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 Michigan. 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 Michigan-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 Michigan 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.

Michigan Billing Challenges we solve

Eliminating the Managed Care chaos across all MHPs

Over 90% of the Medicaid beneficiaries in Michigan are enrolled in Medicaid Health Plans (MHPs) rather than traditional fee-for-service Medicaid. Each MHP operates with its own claims platform, different authorization rules, unique modifier requirements, non-uniform appeal timelines and plan-specific fee schedules. These are further complicated by the monthly auto-assignment switching, where a patient who was with one plan last month can silently move to another without notifying the provider. Claims submitted under the wrong plan gets denied automatically even if the patient is still eligible for Medicaid. We at Shoreline Healthcare Technologies have a built-in payer-specific billing workflows for each of the Michigan’s MHP instead of using the generic Medicaid rules. We verify the real-time payer assignment on daily basis to prevent wrong-plan denials, along with that we keep a track of Monthly MHP auto-assignment. We have also enforced a plan-specific modifier usage and have mapped all the appeal timelines for every MHP, to ensure no filing window is missed. This has helped the providers significantly by reducing the denials due to wrong payers’, shortening the resubmission cycles and stabilizing the cash flow.

Full Behavioral Health & CMHSP Billing Infrastructure

Mental health, substance use disorder (SUD), and developmental disability services in Michigan are not billed likethe standard medical claims. They are carved out and managed through PIHPs and CMHSPs. This creates a separate billing ecosystem with different authorization pathways, nonstandard CPT and modifier combinations, encounter-based reporting instead of traditional claims. We at Shoreline Healthcare Technologies have a dedicated CMHSP and PIHP billing teams trained specifically in encounter-based billing models. This helps behavioral health providers get faster reimbursements.

Solving the HMP’s Cost-Sharing Confusion

The HMP requires beneficiary cost-sharing and contribution tracking, due to which the providers must deal with income-based beneficiary payments, incorrect patient balances appearing on remittance advice and confusions about what can legally be collected at the point of care. We at Shoreline Healthcare Technologies removes this confusion by fully managing the Income-tier based cost-share reconciliation and patient liability tracking. By partnering with us there is NO patient complaints, NO compliance risk, NO revenue loss.

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

Specialized Services tailored to meet Michigan Medicaid rules and regulations

🩺 Services	📍Michigan Specialization	📈 Typical Improvement	⏱️ Turnaround Time
End-to-End Medical Billing	Billing aligned to MDHHS rules, Michigan Medicaid FFS, and all major Medicaid Health Plans (MHPs) including Healthy Michigan Plan (HMP).	15–25% increase in Payment collections with 20–30% reduction in net denial rate.	Initial setup: 2–4 weeks; ongoing claims: 24–72 hours from receipt of documentation.
Claims Management for FFS and MHP’s	Plan-specific billing workflows for all MHPs, including HMP cost-sharing rules, balance-billing compliance, and payer-specific edits.	15–30% drop in denials, faster payment cycles by 7–10 days.	Claims submitted within 24–48 hours of complete encounter data.
CHAMPS Enrollment & Maintenance	Complete management of CHAMPS enrollment, revalidation, ownership/location/taxonomy updates to prevent enrollment-related denials.	Up to 90% fewer CHAMPS-related denials; elimination of sudden Medicaid payment freezes.	New enrollment: 1–3 weeks, continuous profile monitoring.
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 Michigan

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 Michigan

Michigan’s telehealth and RPM guidelines and regulations.

Serving Healthcare Providers Across Michigan

From Alger to Wexford, we provide comprehensive medical billing services across all 83 Michigan counties. .

Upper Peninsula:

Alger, Baraga, Chippewa, Delta, Dickinson, Gogebic, Houghton, Iron, Keweenaw, Luce, Mackinac, Marquette, Menominee, Ontonagon, Schoolcraft

Northern Lower Peninsula:

Alcona, Alpena, Antrim, Arenac, Benzie, Charlevoix, Cheboygan, Clare, Crawford, Emmet, Gladwin, Grand Traverse, Iosco, Kalkaska, Lake, Leelanau, Manistee, Mason, Mecosta, Missaukee, Montmorency, Newaygo, Oceana, Ogemaw, Osceola, Oscoda, Otsego, Presque Isle, Roscommon, Wexford

West Michigan:

Allegan, Barry, Berrien, Branch, Calhoun, Cass, Eaton, Ionia, Kalamazoo, Kent (Grand Rapids), Muskegon, Ottawa, St. Joseph, Van Buren

Mid-Michigan:

Bay, Clinton, Genesee, Gratiot, Huron, Ingham (Lansing), Isabella, Lapeer, Midland, Montcalm, Saginaw, Sanilac, Shiawassee, Tuscola

Southeast Michigan:

Hillsdale, Jackson, Lenawee, Livingston, Macomb, Monroe, Oakland, Washtenaw, Wayne

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 Michigan

Q1. Is Michigan Medicaid mostly managed care or fee-for-service?

