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 Ohio. 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 Ohio-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 Ohio 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.

Ohio Billing Challenges we solve

Fix the “Who do we bill?” problem with payer-responsibility logic

The revenue leakage in the state of Ohio occurs due to the misrouted claims because of the shift in member’s coverage (FFS → MCP, MCP → OhioRISE etc.). Shoreline Healthcare Technologies helps providers by running a pre-bill eligibility + program identification checks so that all claims go to the correct destination the very first time. We have created a billing decision tree that helps the front desk and billing team (what to verify, what to capture, what to flag) so that there is a significant drop in “wrong payer” denials. With us organisations experiences faster first-pass payment, lesser rework and fewer late-filing write-offs.

Prevent timely filing losses with Ohio-specific tracking and “early warning” alerts

Ohio FFS has its own timely filing expectations and workflows in the MITS environment, and certain provider types (FQHC/RHC) can face different timing logic and resubmission mechanics. So, teams applying a generic timely filing assumption across all Ohio Medicaid billing, can unintentionally trigger avoidable denials. At Shoreline Healthcare Technologies we have set payers’ filing-limit trackers (FFS and each MCP) with work-queue aging alerts. We have implemented a “first 14 days” discipline so that anything that is not accepted/acknowledged gets escalated quickly, so there fewer late-filing denials, more recoveries on previously “lost” claims with a cleaner month-end revenue recognition.

Stay ahead of modernization-driven process changes (without operational disruption)

Ohio has been modernizing systems and workflows and these changes in how claims are submitted and accessed can cause confusion and errors for practices. Even a small process drift might create rejections, missing attachments, or status blind spots. We at Shoreline Healthcare Technologies maintains a Ohio payer rule libraries (FFS + major MCPs) and updates claim edits, code pairing, modifier logic, and submission checklists as and when the policies shift. We run claim-quality audits every month focused on Ohio-specific failure points (coverage lane, EVV, authorization, portal routing, and recurring denial codes) and train our team with micro-SOPs so that everyone follows one stable process. This has resulted in fewer surprise rejections after policy/portal changes, higher first-pass resolution rate and more predictable weekly cash flow.

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

Specialized Services tailored to meet Ohio Medicaid rules and regulations

🩺 Services	📍Ohio Specialization	📈 Typical Improvement	⏱️ Turnaround Time
End-to-End Medical Billing	Expertise across Ohio Medicaid FFS, all major Managed Care Plans (MCPs), OhioRISE, and MyCare Ohio billing workflows.	25–40% reduction in denial rates with faster reimbursement cycles.	Claims submitted within 24–48 hours
Eligibility & Coverage Verification	Real-time eligibility checks with dual-eligible flags, and plan responsibility validation	Reduction in eligibility-related denials by 30–45%	Instant/ Within 24 hours
Prior Authorization Management	Ohio MCP & OhioRISE authorization tracking, linkage to claims, and expiration monitoring	40–60% reduction in PA-related denials	3–5 business days
Provider Enrollment & Revalidation	Ohio Medicaid enrollment, revalidation, and MCO credentialing, aligned with current state workflows	Eliminates enrollment related denials.	3-4 weeks
Timely Filing Management	Ohio FFS vs MCP filing-limit tracking, corrected-claim discipline, early-warning alerts	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 Ohio

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 Ohio

Ohio’s telehealth and RPM guidelines and regulations.

Serving Healthcare Providers Across Ohio

From Allen to Wyandot, we provide comprehensive medical billing services across all 88 Ohio counties.

Northeast Region:

Ashland, Ashtabula, Carroll, Columbiana, Cuyahoga, Erie, Geauga, Harrison, Huron, Jefferson, Lake, Lorain, Mahoning, Medina, Portage, Richland, Stark, Summit, Trumbull, Tuscarawas, Wayne.

Central Region:

Champaign, Coshocton, Delaware, Fairfield, Fayette, Franklin, Holmes, Knox, Licking, Logan, Madison, Marion, Morrow, Muskingum, Pickaway, Ross, Union.

Northwest Region:

Allen, Crawford, Defiance, Fulton, Hancock, Hardin, Henry, Lucas, Ottawa, Paulding, Putnam, Sandusky, Seneca, Van Wert, Williams, Wood, Wyandot.

Southwest Region:

Auglaize, Brown, Butler, Clark, Clermont, Clinton, Darke, Greene, Hamilton, Highland, Mercer, Miami, Montgomery, Preble, Shelby, Warren.

