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

Oklahoma Billing Challenges we solve

Navigating SoonerSelect + FFS fragmentation

The state of Oklahoma has shifted many of its Medicaid program to SoonerSelect managed care creating a split in the workflows. The billing team must run two playbooks at the same time with different payer IDs, claim edits, portals, appeal routes, and authorization processes depending on the member’s coverage pathway. At Shoreline we have built a distinct billing workflows for each coverage type FFS vs Managed Care. Our RCM experts identify whether a member was under SoonerSelect or SoonerCare FFS at date of service and select the correct payer routing, claim format, and appeal protocol. With Shoreline providers experiences fewer rejections from simple rule mismatches and claims go cleanly to the right payer system the very first time.

Credentialing + Enrollment support

In Oklahoma, being active with the state program is only part of the story. With managed care, practices can get stuck in a gray zone where the clinician is valid with one plan but not fully loaded in another plan’s system, the group is active but rendering providers are not mapped correctly and taxonomy/location mismatches cause silent rejections that look like “invalid billing provider.” This is especially painful for multi-location groups, mobile providers, and clinics that recently changed ownership, addresses, or NPIs. Shoreline Healthcare Technologies handles the initial enrollment with all SoonerSelect MCOs and SoonerCare FFS, we continuously monitor the expiring enrollments, taxonomy mismatches, and missing network status flags in each payer and re-verifies enrollee status before the frontline billing runs to prevent silent system rejections. This eliminates the rejections that occur after the service was rendered due to inactive credentials.

Tribal / IHS Coordination Support

There is a large Tribal health presence in the state of Oklahoma with many providers involving in coordinating care with the Tribal facilities. This introduces extra coordination points like coverage category nuances, referral patterns, documentation expectations, and payer routing, which often shows up in billing as mismatched coverage assumptions, wrong payer billed first, or documentation not matching the required pathway. For providers interfacing with Tribal facilities or Indian Health Services, Shoreline Healthcare Technologies aligns the primary vs secondary payer determinations, provides referral routes for coordination with the Indian Health Service and captures documentation that reflects the Tribal eligibility flags enabling a smoother billing protocols for complex payer coordination and fewer unbilled or misrouted services due to systemic Tribal eligibility nuances.

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

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 Oklahoma

Oklahoma’s telehealth and RPM guidelines and regulations.

Serving Healthcare Providers Across Oklahoma

From Alfalfa to Woodward, we provide comprehensive medical billing services across all 77 Oklahoma counties.

Red Carpet Country:

Alfalfa, Beaver, Blaine, Cimarron, Dewey, Ellis, Garfield, Grant, Harper, Kay, Kingfisher, Major, Noble, Texas, Woods, Woodward.

Green Country:

Adair, Cherokee, Craig, Creek, Delaware, Mayes, Muskogee, Nowata, Osage, Ottawa, Pawnee, Rogers, Sequoyah, Tulsa, Wagoner, Washington.

Frontier Country:

Canadian, Cleveland, Grady, Hughes, Lincoln, Logan, McClain, Okfuskee, Oklahoma, Payne, Pottawatomie, Seminole.

Great Plains Country:

Beckham, Caddo, Comanche, Cotton, Custer, Greer, Harmon, Jackson, Jefferson, Kiowa, Roger Mills, Stephens, Tillman, Washita.

Chickasaw Country:

Atoka, Bryan, Carter, Coal, Garvin, Johnston, Love, Marshall, Murray, Pontotoc.

Choctaw Country:

Choctaw, Haskell, Latimer, Le Flore, McCurtain, McIntosh, Pittsburg, Pushmataha.

Medical Billing Glossary

Essential Terms for Understanding the Oklahoma’s Medical Billing Landscape

Insure Oklahoma

It is a state-sponsored premium assistance program that helps eligible low-income adults and small businesses in Oklahoma to obtain health insurance coverage. It operates separately from the traditional Medicaid program.

Oklahoma Health Care Authority (OHCA)

The agency that administers the Medicaid program in Oklahoma like policy development, provider enrollment, reimbursement rules, and provides oversight for both the SoonerCare Fee-for-Service and SoonerSelect managed care programs.

Oklahoma Successful Healthcare Information Exchange (OKSHINE)

Oklahoma’s statewide Health Information Exchange (HIE) that enables secure sharing of patient health information among providers. It supports care coordination and documentation accuracy, that indirectly impacts coding, medical necessity support, and audit readiness.

SoonerCare

The health insurance program providing healthcare coverage to eligible low-income children, adults, pregnant women, elderly individuals, and people with disabilities in the state of in Oklahoma. It includes both Fee-for-Service (FFS) coverage and managed care options with distinct billing and reimbursement rules.

SoonerSelect

It is the managed care system that delivers Medicaid services to the eligible members through contracted Managed Care Organizations (MCOs). They have their own plan-specific billing guidelines, authorization requirements, and claim submission processes that differs from the traditional SoonerCare FFS billing.

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	📍Oklahoma Specialization	📈 Typical Improvement	⏱️ Turnaround Time
End-to-End Medical Billing	Expertise in billing SoonerCare FFS and SoonerSelect MCOs, including payer-specific claim rules and edits.	25–40% reduction in denial rates with faster reimbursement cycles.	Claims submitted within 24–48 hours
Eligibility & Coverage Verification	Real-time eligibility checks with Date-of-service–based eligibility checks to identify FFS vs MCO coverage and plan switches	Reduction in eligibility-related denials by 30–45%	Instant/ Within 24 hours
Prior Authorization Management	Plan-specific PA validation, submission tracking, and expiration monitoring.	40–60% reduction in PA-related denials	3–5 business days
Provider Enrollment & Revalidation	Enrollment, revalidation, and maintenance across SoonerCare and all SoonerSelect MCOs.	Fewer “not enrolled” or “inactive provider” denials	30–90 days (payer dependent)
Claims Submission & EDI Management	Optimized EDI configurations for Oklahoma Medicaid and MCOs; proactive edit resolution	Higher clean-claim rate (up to 98%)	Same or next business day
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 Oklahoma - Shoreline

Best In the Industry

Oklahoma Billing Challenges we solve

Navigating SoonerSelect + FFS fragmentation

Credentialing + Enrollment support

Tribal / IHS Coordination Support

Comprehensive Medical Billing Services for Oklahoma

Medical Billing Resources for Oklahoma

Medicaid Billing Guide

Behavioral & Mental Health Billing rules and guidelines

Revenue Cycle Optimization

Telehealth and Remote patient Monitoring in Oklahoma

Serving Healthcare Providers Across Oklahoma

Red Carpet Country:

Green Country:

Frontier Country:

Great Plains Country:

Chickasaw Country:

Choctaw Country:

Savings Estimation Calculator

Frequently Asked Questions

Q1. What is the difference between SoonerCare and SoonerSelect programs?

Q2. Is enrolling with Oklahoma Medicaid enough to bill SoonerSelect plans?

Q3. What are all the documentation that is critical for audit protection?

Q4. What are the initial processes that Shoreline does on onboarding?

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

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

Compliance & Certifications

HIPAA Compliant

AAPC Certified

Oklahoma Licensed

Medical Billing Glossary

Insure Oklahoma

Oklahoma Health Care Authority (OHCA)

Oklahoma Successful Healthcare Information Exchange (OKSHINE)

SoonerCare

SoonerSelect

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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