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 South Carolina. 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.

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 South Carolina 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 South Carolina 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.

South Carolina Billing Challenges we solve

Medicaid Managed Care Variability

South Carolina’s Medicaid program contracts with several MCOs and each have their own claim formats and timelines. Providers face inconsistent claim adjudication rules among managed care organizations (MCOs). Shoreline Healthcare Technologies integrates directly with the SC’s Medicaid MCOs and use adaptive rules engines that update payer logic automatically. This reduces claim rejections due to outdated payer rules and improves first-pass clean claim rate by up to 35–40%.

Rural Hospital Closures & Billing Gaps

The state has one of the nation’s highest rural hospital closure rates, leading to data loss and coding backlogs. Also, small rural hospitals lack certified coders resulting in delayed claim submissions. We offer cloud-based billing and coding platforms accessible to small hospitals with limited IT resources. By outsourcing your billing needs to Shoreline Healthcare Technologies rural hospitals can automate their billing needs without adding staff thereby cutting on manual coding costs by 25%.

Telehealth Coding Post-COVID

The state of South Carolina have expanded the telehealth under temporary waivers that weren’t standardized across payers post-pandemic. And providers often face difficulty in applying the proper place-of-service codes for telehealth visits, leading to low reimbursements or denials. At Shoreline we use built-in telehealth code mapping that aligns with both CMS and SC-specific payers. We help providers streamline their telehealth claims and lowers coding errors post-pandemic transition.

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

Specialized Services tailored to meet South Carolina Medicaid rules and regulations

🩺 Services	📍 South Carolina Specialization	📈 Typical Improvement	⏱️ Turnaround Time
SC Medicaid Billing (FFS)	Integrates with the State’s Medicaid Web Tool and SCDW Portal, automated eligibility checks by virtual assistants for real-time eligibility verification Advanced claim-scrubbing tools aligned with SC Medicaid Billing Manuals and HIPAA EDI 837P/837I standards.	+40% Faster reimbursements, clean claims and reduced rejections.	1-2 weeks
Billing for Managed Care Plans like Healthy Connections Prime	AI-driven, payer-specific validation and modifier mapping ensure accurate claim formatting across South Carolina’s diverse MCOs and Medicare Advantage plans.	+20% increase in revenue through multi-payer optimization.	24-48 Hours
Denial Management	AI based tools to track and flag denial codes and root-cause analysis tailored for SC Medicaid claim categories, identifies high-risk categories and automate resubmissions.	Reduce rate of denial by 75% and with quicker appeals.	5-7 days
Credentialing & Enrollment	Supports provider enrolment revalidation, and credentialing.	Ensures active status and timely reimbursements.	45-90 days
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 South Carolina

Comprehensive resources specifically designed for SC Medicaid Providers to navigate the state’s complex Billing Landscape.

Medicaid Billing Guide

A Complete guide covering SC Medicaid billing requirements, policy updates and compliance standards.

Managed Care program rules and guidelines

Specialized billing guidelines and documentation procedures for managed care programs.

Revenue Cycle Optimization

Best Practices and Strategies to improve cash flow and reduce denials.

Telehealth and Remote patient Monitoring in South Carolina

South Carolina’s telehealth and RPM guidelines and regulations.

Serving Healthcare Providers Across South Carolina

From Abbeville to York, we provide comprehensive medical billing services statewide across all 46 counties of South Carolina

Piedmont / Upstate Region

Abbeville, Anderson, Cherokee, Chester, Fairfield, Greenville, Greenwood, Laurens, McCormick, Newberry, Oconee, Pickens, Saluda, Spartanburg, Union, York

Midlands Region:

Aiken, Barnwell, Calhoun, Edgefield, Kershaw, Lancaster, Lexington, Orangeburg, Richland

Pee Dee Region:

Chesterfield, Clarendon, Darlington, Dillon, Florence, Horry, Lee, Marion, Marlboro, Sumter, Williamsburg

Coastal Region:

Allendale, Bamberg, Beaufort, Berkeley, Charleston, Colleton, Dorchester, Georgetown, Hampton, Jasper

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 South Carolina

Q1. How do D-SNPs differ from the SC Medicaid plans?

D-SNPs are the Medicare Advantage plans combining the benefits of both Medicare and Medicaid under one managed care plan. Individuals must be eligible for both Medicare and Medicaid. Whereas the SC Medicaid plans provide health coverage to low-income residents not qualified for Medicare. Providers must first send their bills to the respective D-SNP plans and after that they can coordinate the secondary billing to Medicaid for cost-sharing and deductibles.

