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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 West Virginia. 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 West Virginia-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 West Virginia 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.

West Virginia Billing Challenges we solve



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Policy-to-Claim Accuracy (BMS compliance built into daily workflows)


The Medicaid Program in West Virginia is administered by the Bureau for Medical Services (BMS), where even a minor deviation from billing manuals can result in full claim denials, with little room for negotiation. At Shoreline Healthcare Technologies we have built WV-specific billing rules by specialty and verifies whether the documentation supports “medical necessity” and service limits before claims go out. We help to prevent avoidable denials caused by missing elements like signatures, plan of care, frequency/duration mismatches so resulting in more clean claims upfront with fewer rework cycles and faster payments.

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Implementing tight Timely-Filing Protection


In West Virginia Medicaid had enforced strict timely filing rules with little flexibility, even when the denials stem from system or eligibility issues. So, without a tight tracking, revenue leakage is almost inevitable. We at Shoreline Healthcare Technologies have the same day charge capture checks and claim build routines with “Aging-to-deadline” alerts for corrections/appeals. We generate weekly reporting on claims at risk of timely filing expiration, so claims don’t age out preventing the permanent revenue loss and stabilizing the monthly collections.

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Supporting Behavioral Health & SUD Billing


Billing for Behavioral health and SUD services are closely monitored by Medicaid with strict medical necessity standards, frequent post-payment audits and session limits enforced retroactively. Claims may pay initially but be recouped months later if documentation does not fully support policy criteria. Shoreline Healthcare Technologies supports providers with a documentation-to-billing alignment process so paid claims stay paid. We ensure that notes match code requirements (time, modality, credentialing, treatment plan link), by validating the authorization requirements and unit logic before submission and perform post-payment “recoupment risk checks” to reduce takebacks. So that there are fewer recoupments, steadier reimbursement and more predictable cash flow.

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

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Specialized Services tailored to meet West Virginia Medicaid rules and regulations

🩺 Services 📍West Virginia Specialization 📈 Typical Improvement ⏱️ Turnaround Time
WVMMIS Claim Monitoring Daily claim-status tracking and reconciliation Shortens payment lag and reduces A/R days Claims submitted within 24–48 hours
Eligibility & Coverage Verification Verifies Medicaid eligibility prior to DOS, identifies FFS vs managed care, tracks retroactive eligibility. Reduction in eligibility-related denials by 30–45% Instant/ Within 24 hours
Charge Capture Management Audits encounter documentation to ensure all billable services are captured. Increases net reimbursement per visit 48 hours
Timely Filing Management Tracks filing and rebilling deadlines for original, corrected, and appeal claims Significant reduction in late-filing write-offs Ongoing, automated
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 West Virginia

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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 West Virginia

West Virginia’s telehealth and RPM guidelines and regulations.

Serving Healthcare Providers Across West Virginia

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From Brooke to Wirt, we provide comprehensive medical billing services across all 55 West Virginia Counties.

West Virginia Map
Northern Panhandle:

Brooke, Hancock, Marshall, Ohio, Wetzel

Mid-Ohio Valley:

Calhoun, Jackson, Pleasants, Ritchie, Roane, Tyler, Wirt, Wood

Mountaineer Country:

Barbour, Doddridge, Harrison, Marion, Monongalia, Preston, Taylor

Eastern Panhandle:

Berkeley, Jefferson, Morgan

Potomac Highlands:

Grant, Hampshire, Hardy, Mineral, Pendleton, Pocahontas, Randolph, Tucker

Mountain Lakes:

Braxton, Clay, Gilmer, Lewis, Nicholas, Upshur, Webster

Metro Valley:

Cabell, Kanawha, Mason, Putnam, Wayne

Hatfield-McCoy Mountains:

Boone, Lincoln, Logan, McDowell, Mingo, Wyoming

New River-Greenbrier Valley:

Fayette, Greenbrier, Mercer, Monroe, Raleigh, Summers

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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 West Virginia

Q1. Does all the Medicaid patients in WV fall under MHT?

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No. Some members remain in fee-for-service Medicaid, depending on their eligibility category. Providers must confirm whether the patient is MHT managed care or Fee-for-service Medicaid before rendering the services.

Q2. Does Shoreline Healthcare Technologies support MHT billing?

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Yes. We at Shoreline Healthcare Technologies helps WV providers for billing the MHT managed care program. Our services include verifying the MHT enrollment and payer routing, managing MCO-specific authorization workflows and appealing denials with payer-specific documentation.

Q3. Can Shoreline work with small or rural practices in West Virginia?

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Yes. Shoreline Healthcare Technologies offer customized billing services that are highly effective for rural clinics, independent practices, and community-based providers who lack in-house Medicaid expertise and have limited administrative staff. We provide the complete end-to-end RCM services for all specialities irrespective of their practice size.

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

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  • ➣ Reviews current billing workflows and denial patterns
  • ➣ Confirms West Virginia 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.

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

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  • ➣ Active status of the provider with West Virginia 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)

Q6. How can Shoreline Healthcare Technologies help providers in West Virginia?

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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.

West Virginia Licensed

Licensed to operate in West Virginia

Medical Billing Glossary

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Essential Terms for Understanding the West Virginia’s Medical Billing Landscape

Bureau for Medical Services (BMS)

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The agency that administers Medicaid program in West Virginia’s. It sets coverage rules, billing policies, reimbursement methodologies, and compliance standards for all Medicaid services in the state.

Health-PAS Online

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The online web portal of West Virginia used for day-to-day billing operations where providers can verify the members eligibility, submit claims and check their status, review the prior authorization submissions and remittance advice.

Mountain Health Trust (MHT)

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A Medicaid managed care program of West Virginia that offers healthcare services with contracted Managed Care Organizations (MCOs) instead of traditional fee-for-service.

Provider Enrollment and Authentication Portal (PEAP)

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The online system used for Medicaid provider enrollment and revalidation in West Virginia.

West Virginia Medicaid Management Information System (WVMMIS)

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The backend system that processes claims, payments, and reports for the West Virginia Medicaid.

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 West Virginia 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 West Virginia-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 West Virginia support team