Michigan’s Medicaid primarily works under managed care. Over 90% of Medicaid members are enrolled in MHPs. Fee-for-service is mainly limited to tribal services, selected waiver populations and retroactive eligibility periods.

Q2. How is a PIHP different from a CMHSP?

PIHP’s receives capitation from the state and funds the regional CMHSPs. It enforces audit and encounter compliances for mental health programs. The Funding pattern is:

Michigan Medicaid → PIHP → CMHSP → Provider.

Q3. Can behavioral health claims be billed to medical MHPs?

No. All mental health program claims and substatnce use disorders must be billed through CMHSP/PIHP systems, and not the standard MHPs.

Q4. What is the HMP different from the regular Medicaid?

The Healthy Michigan Plan (HMP) is Michigan’s Medicaid expansion program for low-income adults (ages 19–64). Unlike traditional Medicaid, HMP includes:

Monthly income-based cost-sharing
Patient contribution tracking
Preventive care incentives
Strict limits on balance billing

Providers must correctly apply cost-share rules, or they might risk compliance violations.

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

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.

Michigan Licensed

Licensed to operate in Michigan

Medical Billing Glossary

Essential Terms for Understanding the Michigan’s Medical Billing Landscape

Community Health Automated Medicaid Processing System (CHAMPS)

It is the Michigan’s official Medicaid provider enrollment, credentialing, and claims management system. All healthcare providers must enroll in CHAMPS to bill their services for Medicaid, to update their ownership, locations, and taxonomy details for maintaining an active provider status and to avoid claim rejections due to enrollment mismatches.

Community Mental Health Services Program (CMHSP)

CMHSPs are local public authorities for managing the Medicaid-funded behavioral health, intellectual disability, and substance use disorder services at the county or regional level in Michigan. They operate under the Michigan’s behavioral health carve-out system and receive funding through PIHPs.

Children’s Special Health Care Services (CSHSC)

The special healthcare program for children and adults with genetic disorders, chronic illnesses, and physical impairments. They have their own eligibility, authorization, and reimbursement rules.

Healthy Michigan Plan (HMP)

It is the Medicaid expansion program created under the Affordable Care Act, for providing healthcare coverage to low-income adults in the age group of 19–64. It includes unique cost-sharing and contribution requirements that are not found in the traditional Medicaid.

Michigan Department of Community Health (MDCH)

It is the former state agency which managed the public health and Medicaid services for the state of Michigan. Its responsibilities are now handled by MDHHS.

Michigan Department of Health and Human Services (MDHHS)

The primary state agency in Michigan responsible for administering the Medicaid, behavioral health services, public health programs, and eligibility systems. It oversees the Medicaid policies, PIHP and CMHSP administration, provider enrollment rules, program compliance, waiver programs, audits and eligibility systems.

Prepaid Inpatient Health Plan (PIHP)

They are the regional behavioral health managed care entities that receive capitation payments from the state to manage Medicaid-funded programs for mental illness, emotional, intellectual and developmental disabilities and substance use disorder.

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 Michigan 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 Michigan -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 Michigan support team

The Best Medical Billing Company in Michigan - Shoreline

Best In the Industry

Michigan Billing Challenges we solve

Eliminating the Managed Care chaos across all MHPs

Full Behavioral Health & CMHSP Billing Infrastructure

Solving the HMP’s Cost-Sharing Confusion

Comprehensive Medical Billing Services for Michigan

Medical Billing Resources for Michigan

Medicaid Billing Guide

Behavioral & Mental Health Billing rules and guidelines

Revenue Cycle Optimization

Telehealth and Remote patient Monitoring in Michigan

Serving Healthcare Providers Across Michigan

Upper Peninsula:

Northern Lower Peninsula:

West Michigan:

Mid-Michigan:

Southeast Michigan:

Savings Estimation Calculator

Frequently Asked Questions

Q1. Is Michigan Medicaid mostly managed care or fee-for-service?

Q2. How is a PIHP different from a CMHSP?

Q3. Can behavioral health claims be billed to medical MHPs?

Q4. What is the HMP different from the regular Medicaid?

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

Compliance & Certifications

HIPAA Compliant

AAPC Certified

Michigan Licensed

Medical Billing Glossary

Community Health Automated Medicaid Processing System (CHAMPS)

Community Mental Health Services Program (CMHSP)

Children’s Special Health Care Services (CSHSC)

Healthy Michigan Plan (HMP)

Michigan Department of Community Health (MDCH)

Michigan Department of Health and Human Services (MDHHS)

Prepaid Inpatient Health Plan (PIHP)

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?