logo
Appointment Get Free Trail
  • 1-855-838-1370
  • 4 Scammon Street, Suite 19-343, Saco, ME 04072
  • Mon to Fri 9:00AM to 06:00PM EST
Get Free Trail

The Best Medical Billing Company in Washington

doctor_image_in_collab

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 Washington. 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 Washington based practice. Ready to outsource your billing needs? We’ll guide you through your account receivables account to make sure that your claims get paid.

Best In The Industry

title_line

Shoreline Healthcare Technologies in Washington 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.

Eliminating the Billing Barriers for Washington Providers

title
Managing ProviderOne complexity, deadlines and quirks

Washington requires almost all Apple Health claims to be submitted electronically through ProviderOne which has its own data-entry rules, file formats, and error codes that differ from other states MMIS systems. They have weekly submission cutoffs (Tuesday 5:00 p.m. for payment the following Monday), and some program-specific rules that keeps changing frequently. Our team stay updated on ProviderOne format and error code sets to catch rejections before submissions. We have streamlined our operations to help meeting the cut-off deadlines and have quicker claim submissions.

Helping with the High managed-care penetration

Washington’s Apple Health largely operates through managed care plans, and each plan has its own prior-auth rules, referral requirements and claim submission nuances. Providers must check and follow plan-specific billing instructions (and network rules) which would otherwise results in increased denials from mismatched billing expectations. Our expert team at Shoreline Healthcare Technologies helps providers to understand the plan-by-plan differences and ensures that claims are submitted according to each managed care plan’s rules and avoids denials.

Navigating Washington’s Tribal and IHS Billing Maze

Washington has numerous federally recognized tribes and tribal health programs, and HCA publishes dedicated Tribal Health Billing Guides and uses special payment methodologies. All Tribal providers and non-tribal providers treating AI/AN patients must navigate additional billing rules (unique taxonomies, encounter reporting, different encounter/payment rates). Errors in this may lead to rejected claims or underpayment which are more common in states with many tribes. Shoreline simplifies this complexity for both tribal and non-tribal practices by implementing AI/AN specific claim logic to ensure correct routing through ProviderOne. We Prevent denials from missing eligibility indicators or incorrect taxonomy codes and ensures compliance with HCA’s tribal reimbursement and audit requirements.

Comprehensive Medical Billing Services for Washington

title

Our comprehensive suite of Services is tailored to meet Washinton’s Medicaid rules and regulations

🩺 Services 📍 Washington Specialization 📈 Typical Improvement ⏱️ Turnaround Time
Apple Health Medicaid Billing Virtual assistants for front-end management, real-time eligibility verification through ProviderOne, and electronic claim submission via OneHealthPort. +35% Faster reimbursements through reduced claim errors. 1-2 weeks
Billing for Managed Care Programs (Apple Health MCOs) Expertise in Washington’s MCO billing workflows with correct program/aid code routing and portal submissions. +20% increase in revenue and faster payment cycles 24-48 Hours
Denial Management AI-driven analytics to detect ProviderOne rejection codes, track trends, and automate resubmissions with corrective actions. Reduce denial rates by 75% 5-7 days
Credentialing & Enrollment Assistance with HCA provider enrollment, ProviderOne setup, revalidation, and tribal or IHS-affiliated clinic credentialing. Direct payment activation from Apple Health and compliance with state updates. 45-90 days
Patient Statements & Follow-Up Clear Explanation of EOB and Patient communication. Help reduce overdue patient balances and improve satisfaction. 1-2 weeks

Washington Medical Billing Resources

title

Comprehensive resources specifically designed for Washington Healthcare Providers to navigate the complex Billing Landscape.

Apple Health Medicaid Billing Guide

Complete guide to Apple Health Medicaid billing requirements and policy updates.

Managed Care program Rules.

Specialized billing guidelines and code sets for managed care programs.

Revenue Cycle Optimization

Strategies to improve cash flow and reduce denials.

Untangling the Web of Tribal and IHS Billing in Washington

Washinton’s tribal health billing guidelines and regulations.

Serving Healthcare Providers Across Washington

title

From Bellingham to Vancouver, we provide comprehensive medical billing services statewide across all 39 counties of Washington State.

West Region (Central Puget Sound & Olympic Peninsula)

Clallam, Jefferson, Kitsap, King, Mason, Pierce (Includes Tacoma),Snohomish (Includes Everett)

North Region (Northwest & San Juan Islands)

Island, San Juan, Skagit, Whatcom

Southwest Region (Lower Columbia River & Coast)

Clark (Includes Vancouver), Cowlitz, Grays Harbor, Lewis, Pacific, Thurston (Includes Olympia), Wahkiakum

Northeast Region (Upper Inland Empire)

Ferry, Lincoln, Okanogan, Pend Oreille, Spokane (Includes the city of Spokane), Stevens

South Central Region (Columbia Basin & Yakima Valley)

Adams, Chelan, Douglas, Grant, Kittitas, Klickitat, Skamania, Yakima

Southeast Region (Blue Mountains & Tri-Cities Area)

Asotin, Benton (Part of Tri-Cities), Columbia, Franklin (Part of Tri-Cities), Garfield, Walla Walla, Whitman

Savings Estimation Calculator
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

title

FAQs about Medical Billing Services in Washington.

Q1. How can providers check a patient’s eligibility for Washington Apple Health (Medicaid)?

