Turning a $10 Million Billing Backlog into a $3.8 Million Recovery
A Maine eye center faced a $10 million billing backlog during COVID-19 due to staff shortages, outdated software, and missed timely filing deadlines.
Shoreline Medical Billing company worked manually within their existing system, negotiated with payers to reopen filing limits, and recovered $3.8 million without costly software upgrades.
About The Client
A high-volume ophthalmic surgical and vision care center in Southern Maine.
Specialized Eye Care & Advanced Surgical Services
A premier Maine-based eye care facility providing comprehensive ophthalmology and optometry services, featuring advanced diagnostic technology, specialized surgical suites, and an experienced team of multi-specialist physicians.
The Challenge: A Mountain of Backlogged Claims
How pandemic disruption and rigid technology forced a high-volume eye care center to a financial standstill
Before COVID-19, the organization had a well-functioning in-house billing team and like many healthcare facilities, they faced severe staff shortages during the pandemic. Claims piled up quickly, and because their practice management software was an older version, they couldn’t submit claims electronically.
Their situation was further complicated when several outsourcing companies refused to take on the project unless the eye center upgraded its entire billing software, a change that would cost them thousands of dollars and weeks of downtime.
The revenue cycle came to a grinding halt. And by the time the pandemic settled, nearly $10 million was sitting idle in Accounts Receivable (AR) and most of it looked unrecoverable.
Pandemic Staffing Depletion
In-house billing team severely reduced, causing rapid backlog accumulation across all provider schedules.
Legacy Software Limitations
Inability to submit claims electronically without a forced, costly platform overhaul rejected by other billing vendors.
$10 Million Stalled in AR
Missed timely filing windows and aged balances that appeared completely uncollectible under payer rules.
The Shoreline Approach: Working Smarter, Not Costlier
At Shoreline Medical Billing company, we believe that technology should serve providers and should not burden them. Instead of recommending a costly system upgrade, our team decided to work manually within the existing platform, saving the provider from an unnecessary investment.
We began by dividing the AR into two strategic categories:
- Timely filing claims that could still be submitted within the deadline.
- Past timely claims that had already expired under payer rules.
- Focused first on recoverable funds while simultaneously creating a plan for expired claims.
Manual Precision and Team Collaboration
Our billing specialists collaborated with the practice’s internal staff to access claim data, cross-verify patient records, and ensure compliance accuracy. Each claim was carefully reviewed, corrected, and submitted manually. Even though it was time-consuming, it saved the practice significant costs and avoided the chaos of a system transition.
Negotiating with Payers: Reopening the Filing Window
For claims that had already crossed the timely filing limit, our team took an unconventional route: we directly contacted the Chief Operating Officers (COOs) of several private insurance companies. We explained the unique circumstances where during the pandemic, healthcare workers prioritized patient care over paperwork. Many risked their own safety to keep patients healthy, and administrative processes naturally took a back seat. Some insurance companies empathized with the situation and agreed to reopen the filing windows temporarily. Our negotiations with the payer was key to recover funds that were previously considered uncollectible.
Patient Follow-Ups and Outstanding Balances
In parallel, Shoreline’s virtual assistants initiated a structured follow-ups for the overdue balances. Through compassionate communication and transparent payment options, we were able to collect nearly $800,000 directly from patients who had outstanding balances.
From Analysis to Excellence
Shoreline’s 4 phase approach that transforms challenges into measurable financial excellence
Comprehensive AR Analysis
Duration: Week 1–3Our team conducted a deep audit of the client’s Accounts Receivable (AR) backlog, reviewing payer types, claim statuses, timely filing limits, and software capabilities. We categorized claims based on their recovery potential and compliance status.
Targeted Claim Optimization
Duration: Week 3–6We divided claims into timely filing and past timely filing segments to focus resources efficiently. This step helped streamline the recovery process while maintaining compliance with payer-specific timelines.
Direct Payer & Patient Engagement
Duration: Week 6–12Our President reached out directly to the COOs of multiple insurance companies to reopen the filing limits under COVID-19 exceptions. Simultaneously, our patient engagement team conducted structured outreach for overdue balances through transparent communication.
Continuous Monitoring & Improvement
Duration: OngoingAfter recovering the possible old AR, we have started a regular AR tracking, with denial pattern analysis, and customized reporting to ensure sustained revenue integrity and future claim compliance.
The Results: $3.8 Million Recovered and Renewed Confidence
How Shoreline delivered measurable financial recovery without software upgrade disruption
Collected from timely filing claims.
Recovered from re-opened claims following insurer negotiations.
Collected through structured patient follow-ups.
Together, this amounted to an impressive $3.8 million in recovered AR all without a system upgrade or additional technology costs. Of the $10M gross historical billing backlog, Shoreline successfully recovered 100% of the active collectible window ($2.3M timely filed + $700K reopened + $800K patient collections), while cleanly adjusting off aged pre-intervention filing forfeitures incurred during the height of the clinic's staffing shortage.
Even better, 95% of timely filed claims were accepted upon first submission, proving that Shoreline’s accuracy and hands-on approach can deliver measurable results even under challenging circumstances.
What Our Clients Say
Real feedback from healthcare practices across the United States who trust Shoreline for their billing needs.
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 were really a life saver. I never feel like just a number, as I might with a large corporation.
Family Medicine Centre
Maine
We use Shoreline for all our billing needs — the support is second to none! Always up to date with coding updates which ensures timely billings and prompt payments. I highly recommend Shoreline to any practice.
Nephrology Group
New Hampshire
I'm a small pediatric OT practice and have been with Shoreline for several years. They make it so easy to focus on patient care. When I have questions, they are always available. Couldn't be happier!
Pediatric OT Clinic
Maine
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 — one less thing to worry about.
Internal Medicine
Arizona
Why Choose Shoreline?
We at Shoreline Medical Billing company go beyond claim submissions to build lasting partnerships that drives revenue, compliance, and confidence.
HIPAA-Compliant
Secure & Encrypted Platform. Every process we follow meets 100% HIPAA privacy and security standards.
Certified RCM Specialists
Expert billing staffs with hands-on experience across multiple specialties.
24/7 Support
Round the clock assistance whether it is a claim update or a reporting query, our support team is just a call or message away.
Cost-Efficient Solutions
We deliver enterprise-level billing expertise without the heavy overhead.
Cloud-Based Technology
Secure, easily accessible and interoperable cloud-powered systems.
Nationwide Coverage
From solo practices in Texas to large hospitals in New York we cover diverse geographical areas.
Diverse Client Base
From Billing companies in California to Nurse practitioners in Washington we serve multiple specialties.
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