The Best Medical Billing Company in New York - Shoreline
Shoreline Medical Billing company delivers certified billing, AR recovery, and 96% clean claim rates to healthcare providers across New York.
Comprehensive Medical Billing Services for New York 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 New York. 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 New York 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 New York 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.
New York Healthcare Billing Challenges We Solve
eMedNY claims system quirks and ETIN enrollment requirements
eMedNY enrollment and ETIN setup procedures are the common source of delays in New York. Providers in New York must enroll through the eMedNY portal for obtaining and affiliating an ETIN, they must follow eMedNY-specific claim formatting procedures, and any mistakes can cause rejections. We at Shoreline Medical Billing company offers credentialing & enrollment support and our full suite of cloud-based RCM includes state specific functionalities. And helps providers to ensure correct enrollment/registration and understand the state's eMedNY submission rules.
Shorter Claim Submission Deadlines
All original Medicaid claims must be submitted within 90 days of the date of service. And Providers must have a quicker workflow to submit the claims early to avoid late submissions, denials, delayed payments. They must also adhere to correct claim formats, include proper documentation, and verify patient eligibility before submission to minimize errors. We at Shoreline Medical Billing company assists providers in managing claim submission deadlines efficiently. Our team monitors all claims to ensure they are filed within state-mandated timelines, performs real-time eligibility verification through MEVS/ePACES, and scrubs claims for compliance with NY Medicaid billing rules. We also handle re-submissions for denied claims, reducing the risk of lost revenue and administrative delays. By partnering with Shoreline, providers can focus on patient care while maintaining timely, accurate, and compliant claim submission workflows.
Managing the ePACES prior approval (PA) rules and submission requirements
Many items require prior approval (DME, some drug/equipment, medical necessity reviews) and must be submitted via ePACES or state PA forms missing the correct form/attachment or the ePACES workflow leads to denials. At Shoreline Medical Billing company we provide personalized support tailored to the unique needs of NYS providers. Our team of experts understands the intricacies of the New York healthcare landscape and offers guidance to help practices navigate these challenges effectively with our cloud-based RCM solutions for an optimized Revenue Cycle Management.
Comprehensive Revenue Cycle Management Services for New York
Specialized Services tailored to meet New York's Medicaid rules and regulations
Medicaid Billing
Integration with eMedNY for Medicaid billing, virtual assistants for real-time eligibility verification through MEVS/ePACES, electronic claim scrubbing software.
Billing for Managed Care Plans
Unified billing for New York Medicaid Managed Care Organizations (MCOs), MLTC, and HARP plans with automated payer-specific validation and modifier mapping.
Denial Management
AI based tools to track and flag denial codes, identify high-risk categories (e.g., long-term care, behavioral health), and automate resubmissions
Credentialing & Enrollment
Provider enrollment and revalidation with eMedNY, assistance with CAQH and credentialing audits.
Patient Statements & Follow-Up
Communicate with patients and give Explanation of Benefits (EOBs)
Practice Revenue Audits
100% chart-to-claim review, NCCI edit checks, fee schedule allowable auditing, and revenue leakage detection for New York practices.
New York Medical Billing Knowledge Hub
Essential regulatory benchmarks, payer policies, and billing guidelines for healthcare practitioners in New York.
New York Medicaid Filing Windows
Claims for New York Medicaid must be submitted within 90 days from date of service for NY Medicaid; 90-180 days for commercial plans. Claims exceeding this window are permanently denied unless accompanied by documented proof of timely filing with another primary payer.
Statutory Pay Protection
Under N.Y. Ins. Law § 3224-a (30 calendar days for electronic claims; 12% annual interest), commercial insurers and HMOs must settle clean claims on time. Delayed claims trigger statutory interest penalties that our recovery team collects on your behalf.
eMedNY Provider Portal & MEIPASS (emedny.org) Connectivity
We maintain direct EDI connections for electronic claim submission, real-time eligibility inquiry, and rapid electronic remittance advice posting.
Serving Healthcare Providers Across New York
From Albany to Wyoming, we provide comprehensive medical billing services statewide across all 62 counties of New York.
North Country
Clinton, Essex, Franklin, Hamilton, Jefferson, Lewis, St. Lawrence, Warren, Washington.
Capital Region
Albany, Columbia, Greene, Rensselaer, Saratoga, Schenectady, Warren, Washington.
Mohawk Valley
Fulton, Herkimer, Montgomery, Oneida, Otsego, Schoharie.
Central New York
Cayuga, Cortland, Madison, Onondaga, Oswego.
Finger Lakes
Chemung, Livingston, Monroe, Ontario, Schuyler, Seneca, Steuben, Tompkins, Wayne, Yates.
Western New York
Allegany, Cattaraugus, Chautauqua, Erie, Niagara, Orleans, Wyoming, Genesee.
Hudson Valley
Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster, Westchester
New York City
Bronx, Kings (Brooklyn), New York (Manhattan), Queens, Richmond (Staten Island)
Long Island
Nassau, Suffolk.
New York Medical Billing Glossary
Key regulatory terms and definitions essential for compliant medical billing in New York.
Claim Correction Form (CCF)
The form generated by eMedNY when a claim requires correction. It signals a required correction instead of full denial helping to prioritise re-submission. Providers must complete the form correcting the indicated data and resubmit the claim.
Claim Correction Form (CCF)
The form generated by eMedNY when a claim requires correction. It signals a required correction instead of full denial helping to prioritise re-submission. Providers must complete the form correcting the indicated data and resubmit the claim.
The electronic Medicaid system of New York State (eMedNY )
The online platform of New York State used for eligibility verifications and where providers submit their claims for payment processing.
Electronic Provider Assisted Claim Entry System (ePACES)
The web-based application of eMedNY that allows enrolled NY Medicaid providers to submit/receive HIPAA-compliant claims, eligibility requests, prior approval requests and claim status inquiries online.