Q2. What is the timeline for claim submissions in South Carolina?

Claim Type	Filing Deadline
Healthy Connections (Fee-for-Service Initial claim)	Within 365 days from the date of service
Resubmissions or corrected claims	180 days from the remittance date
Healthy Connections Prime (Dual-Eligible Program	180 days (Medicare Filing Rule)

Q3. How can providers submit their claims to South Carolina Medicaid?

Providers can submit their claims electronically using the SC Medicaid Web Tool or through a clearinghouse that’s integrated with the Medicaid EDI system. Always double-check the claims to align with the state specific billing manuals and payer specific rules before submitting.

Q4. How do providers check a patient’s eligibility for Medicaid in South Carolina?

Providers can verify the patient’s eligibility by using the SC Medicaid Web Tool (Portal). Have your NPI, the patient’s Medicaid ID, and the date of service.

Q5. How can providers enroll or revalidate themselves as a South Carolina Medicaid provider?

Providers can enroll or revalidate their status through online via the SCDHHS Provider Enrollment Portal. Revalidation is required for every five years to ensure compliance and maintain active status.

Q6. How can Shoreline Healthcare Technologies help providers in South Carolina?

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.

South Carolina Licensed

Licensed to operate in South Carolina

Medical Billing Glossary

Essential Terms for Understanding South Carolina’s Medical Billing Landscape

Dual Special Needs Plans (D-SNPs)

It is the Medicare Advantage plans for eligible individuals with both Medicare and Medicaid. In South Carolina some private insurers administer D-SNPs, and they need dual eligibility verification and distinct claim submission processes.

Healthy Connections

The official name of the Medicaid program in for South Carolina covering children of low-income group, pregnant women, elderly adults, and individuals with disabilities.

Healthy Connections Prime

An enhanced program combining all the benefits of Medicare and Medicaid into one coordinated plan for simplified billing. It is managed by the selected MCOs and adheres to both CMS and SCDHHS documentation standards.

Medicaid Targeted Case Management (MTCM)

The care coordination services of Medicaid targeting specific populations like individuals with mental illness or developmental disabilities. Billing requires precise coding for target groups and service documentation per SCDHHS policy guidelines.

South Carolina Department of Health and Human Services (SCDHHS)

Manages the Medicaid (Healthy Connections) and other related healthcare programs in South Carolina. It issues provider bulletins, billing manuals, policy updates, enabling providers to stay in compliant with the billing and coding standards.

South Carolina Data Warehouse Portal (SCDW Portal)

A web-based platform used by SCDHHS for Medicaid analytics and performance tracking. Providers can access claim, eligibility, and utilization data from here for compliance and reporting purposes.

SC Medicaid Portal (SC DHHS Web Tool)

The online portal of South Carolina used to verify eligibility, submit claims, view remittance advice (RA), and check claim status for Healthy Connections Medicaid. It’s maintained by SCDHHS and is the main billing access point for Medicaid providers.

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 South Carolina 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 South Carolina’s-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 South Carolina support team

The Best Medical Billing Company in South Carolina - Shoreline

Best In the Industry

South Carolina Billing Challenges we solve

Medicaid Managed Care Variability

Rural Hospital Closures & Billing Gaps

Telehealth Coding Post-COVID

Comprehensive Medical Billing Services for South Carolina

Medical Billing Resources for South Carolina

Medicaid Billing Guide

Managed Care program rules and guidelines

Revenue Cycle Optimization

Telehealth and Remote patient Monitoring in South Carolina

Serving Healthcare Providers Across South Carolina

Piedmont / Upstate Region

Midlands Region:

Pee Dee Region:

Coastal Region:

Savings Estimation Calculator

Frequently Asked Questions

Q1. How do D-SNPs differ from the SC Medicaid plans?

Q2. What is the timeline for claim submissions in South Carolina?

Q3. How can providers submit their claims to South Carolina Medicaid?

Q4. How do providers check a patient’s eligibility for Medicaid in South Carolina?

Q5. How can providers enroll or revalidate themselves as a South Carolina Medicaid provider?

Q6. How can Shoreline Healthcare Technologies help providers in South Carolina?

Compliance & Certifications

HIPAA Compliant

AAPC Certified

South Carolina Licensed

Medical Billing Glossary

Dual Special Needs Plans (D-SNPs)

Healthy Connections

Healthy Connections Prime

Medicaid Targeted Case Management (MTCM)

South Carolina Department of Health and Human Services (SCDHHS)

South Carolina Data Warehouse Portal (SCDW Portal)

SC Medicaid Portal (SC DHHS Web Tool)

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?