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  • 1-855-838-1370
  • 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 Nevada. 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 Nevada-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 Nevada 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.

Nevada Billing Challenges we solve



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Tribal, IHS and FQHC reimbursements and special billing instructions


This state of Nevada has Tribal clinics, IHS sites and Federally Qualified Health Centers that follow special billing rules like enhanced FQHC rates, encounter vs CPT rules and specific attachments, failing to follow these can cause denials or incorrect reimbursement levels. Also coordinating between the state policy, federal rules and tribal protocols adds complexity. At Shoreline Healthcare Technologies we have experts for handling the Tribal clinics, IHS, and FQHC encounter/visit reporting. They make sure to check the encounter claims use correct encounter IDs, wraparound billing, and prospective payment adjustments. We conduct routine audits to compare the paid encounters with the expected enhanced FQHC rates to capture underpayments and missed wraparounds. This enhances reimbursements and prevents under-coding for encounter-based claims.

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Electronic-only submission requirement + EDI portal quirks

The Medicaid program in Nevada mandates electronic claim submission the process of transitioning the legacy workflows (paper or hybrid) to strict EDI have created submission delays. Smaller practices or new enrollments often lack the EDI readiness, leading to avoidable denials and longer cash cycles. Shoreline Healthcare Technologies handles all EDI set-ups with ongoing monitoring with all the MCO trading partners. This decreases the submission delays and resubmissions by 30–60% and speeds up the cashflow.

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

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Specialized Services tailored to meet Nevada Medicaid rules and regulations

🩺 Services 📍Nevada Specialization 📈 Typical Improvement ⏱️ Turnaround Time
End-to-End Medical Billing Complete RCM services with AI-driven tools, payer-specific edits and accurate claim formatting aligned with the state’s Medicaid and MCOs. 25–40% reduction in denial rates with faster reimbursement cycles. Claims submitted within 24–48 hours
Eligibility & Coverage Verification Service-level eligibility checks identifying MCO assignment, carve-outs, and retroactive eligibility common in Nevada 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 Nevada 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

Medical Billing Resources for Nevada

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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 Nevada

Nevada’s telehealth and RPM guidelines and regulations.

Serving Healthcare Providers Across Nevada

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From Clark to White Pine, we provide comprehensive medical billing services across all 17 Nevada counties.

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Southern Nevada:

Clark , Lincoln, Nye

Northern & Western Nevada:

Washoe , Carson City , Douglas, Lyon, Storey

Central & Northeastern Nevada:

Churchill, Elko, Esmeralda, Eureka, Humboldt, Lander, Mineral, Pershing, White Pine.

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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 Nevada

Q1. How do we verify the members eligibility for the Medicaid program in the state of Nevada?

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Providers can check the members eligibility through the Provider Web Portal (PWP), EDI transactions, or calling the Automated Response System (ARS)

Q2. Do Nevada Medicaid support paper claims?

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No. Nevada Medicaid does not support paper claims. It requires electronic claim submission only for both the FFS and MCOs claims.

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

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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 along with real time billing dashboards.

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

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  • ➣Active status of the provider with Nevada Medicaid 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)

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

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  • ➣ Reviews current billing workflows and denial patterns
  • ➣ Confirms Nevada Medicaid and MCO enrollment status
  • ➣ Sets up payer-specific claim rules and authorization workflows
  • ➣ Transits claims without disrupting the 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.

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

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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.

Nevada Licensed

Licensed to operate in Nevada

Medical Billing Glossary

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Essential Terms for Understanding the Nevada’s Medical Billing Landscape

Division of Health Care Financing and Policy Portal (DHCFP)

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The online web portal used in the state of Nevada to access their Medicaid updates, provider manuals, web announcements, billing guidance, and other policy related information.

Gainwell Technologies

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The fiscal agent in Nevada responsible for MMIS operations, claims processing, provider portals, and EDI transactions.

Nevada Medicaid (NV Medicaid)

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The state’s health insurance program providing healthcare coverage to the eligible residents of Nevada through the Fee-for-Service or Managed Care delivery models.

Preadmission Screening and Resident Review (PASRR)

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The screening process that is mandated by the federal government for the individuals with serious mental illness or intellectual/developmental disabilities for determining the need for specialized services and check their eligibility status for payment before admitting them to the nursing facility.

Provider Web Portal (PWP)

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The online portal for the providers in the state of Nevada where they submit claims, verify members eligibility, check the status of the claims, view remittance advice, and manage related profile electronically.

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 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 Nevada 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 Nevada -specialized billing services.

Get Your Free Consultation

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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 Nevada support team