Appanoose, Clarke, Decatur, Lucas, Madison, Marion, Monroe, Ringgold, Warren, Wayne

Southeast:

Davis, Des Moines, Henry, Keokuk, Lee, Louisa, Mahaska, Van Buren, Wapello, Washington

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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 Iowa

Q1. How does a provider enroll in Iowa Medicaid?

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Providers can enroll themselves by completing the enrollment through Iowa’s provider enrollment system with credential verification, taxonomy validation, and ownership disclosure.

Q2. What Is Iowa Health Link?

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Iowa Health Link is the primary managed care delivery system for Iowa Medicaid. Most of the Medicaid members receive their healthcare benefits through a Managed Care Organization (MCO) that they select. It is designed to integrate physical health, behavioral health, and long-term care services into a single, coordinated system of care. Through this program, members receive structured access to primary care, specialty care, home health, behavioral health services, and long-term support services. All the majority of Iowa Medicaid members are enrolled in Iowa Health Link.

Q3. Does Hawki follow Medicaid billing rules?

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No. Hawki uses commercial insurance logic, and not Medicaid logic. Some benefits require cost sharing; they have annual service limits and enforce broader medical necessity edits.

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

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HFS Fee-for-Service 365 days from the date of service
Most MCOs 180 days varies across plans
Long term care 180-365 days

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

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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.

Iowa Licensed

Licensed to operate in Iowa

Medical Billing Glossary

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Essential Terms for Understanding the Iowa’s Medical Billing Landscape

Annual Choice

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It is the Iowa Medicaid’s once-a-year managed care plan selection window for most of the Medicaid members. For providers, this program is important because patients can change their Managed Care Organization (MCO) only during this period unless they qualify for a special exception.

Electronic Verification System (ELVS)

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The Medicaid’s real-time eligibility verification system that confirms the eligibility status, MCO assignment, Coverage category and Lock-in status for Primary Care Providers.

Healthy and Well Kids in Iowa (Hawki)

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It is the Children’s Health Insurance Program (CHIP) that provides health insurance to the children under the age of 19 with family’s income too high for Medicaid but still they couldn’t afford private insurance.

Iowa Health and Wellness Plan (IHAWP)

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It is the Iowa’s Medicaid expansion program for adults in the age group of 19–64 years with income up to 133% of the Federal Poverty Level. What makes IHAWP different from standard Medicaid is that it includes personal responsibility requirements, where members have to make monthly contributions.

The Private Duty Nursing/Personal Cares (PDN/PC) program

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The program that covers continuous skilled nursing and personal care services for members with complex medical needs, ventilator dependency, severe chronic conditions, pediatric or technology-dependent care. It is one of the most compliance-heavy billing programs in Iowa with tight hourly service limits, EVV synchronization mandates, medical necessity reviews tied to physician orders, plan of care and nursing acuity scoring.

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 Iowa 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 Iowa -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 Iowa support team