The Best Medical Billing Company in Indiana - Shoreline
Shoreline Medical Billing company delivers certified billing, AR recovery, and 96% clean claim rates to healthcare providers across Indiana.
Comprehensive Medical Billing Services for Indiana Practices
Shoreline Medical Billing company is a proud Maine-based company that offers end to end revenue cycle management services to physicians and Medical billing companiesin Indiana. 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 2010. 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 Indiana-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 Medical Billing company in Indiana 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.
Indiana Healthcare Billing Challenges We Solve
POWER Account Monitoring + Automated HIP Plus → HIP Basic Tracking
HIP's member-contribution model is one of the biggest reasons for the claims to flip from payable to non-payable. Shoreline Medical Billing company helps to build stability by pulling daily data through its eligibility synchronization workflows to flag members who are trending toward a HIP Basic downgrade. This enables providers to get real-time alerts even before a patient shows up. We route each denied claim back with the corrected coverage indicators and applies Indiana-specific modifiers to stabilize reimbursement.
Eliminating the INXConnect vs. MCO Eligibility Mismatch Problem
INXConnect often shows a member as eligible even when the MCO's system hasn't updated. This is one of Indiana's most expensive sources of denial delays. We at Shoreline Medical Billing company solves this by running dual eligibility verification (State + MCO file) and flag mismatches instantly. We redirect all the claims to the correct payer based on the exact effective enrollment date, not just the portal snapshot. This results in no more bouncing claims between plans, and no waiting 60+ days to resubmit a denial.
Centralizing Prior Authorization Rules Across All Indiana MCEs
Each MCE has different PA requirements, leading to denials. At Shoreline we have simplified PA management by building a central PA rules engine that merges all policies into a single view, flagging services that need PA before the patient is seen. Our team consistently tracks all PA approvals and links the PA number to the claim. So, there is no more duplicate faxes, no more missing PA numbers, and no more "authorization not on file" denials. This has contributed to a massive reduction in preventable denials with faster and more predictable reimbursements.
Comprehensive Revenue Cycle Management Services for Indiana
Specialized Services tailored to meet Indiana's Medicaid rules and regulations
End-to-End Medical Billing
Tailored to meet the needs of Indiana Medicaid, HIP Plus/Basic rules.
Eligibility & Coverage Verification
Dual verification with INXConnect + MCE enrollment data to prevent mismatched payer submissions
Prior Authorization Management
Centralized PA workflows for Indiana's fragmented MCE PA lists
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.
HIP POWER Account & Coverage Tier Monitoring
Automated tracking of HIP Plus → HIP Basic shifts, pregnancy switches, and retroactive eligibility updates
Telehealth Billing
Applies telehealth geography rules, specific codes, modifiers, and POS
Indiana Medical Billing Knowledge Hub
Essential regulatory benchmarks, payer policies, and billing guidelines for healthcare practitioners in Indiana.
Indiana Medicaid Filing Windows
Claims for Indiana Medicaid must be submitted within 365 days / 90-180 days MCEs from date of service. Claims exceeding this window are permanently denied unless accompanied by documented proof of timely filing with another primary payer.
Statutory Pay Protection
Under State statutory prompt payment laws (Ind. Code § 27-8-5.7 (30 days; 12% interest)) with strict interest penalty enforcement, commercial insurers and HMOs must settle clean claims on time. Delayed claims trigger statutory interest penalties that our recovery team collects on your behalf.
Indiana State Provider Portal & MMIS Connectivity
We maintain direct EDI connections for electronic claim submission, real-time eligibility inquiry, and rapid electronic remittance advice posting.
Serving Healthcare Providers Across Indiana
From Acadia to West Feliciana, we provide comprehensive medical billing services across all 64 Indiana Parishes.
Northwest Indiana
Lake, Porter, LaPorte, Jasper, Newton
North Central Indiana
St. Joseph, Elkhart, Marshall, Kosciusko, Fulton
Northeast Indiana
Allen, Adams, Wells, Huntington, Whitley, DeKalb, Noble, Lagrange, Steuben
West Central Indiana
Tippecanoe, White, Benton, Warren, Fountain, Montgomery, Clinton, Carroll
Central Heartland
Marion, Hamilton, Boone, Hancock, Hendricks, Morgan, Johnson, Shelby, Madison, Tipton, Howard
East Central Indiana
Delaware, Henry, Wayne, Randolph, Jay, Blackford
Southwest Indiana
Vanderburgh, Posey, Gibson, Warrick, Spencer, Perry
South Central Indiana
Dubois, Pike, Knox, Daviess, Martin, Lawrence, Orange, Brown, Bartholomew, Jackson, Jennings
Southeast Indiana
Clark, Floyd, Harrison, Washington, Scott, Jefferson, Switzerland, Ohio, Dearborn, Ripley
Indiana Medical Billing Glossary
Key regulatory terms and definitions essential for compliant medical billing in Indiana.
Acentra Health
The state’s contracted partner for handling prior authorization (PA) reviews for Indiana Medicaid programs. Providers must submit the clinical documentation to Acentra for services that require medical necessity review before the claim can be approved.
Acentra Health
The state’s contracted partner for handling prior authorization (PA) reviews for Indiana Medicaid programs. Providers must submit the clinical documentation to Acentra for services that require medical necessity review before the claim can be approved.
Family and Social Services Administration (FSSA)
The Indiana’s state agency that oversees Medicaid. It manages the IHCP program, sets and supervises MCE contracts and policies. It is responsible for running systems like CoreMMIS and INXConnect through the Office of Medicaid Policy and Planning (OMPP).
Healthy Indiana Plan (HIP)
The Indiana’s flagship Medicaid program for low-income adults. It uses a unique POWER Account system, where member contribution status determines coverage level (HIP Plus vs. HIP Basic). HIP rules often affect prior authorization, cost-sharing, and benefit eligibility.