+

Providers can check the patient’s eligibility by any one of the following ways:

  • ✔ Dialling the ProviderOne IVRS at 1-800-562-3022
  • ✔ Submitting a 270 Health Care Eligibility Inquiry via Electronic Data Interchange (EDI).
  • ✔ Using the ProviderOne Portal

Q2. What is the timely filing limit for Medicaid claims in Washington?

+

In Washington, for Apple Health (Medicaid) the timely filing rules are set as 365 calendar days (1 year) from the date the service was furnished. We can resubmit, modify or adjust any initial timely filed claim within 24 months from date of service.

Q3. What are the requirements for submitting claims to Managed Care Organization (MCO) under Washington Apple Health?

+

Most of the Medicaid clients in Washington are enrolled in Managed Care Organizations (MCOs) and providers must submit claims directly to the member’s MCO and not to the state. All providers must check the plan eligibility before offering services and must follow MCO’s specific authorization and billing rules.

Q4. What do you mean by a Direct IHS Clinic, a Tribal 638 Clinic, or a Tribal FQHC?

+

Direct IHS Clinics are operated by the Indian Health Services.

Tribal 638 Clinic are run by the tribals or tribal group and receive funds under the Indian Self-Determination and Education Assistance Act (Public Law 93-638).

Tribal FQHC are Tribal 638 Clinics operated by tribes and enrolled in the state Medicaid program as a Federally Qualified Health Center.

All these clinics provide outpatient care and are paid using the IHS encounter rate, which is published each year in the Federal Register.

Q5. How can providers enroll them for Washington Apple Health (Medicaid)?

+

Providers can apply online through Washington State ProviderOne Enrollment Portal and submit the following:

  • ✔ A valid National Provider Identifier (NPI)
  • ✔ Appropriate state licenses and certifications
  • ✔ Any required background checks or documentation

Once approved, you’ll receive a ProviderOne ID to begin billing Apple Health.

Q6. How are crossover claims handled for dual-eligible (Medicare + Medicaid) patients in Washington?

+

In case of dual-eligible beneficiaries, claims are first billed to Medicare and after receiving the Medicare payment, the claims are forwarded (crossed over) to Apple Health for secondary payment.Check the COB (Coordination of Benefits) information before offering the service to avoid denials.

Q7. How can Shoreline Healthcare Technologies help Washington providers?

+

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 Apple Health rules.

Compliance & Certifications

title

Your data security and compliance are our top priorities.

HIPAA Compliant

Full HIPAA compliance with regular audits

AAPC Certified

Certified Billing Professionals

Washington Licensed

Licensed to operate in Washington

Medical Billing Glossary

title

Essential Terms for Understanding Washington’s Medical Billing Landscape

Apple Health:

+

The brand name used by Washington State for its Medicaid programs. It provides medical assistance and other health related programs including CHIP, etc.

Comagine Health:

+

A nonprofit contractor that partners with Washington State Medicaid (Apple Health) and WA’s Department of Labor & Industries to perform utilization review for certain services like advanced imaging, spinal injections and outpatient procedures under the state rules.

Health Care Authority (HCA):

+

The State agency of Washington that administers the Apple Health programs and oversees ProviderOne policies and billing rules, etc.

Indian Health Service (IHS):

+

The federal agency of US responsible for providing tribal health programs and medical assistance to members of federally recognized tribes like American Indians and Alaskan Natives.

OneHealthPort:

+

The secure portal used by providers in Washington to access the payer systems (including ProviderOne) for checking eligibility, claims status, authorizations, etc.

ProviderOne:

+

The online system used by HCA for Apple Health providers to submit claims, check eligibility, view remittance, etc.

Transaction Control Number (TCN)

+

A unique identifier assigned to a claim by the ProviderOne when a claim is submitted. It is needed to track, adjust, or resubmit claims.

Our Services

title

Shoreline proudly supports physicians, medical groups, and medical billing companies. Following are the revenue cycle management steps we offer.

AI Center

Testimonials

title
quote

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. quote

shoreline logo
★ ★ ★ ★ ★
Family Medicine Centre in Maine
quote

“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.”

quote


shoreline logo
★ ★ ★ ★ ★
Nephrology Group in New Hampshire
quote

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.


quote


shoreline logo
★ ★ ★ ★ ★
Pain Management in New Jersey
quote

We switched to Shoreline Medical Billing. Our claims are getting paid, and we are getting friendly, knowledgeable service. We highly recommend Shoreline.


quote


shoreline logo
★ ★ ★ ★ ★
Internal Medicine & Nephrology in Georgia
quote

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!

quote


shoreline logo
★ ★ ★ ★ ★
Peds OT Clinic in Maine
quote

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. quote

shoreline logo
★ ★ ★ ★ ★
Nurse Practitioner Group in Washington
quote

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.

quote


shoreline logo
★ ★ ★ ★ ★
Nurse practitioner in Delaware
quote

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.



quote


shoreline logo
★ ★ ★ ★ ★
Internal Medicine in Arizona

We Care

title

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 Washington understands how to navigate today’s complex healthcare revenue environment.

Ready to Optimize Your Medical Billing?

title

Get your free consultation and discover how much you could save with our Washington-specialized billing services.

Get Your Free Consultation

mail_image
Sending...

Contact Information

  • 4 Scammon Street, Suite 19-343, saco, ME 04072
  • 1-855-838-1370
  • info@shorelinemb.com
  • M-F, 9am - 5pm EST
Why work with us?
  • ✔ 40% average denial rate reduction
  • ✔ Apple Health billing specialist
  • ✔ 24-48 hour claim turnaround
  • ✔ Dedicated Washington support team