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  • 445 Main Street, 2nd Floor, #1, Saco, ME 04072
  • Mon to Fri 9:00AM to 06:00PM EST
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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 Missouri. 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 Missouri-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 Missouri 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.

Missouri Billing Challenges we solve



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Complex Behavioral Health and CMHC Billing Requirements

In Missouri billing for Community Mental Health Center (CMHC) is uniquely complex due to the separate reporting expectations for BH encounters, distinct service definitions tied to state certification and enhanced documentation audits. Any small errors like mismatched service location codes or incomplete treatment plan references might frequently results in recoupments even months after the payment is received. Hence CMHC billing in Missouri requires specialized workflows that general billing teams often lack. Shoreline Healthcare Technologies have a specialized billing team that supports CMHC-specific service definitions and documentation, with expert billing staffs who validates every treatment plan, service location codes, and rendering provider credentials before the submission of every claim to avoid denials and also to withstand the post-payment audits. With Shoreline in your team providers experiences stronger compliance and fewer recoupments.

Arizona
Managing the Timely Filing limits across MCOs

The state of Missouri does not apply a single timely filing rule across all Medicaid services. Filing limits vary based on FFS, Managed Care, waiver programs and third-party liability involvement. At Shoreline we always keep a track of payer-specific filing deadlines, prioritizing the claims nearing expiration, we also manage the corrected claims and reconsiderations within the allowable timeframes and also maintains the documents proof for timely filing when required thereby protecting the revenue that would otherwise be lost due to missed deadlines.

Billing
Prior Authorization Coordination across the Managed Care Plans

MO HealthNet managed care plans do not follow a uniform authorization standard. The same CPT code may require prior authorization under one plan but be exempted under another also they may require different documentation formats altogether. Providers delivering services across multiple Missouri MCOs must manage plan-specific PA matrices, increasing the administrative burden and denial risk. Shoreline helps providers to track plan-level PA requirements for each MCOs, obtains and validates authorizations before the services are rendered, links PA numbers correctly to the claims and monitors authorization expiration and visit limits. This prevents high-dollar denials caused by authorization mismatches.

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

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Specialized Services tailored to meet Missouri Medicaid rules and regulations

🩺 Services 📍Missouri Specialization 📈 Typical Improvement ⏱️ Turnaround Time
End-to-End Medical Billing Complete RCM services with AI-driven, payer-specific validation with accurate claim formatting across Missouri’s diverse MCOs. 25–40% reduction in claim rejections and faster reimbursements Claims submitted within 24–48 hours
Eligibility & Benefits Verification Automated API Driven Real-time verification across various plans. Reduction in eligibility-related denials by 30–45% Instant/ Within 24 hours
Prior Authorization Management Plan-level PA validation for Missouri Medicaid MCOs with service-specific documentation alignment 40–60% reduction in PA-related denials 3–5 business days
Coding & Charge Capture Assigns ICD-10 and CPT codes aligning with MO HealthNet policy manuals and state edit logics. First-pass clean claim rate increases to 95–98% Claims filed within 24–48 hours
CMHC & Behavioral Health Billing Specialized workflows for Missouri CMHCs, including service definitions, documentation validation, and audit defense Improved reimbursement accuracy by 20-25% Claims processed within 48 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. 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 Missouri

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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 Missouri

Missouri’s telehealth and RPM guidelines and regulations.

Serving Healthcare Providers Across Missouri

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From Andrew to Wayne, we provide comprehensive medical billing services across all 115 Missouri 115 county-level government units.

Missouri Map
St. Louis MSA:

Franklin, Jefferson, Lincoln, St. Charles, St. Louis County, St. Louis city

Kansas City MSA:

Cass, Clay, Clinton, Jackson, Lafayette, Platte, Ray

Springfield - Branson:

Christian, Dallas, Greene, Polk, Stone, Taney, Webster

Central:

Audrain, Boone, Callaway, Cole, Cooper, Gasconade, Howard, Moniteau, Montgomery, Osage, Randolph

West Central:

Bates, Benton, Henry, Hickory, Johnson, Pettis, St. Clair, Saline

Lake Ozark - Rolla:

Camden, Crawford, Dent, Laclede, Maries, Miller, Morgan, Phelps, Pulaski

Northwest:

