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 Nebraska. 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 Nebraska-based practice. Ready to outsource your billing needs? We’ll guide you through your receivable account to make sure that your claims are paid.

Nebraska Billing Challenges we solve

Correctly Routing Claims Across Heritage Health and FFS Medicaid

With Nebraska’s transition to Heritage Health managed care providers are required to determine whether the billing goes to a MCO or Medicaid FFS. Because eligibility files do not always clearly flag the carve-out status at the service level, due to which claims are frequently submitted to the wrong payer entity, resulting in avoidable denials and missed timely filing windows. Eligibility checks by Shoreline Healthcare Technologies go beyond “active coverage” and identify the MCO assignment, carve-out status and service-specific payer responsibility. We apply payer-routing rules at the charge level, resulting in nearly more than 95% of clean first-pass submissions and fewer denials caused by payer misdirection.

Stabilizing Behavioral Health and Community-Based Service Billing

Behavioral health providers in Nebraska faces a dual-system billing environment, especially those serving Medicaid and waiver populations. The challenges include differing code sets for outpatient vs. community-based services, separate authorization workflows depending on service type. This causes high denial rates for mental health and substance use services, even when services are medically necessary and authorized. We at Shoreline Healthcare Technologies separates medical, behavioral, and waiver billing workflows to avoid rule conflicts. Authorizations are cross-checked against billed units, dates, and service plans. We proactively validate the same-day service rules and bundled services which reduces the denial rates for mental health and substance use services and increases the predictability of the payments.

Supporting Rural and Telehealth-Driven Providers

Nebraska’s large rural footprint has created unique billing challenges that are not seen in most of the urban Medicaid programs like varying telehealth coverage rules by service type and originating site, need for precise documentation for mileage and transportation claims, and the limited broadband connectivity affecting the real-time eligibility verification and claim status checks. So Rural providers always face higher denial risk and slower cash flow due to documentation and connectivity constraints. At Shoreline Healthcare Technologies all telehealth claims are validated for eligible originating sites, correct POS and modifiers and Nebraska-specific coverage rules. We code and document all transportation and mileage claim precisely. With Shoreline in your team rural providers receive the appropriate reimbursement without repeated follow-ups or rejections.

We at Shoreline Healthcare Technologies provide personalized support tailored to the unique needs of Nebraska providers. Our team of experts understands the intricacies of the Nebraska billing landscape and offers guidance to help practices navigate these challenges effectively with our cloud-based RCM solutions for an optimized Revenue Cycle Management.

Medical Billing Resources for Nebraska

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 Nebraska

Nebraska’s telehealth and RPM guidelines and regulations.

Serving Healthcare Providers Across Nebraska

From Antelope to York, we provide comprehensive medical billing services across all 93 Nebraska counties.

Metro Region:

Cass, Douglas, Lancaster, Sarpy, Saunders, Washington

Southeast Region:

Butler, Fillmore, Gage, Jefferson, Johnson, Nemaha, Otoe, Pawnee, Polk, Richardson, Saline, Seward, Thayer, York

Northeast Region:

Antelope, Boone, Burt, Cedar, Colfax, Cuming, Dakota, Dixon, Dodge, Knox, Madison, Nance, Pierce, Platte, Stanton, Thurston, Wayne

Central Region:

Adams, Blaine, Buffalo, Clay, Custer, Franklin, Garfield, Greeley, Hall, Hamilton, Harlan, Howard, Kearney, Loup, Merrick, Nuckolls, Phelps, Sherman, Valley, Webster, Wheeler

Western Region:

Arthur, Banner, Box Butte, Boyd, Brown, Chase, Cherry, Cheyenne, Dawes, Dawson, Deuel, Dundy, Frontier, Furnas, Garden, Gosper, Grant, Hayes, Hitchcock, Holt, Hooker, Keith, Keya Paha, Kimball, Lincoln, Logan, McPherson, Morrill, Perkins, Red Willow, Rock, Scotts Bluff, Sheridan, Sioux, Thomas

Medical Billing Glossary

Essential Terms for Understanding the Nebraska’s Medical Billing Landscape

Heritage Health

It is a managed care program that coordinates varies health plans and services like physical, behavioral, dental, and pharmacy care into one coordinated plan for the eligible Nebraskans.