Southeast Region:

Adams, Athens, Belmont, Gallia, Guernsey, Hocking, Jackson, Lawrence, Meigs, Monroe, Morgan, Noble, Perry, Pike, Scioto, Vinton, Washington.

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 Ohio

Q1. Is MITS used for Ohio Medicaid managed care claims?

No. Managed Care Plan (MCP) claims are billed directly to the individual health plans. MITS is used only for FFS claims, adjustments, and eligibility lookups.

Q2. What is OH|ID and why do providers need it?

OH|ID is Ohio’s secure login system. Providers need a OH|ID credentials for accessing the OMES modules, like provider enrolment, checking the claims status and other network management tools.

Q3. Does enrolling in PNM automatically enroll a provider with all Ohio Medicaid plans?

No. PNM enrollment establishes participation with Ohio Medicaid only, providers must complete separate contracting or credentialing with individual managed care plans for billing those.

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

➣ Active status of the provider with Ohio 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?

➣ Reviews current billing workflows and denial patterns
➣ Confirms Ohio 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 Ohio?

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.

Ohio Licensed

Licensed to operate in Ohio

Medical Billing Glossary

Essential Terms for Understanding the Ohio’s Medical Billing Landscape

Medicaid Information Technology System (MITS)

It is the Medicaid’s Fee-for-Service (FFS) claims and eligibility platform used by providers to submit, track, correct, and view their Medicaid FFS claims, they can also check the members eligibility, and access information about the remittance advice for the FFS services.

Next Genaeration MyCare

It is an integrated care model for members who are eligible for both Medicare and Medicaid. It replaces the earlier MyCare structures and emphasizes for better coordination of physical health, behavioral health, and long-term services and have introduced new billing, authorization, and payer-responsibility rules for providers serving dual-eligible members.

Ohio Department of Medicaid (ODM)

The state agency for administering the Ohio’s Medicaid programs, setting billing policies, contract with the managed care plans, oversees OhioRISE and MyCare programs, and managing the Medicaid systems such as OMES and MITS.

OH|ID

OH|ID is Ohio’s secure identity and access management system used for logging in to the Medicaid systems. It ensures controlled, role-based access for the security of claims, enrollment, and other administrative tools.

Ohio Medicaid Enterprise System (OMES)

The Medicaid enterprise platform that houses multiple operational modules for supporting provider enrollment, credentialing, managed care administration, claims oversight, and other program management across the state’s Medicaid Program.

OhioRISE (Resilience through Integrated Systems and Excellence)

The managed care program for children and youth with complex behavioral health needs.

Provider Network Management (PNM) module

It is a component of OMES used for provider enrollment, revalidation, credentialing, and demographic maintenance.

Our Services

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

RCM
Solution

Eligibility Verification

Prior Authorization

Virtual Assistance

Coding ICD-10

Charge Capture

Claims Submission

Claims Audit

Payment Posting

Denial Management

AR Follow Up

Patient Statements

Credit Balance

Credentialing

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 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 Ohio 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 Ohio-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 Ohio support team

The Best Medical Billing Company in Ohio - Shoreline

Best In the Industry

Ohio Billing Challenges we solve

Fix the “Who do we bill?” problem with payer-responsibility logic

Prevent timely filing losses with Ohio-specific tracking and “early warning” alerts

Stay ahead of modernization-driven process changes (without operational disruption)

Comprehensive Medical Billing Services for Ohio

Medical Billing Resources for Ohio

Medicaid Billing Guide

Behavioral & Mental Health Billing rules and guidelines

Revenue Cycle Optimization

Telehealth and Remote patient Monitoring in Ohio

Serving Healthcare Providers Across Ohio

Northeast Region:

Central Region:

Northwest Region:

Southwest Region:

Southeast Region:

Savings Estimation Calculator

Frequently Asked Questions

Q1. Is MITS used for Ohio Medicaid managed care claims?

Q2. What is OH|ID and why do providers need it?

Q3. Does enrolling in PNM automatically enroll a provider with all Ohio Medicaid plans?

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

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

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

Compliance & Certifications

HIPAA Compliant

AAPC Certified

Ohio Licensed

Medical Billing Glossary

Medicaid Information Technology System (MITS)

Next Genaeration MyCare

Ohio Department of Medicaid (ODM)

OH|ID

Ohio Medicaid Enterprise System (OMES)

OhioRISE (Resilience through Integrated Systems and Excellence)

Provider Network Management (PNM) module

Our Services

RCMSolution

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?

RCM
Solution