Andrew, Atchison, Buchanan, Caldwell, Daviess, DeKalb, Gentry, Harrison, Holt, Nodaway, Worth

Northeast:

Adair, Clark, Knox, Lewis, Macon, Marion, Monroe, Pike, Ralls, Schuyler, Scotland, Shelby

North Central:

Carroll, Chariton, Grundy, Linn, Livingston, Mercer, Putnam, Sullivan

Lower East Central:

Bollinger, Cape Girardeau, Iron, Madison, Perry, Reynolds, Ste. Genevieve, St. Francois, Washington

Bootheel:

Butler, Carter, Dunklin, Mississippi, New Madrid, Pemiscot, Ripley, Scott, Stoddard, Wayne

Southwest:

Barry, Barton, Cedar, Dade, Jasper, Lawrence, McDonald, Newton, Vernon

South Central:

Douglas, Howell, Oregon, Ozark, Shannon, Texas, Wright

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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 Missouri

Q1. What do you mean by spend down in Missouri Medicaid?

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Spend down is a program that allows medically needy patients to qualify for Medicaid coverage despite their higher income by making them to pay a specific amount as out-of-pocket medical expense during a specific eligibility period.

Q2. What are the filing limits for MO HealthNet Claims?

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All original claims must be submitted within 12 months from the date of service. And for the claims initially submitted to Medicare the timely limit is 12 months from the DOS or 6 months from the date of Medicare’s notice whichever is later.

Q3. Does Shoreline Healthcare Technologies provide any analytics reporting to healthcare organizations in Missouri?

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Yes. We provide robust analytics and reporting services tailored to meet the needs of healthcare organizations that helps providers make informed operational decisions. We provide denial trend analytics, along with provider productivity and revenue forecasting, monthly and bi-weekly performance reports and real time billing dashboards.

Q4. How long does onboarding to Shoreline RCM services take?

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Onboarding to Shoreline Healthcare Technologies’ RCM services typically takes 3–4 weeks, depending on the provider’s size, specialty, payer mix, and current enrollment status.

Q5. What are the factors that influences the process of onboarding?

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  • ➢ Active status of the provider with MO HealthNet and other MCOs
  • ➢ Data access (EHR, clearinghouse, payer portals)
  • ➢ Volume of legacy A/R and denied claims
  • ➢ Scope of services (full RCM vs. partial support)

Q6. What are the initial processes that Shoreline does on onboarding?

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  • ➢ Reviews current billing workflows and denial patterns
  • ➢ Confirms Missouri Medicaid and MCO enrollment status
  • ➢ Sets up payer-specific claim rules and authorization workflows
  • ➢ Transiting claims without disrupting cash flow

Providers can see an increase in clean claim submission within the first few weeks of onboarding, with measurable performance improvements by partnering with Shoreline Healthcare Technologies.

Q7. How can Shoreline Healthcare Technologies help providers in Missouri?

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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.

Missouri Licensed

Licensed to operate in Missouri

Medical Billing Glossary

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Essential Terms for Understanding the Missouri’s Medical Billing Landscape

Department of Social Services (DSS)

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The state agency in Missouri responsible for administering the MO HealthNet, eligibility determination, and other Medicaid related policy oversight.

eMOMED

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The Online Medicaid Billing portal used by providers in Missouri to submit claims, check claim status, and verify patient eligibility for MO HealthNet.

Family Assistance Client Eligibility System (FACES)

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The eligibility system used by DSS to determine and manage Medicaid coverage, including spend down and retroactive eligibility.

Home State Health

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The Medicaid Managed Care Organization (MCO) in the state of Missouri that administers benefits for MO HealthNet members under managed care plan.

Local Community Care Coordination Program (LCCCP)

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Program for coordinating healthcare services for individuals with complex medical or behavioral health needs requiring specialized billing and documentation.

MO HealthNet

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The Medicaid program for the state of Missouri that includes coverage for children, parents, adults, and seniors through fee-for-service, managed care, and waiver programs.

Show Me Healthy Kids

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The CHIP program that provides health coverage for uninsured children who do not qualify for MO HealthNet based on income.

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.

AI Center

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 Missouri 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 Missouri-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 Missouri support team