Home and Community-Based Services (HCBS)

It is a Medicaid-funded programs for helping eligible individuals to get long-term support such as personal care, habilitation, and certain therapeutic services at their home or community instead of an institutional setup.

iServe Nebraska

The online portal for verifying the eligibility and benefits status of the members, it is also used for applying to Medicaid, CHIP, and other assistance programs and get the retroactive coverage updates.

Nebraska Provider Data Management System (PDMS)

The centralized system for storing and managing the provider enrollment, credentialing, and other demographic data for the Medicaid program of Nebraska.

Nebraska Medicaid Program (NMAP)

The official Medicaid program in the state of Nebraska, that includes both Fee-for-Service and managed care programs through Heritage Health.

Nebraska Medicaid Enterprise System (NMES)

Nebraska’s Medicaid claims processing and information system that handles eligibility verification, claims adjudication, and payment processing.

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.

★ ★ ★ ★ ★

🩺 Services	📍Nebraska Specialization	📈 Typical Improvement	⏱️ Turnaround Time
End-to-End Medical Billing	Complete RCM services with AI-driven, payer-specific validation with accurate claim formatting and alignment with Nebraska Medicaid (NMAP/Molina) and all Heritage Health MCOs billing edits, encounter rules, and carve-out logics.	25–40% reduction in claim rejections and faster reimbursements	Claims submitted within 24–48 hours
Eligibility & Coverage Verification(ELVS)	Service-level eligibility checks identifying MCO assignment, carve-outs, and retroactive eligibility common in Nebraska	Reduction in eligibility-related denials by 30–45%	Instant/ Within 24 hours
Prior Authorization Management	MCO-specific PA tracking for behavioral health, LTSS, and high-risk outpatient services	40–60% reduction in PA-related denials	3–5 business days
Managed Care Claim Routing	Accurate routing between Heritage Health MCOs and FFS Medicaid based on service type and member status	Fewer payer-misdirection denials and First-pass clean claim rate increases by 95–98%	Claims filed within 24–48 hours
Rural & Telehealth Billing Compliance	Validation of POS, modifiers, originating site rules, and mileage documentation for rural Nebraska providers	Higher acceptance of telehealth and transportation claims	Same-day claim validation
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
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 increases the 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

The Best Medical Billing Company in Nebraska - Shoreline

Best In the Industry

Nebraska Billing Challenges we solve

Correctly Routing Claims Across Heritage Health and FFS Medicaid

Stabilizing Behavioral Health and Community-Based Service Billing

Supporting Rural and Telehealth-Driven Providers

Comprehensive Medical Billing Services for Nebraska

Medical Billing Resources for Nebraska

Medicaid Billing Guide

Behavioral & Mental Health Billing rules and guidelines

Revenue Cycle Optimization

Telehealth and Remote patient Monitoring in Nebraska

Serving Healthcare Providers Across Nebraska

Metro Region:

Southeast Region:

Northeast Region:

Central Region:

Western Region:

Savings Estimation Calculator

Frequently Asked Questions

Q1. How do providers enroll themselves in Nebraska Medicaid?

Q2. Do Nebraska Medicaid support electronic claims? What supports and processes all the Medicaid claims for the state of Nebraska?

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

Q4. What are the factors that influences the process of onboarding?

Q5. What are the initial processes that Shoreline does on onboarding?

Q6. How can Shoreline Healthcare Technologies help providers in Nebraska?

Compliance & Certifications

HIPAA Compliant

AAPC Certified

Nebraska Licensed

Medical Billing Glossary

Heritage Health

Home and Community-Based Services (HCBS)

iServe Nebraska

Nebraska Provider Data Management System (PDMS)

Nebraska Medicaid Program (NMAP)

Nebraska Medicaid Enterprise System (NMES)

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

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