The Best Medical Billing Company in Louisiana - Shoreline
Shoreline Medical Billing company delivers certified billing, AR recovery, and 96% clean claim rates to healthcare providers across Louisiana.
Comprehensive Medical Billing Services for Louisiana 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 companies in Louisiana. 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 Louisiana-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 Louisiana 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.
Louisiana Healthcare Billing Challenges We Solve
Coordination with Hurricane-Related Emergency Policies
Louisiana frequently activates temporary Medicaid flexibilities during hurricanes, that might include suspended PA rules, alternative sites of care, backdated relaxations for claims. But once the emergency ends, rolling back these flexibilities causes confusion. Providers often get denials because they would have billed under emergency rules after the expiration date, MCOs reverted at different times, documentation expectations tightened without warning. Shoreline Medical Billing company keeps providers safe by monitoring LDH emergency announcements in real time, adjusting PA, place-of-service, and billing rules during emergency periods and rolling back the temporary billing flexibilities the moment LDH ends them. This ensures no bill is generated under the expired rules or lose reimbursement due to timing gaps.
Handling the Transitions Between Fee-For-Service & MCO Programs
Certain services like waiver programs, long-term care, dental, and specialized therapies keeps shifting back and forth between FFS and managed care oversight. And during these transitions claims hit outdated PA rules, providers might submit the claims to the wrong payer because mapping tables lag behind LDH announcements. This constant toggling creates unique gaps in coverage validation. A shoreline we avoid these confusions by monitoring the LDH transition bulletins and updating payer-of-record rules instantly, tagging claims for special handling during transition months (e.g., when PA rules change mid-quarter) and validate each claim against both systems before submission. This makes coverage transitions financially painless.
Bridging the Communication Gaps Between LDH and Healthy Louisiana MCOs
Louisiana's Medicaid ecosystem still carries the older LDH platforms and workflows. When LDH updates coverage rules or PA criteria, the information does not always reach the Healthy Louisiana MCOs at the same pace. Providers often note that PA rules are updated by one plan before another, LDH bulletins taking more days or weeks to reflect in MCO provider manuals and claim editing logic differing drastically between plans despite the uniform state requirements. This mismatch forces practices to maintain separate rulesets for each plan, increasing administrative load and delaying reimbursement. We at Shoreline Medical Billing company maintain a seperate plan-by-plan rule trackers for all the Healthy Louisiana MCOs. Our billing teams receive weekly LDH bulletin digests, so updates propagate instantly into our claim's workflow. Our denial management system flags pattern-based issues, meaning if one MCO suddenly changes editing logic, we detect it and adjust coding rules before more claims go out. This eliminates the silent errors that often drain revenue for months.
Comprehensive Revenue Cycle Management Services for Louisiana
Specialized Services tailored to meet Louisiana's Medicaid rules and regulations
End-to-End Medical Billing
Custom workflows to meet the needs of Louisiana Medicaid and all major MCOs and FFS Medicaid Programs
Eligibility & Coverage Verification
Day-level verification to catch frequent Louisiana retroactive eligibility changes and mid-month MCO flips
Prior Authorization Management
Plan specific PA handling and routing
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.
Telehealth Billing
Applies telehealth geography rules, specific codes, modifiers, and POS
Patient Statements & Follow-Up
Communicate with patients and give Explanation of Benefits (EOBs). Includes text/email payment reminders and online payment options.
Louisiana Medical Billing Knowledge Hub
Essential regulatory benchmarks, payer policies, and billing guidelines for healthcare practitioners in Louisiana.
Louisiana Medicaid Filing Windows
Claims for Louisiana Medicaid must be submitted within 365 days / 90-180 days MCOs 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 (La. R.S. § 22:1838 (25 days)) 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.
Louisiana 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 Louisiana
From Acadia to West Feliciana, we provide comprehensive medical billing services across all 64 Louisiana Parishes.
Greater New Orleans
Jefferson, Orleans, Plaquemines, St. Bernard, St. Charles, St. John the Baptist, St. Tammany
Plantation Country
Ascension, East Baton Rouge, East Feliciana, Iberville, Livingston, Pointe Coupee, St. Helena, St. James, Tangipahoa, Washington, West Baton Rouge, West Feliciana
Cajun Country
Acadia, Assumption, Calcasieu, Cameron, Evangeline, Iberia, Jefferson Davis, Lafayette, Lafourche, St. Landry, St. Martin, St. Mary, Terrebonne, Vermilion
Crossroads
Avoyelles, Catahoula, Concordia, Grant, La Salle, Natchitoches, Rapides, Sabine, Winn
Sportsman's Paradise
Bienville, Bossier, Caddo, Caldwell, Claiborne, De Soto, East Carroll, Franklin, Jackson, Lincoln, Madison, Morehouse, Ouachita, Red River, Richland, Tensas, Union, Webster, West Carroll
Louisiana Medical Billing Glossary
Key regulatory terms and definitions essential for compliant medical billing in Louisiana.
Healthy Louisiana
The Medicaid managed care program of the state of Louisiana that includes the major MCOs. Most of the Medicaid recipients are enrolled in Healthy Louisiana rather than the fee-for-service.
Healthy Louisiana
The Medicaid managed care program of the state of Louisiana that includes the major MCOs. Most of the Medicaid recipients are enrolled in Healthy Louisiana rather than the fee-for-service.
Health Standards Section (HSS)
The division responsible for licensing, surveying, and regulating healthcare facilities, home health agencies, behavioral health providers, and long-term care entities in Louisiana.
KIDMED
The Early and Periodic Screening, Diagnostic, and Treatment program in Louisiana which includes preventive health screenings for children under the age of 21.
