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  • 1-855-838-1370
  • 445 Main Street, 2nd Floor, #1, Saco, ME 04072
  • Mon to Fri 9:00AM to 06:00PM EST
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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 Delaware. 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 Delaware-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

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Shoreline Healthcare Technologies in Delaware 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.

Delaware Billing Challenges we solve



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Complex provider enrollment, revalidation and NPI/Taxonomy management

The state of Delaware requires providers to enroll and maintain an active status in the DMAP provider portal, missing or mis-submitted enrollment items (NPIs, taxonomy, service locations) can stop claims. Revalidations and location updates are frequent and must flow to MCOs. At Shoreline Healthcare Technologies we have a dedicated enrollment team that completes DMAP portal applications, attachments, and revalidations on behalf of providers. We continuously reconcile the NPI/taxonomy/service location lists between provider records, DMAP, and MCO rosters and have scheduled automation to detect expiring documents or missing attestations and trigger immediate remediation. By partnering with us providers experiences fewer rejected/denied claims for enrollment issues, 95% of first-pass claims acceptance and quicker payments.

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Managing the Multiple MCO rules & managed-care plan variation

The providers in Delaware must interact with multiple MCOs (each with their own prior-auth rules, claim filing quirks, and medical necessity policies). A claim accepted by DMAP doesn't guarantee the MCO will pay unless its rules are met. Shoreline fixes these issues by building and maintaining MCO-specific claim scrubbers and adjudication rule sets, so that claims are formatted and coded according to each payer’s requirements. We use payer-specific edits and payer routing so claims go to the correct MCO. We continuously update and maintain an internal knowledge base of MCO rules and have scanned them into our RCM engine. This have resulted in higher clean-claim rates, fewer plan-specific denials and faster collections.

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Electronic Visit Verification (EVV) compliance for home & waiver services

The state of Delaware requires EVV registration with correct NPI/taxonomy/billing address mapping in DMAP for personal care/HCB services. Mis-registered EVV credentials or missing EVV IDs can cause denials. We at Shoreline Healthcare Technologies helps to register the provider NPIs/taxonomies in the DMAP/EVV environment and reconcile EVV visit files with every claim before submission. We perform periodic internal audits to check EVV compliances like timestamps, caregiver ID, member signoff etc so that we are always ready for payers or external audits. With Shoreline providers experiences a dramatic reduction in EVV-related denials and delayed payments for HCBS/home health.

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

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Specialized Services tailored to meet Delaware Medicaid rules and regulations

🩺 Services 📍Delaware Specialization 📈 Typical Improvement ⏱️ Turnaround Time
End-to-End Revenue Cycle Management Fully customized workflows for Delaware Medicaid, maintains compliance with DMAP and all other MCOs, payer-specific edits, with documentation alignment and claim formatting. 20–35% reduction in denials, faster payment cycles across multiple plans. 30–45 days for full RCM onboarding with measurable improvements within 60–90 days.
Eligibility & Coverage Verification Automated eligibility checks through DMAP & MCO portals, validation of managed-care assignments, and COB verification for duals (Medicare/Medicaid). 15–30% drop in eligibility-based denials. Same-day verification
Prior Authorization Management Handles MCO-specific PA rules 40–60% reduction in PA denials 3–5 business days for standard PAs
Denial Management AI based tools to track and flag denial codes and root-cause analysis tailored for Medicaid claims, 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
Telehealth Billing Applies telehealth geography rules, specific codes, modifiers, and POS 25–40% fewer telehealth denials Same-day telehealth claim processing.
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 better collection rates. 1-2 weeks
Provider Enrollment & Revalidation DMAP provider portal completion, NPI/taxonomy validation, location mapping, and continuous monitoring for updates across Delaware MCOs. 80–90% reduction in enrollment-related denials. Ensures active status and timely reimbursements. 45-90 days
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 Delaware

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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.

Managed Care Organizations Billing rules and guidelines

Specialized billing guidelines and documentation procedures for MCOs.

Revenue Cycle Optimization

Best Practices and Strategies to improve cash flow and reduce denials.

Telehealth and Remote patient Monitoring in Delaware

Delaware’s telehealth and RPM guidelines and regulations.

Serving Healthcare Providers Across Delaware

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From New Castle to Sussex, we provide comprehensive medical billing services across all 3 Delaware counties.

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Northern Delaware:

New Castle County

Central Delaware:

Kent County

Southern Delaware:

Sussex County

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Primary Care
Specialty Clinic
Rural Health
Mental Health
Cardiology
Dermatology
Emergency Medicine
Family Medicine
Internal Medicine
Neurology
Oncology
Orthopedics
Pediatrics
Psychiatry
Radiology
Surgery
Urgent Care
Women's Health

Frequently Asked Questions

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FAQs about Medical Billing Services in Delaware

Q1. How do providers enroll with Delaware Medicaid?

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Providers can enroll through the DMAP Provider Portal (powered by Gainwell). For enrolling they might require NPIs, taxonomy codes, licensure documentation, ownership details, and service location information.

Q2. Do Delaware MCOs require separate credentialing?

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Yes. Each MCOs in Delaware requires its own credentialing in addition to DMAP enrollment.

Q3. What is the timely filing limit for Delaware Medicaid and its MCOs?

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Delaware and its MCOs generally follow:

  • ✓ 180 days from date of service for initial claims (plan-specific)
  • ✓ 90 days for corrected/appeal re-submissions

Q4. Does Medicaid cover out-of-state care in Delaware?

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Yes, but only with prior authorization unless it is an emergency or life-threatening situation. The PA must justify why in-state care was not feasible.

Q5. How do Shoreline Healthcare Technologies help providers in Delaware?

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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.

Q6. Can Shoreline manage Delaware EVV compliance?

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Yes. We handle the entire EVV setup, NPI/taxonomy mapping, visit reconciliation, and claim matching to avoid EVV denials.

Compliance & Certifications

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Your data security and compliance are our top priorities.

HIPAA Compliant

Full HIPAA compliance with regular audits

AAPC Certified

Certified Professional Billing Staffs.

Delaware Licensed

Licensed to operate in Delaware

Medical Billing Glossary

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Essential Terms for Understanding the Delaware’s Medical Billing Landscape

Delaware Health Care Provider Directory (DHCP)

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The centralized database used to maintain accurate information about the healthcare providers across various programs including Medicaid networks in Delaware.

Delaware Health and Social Services (DHHS)

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The cabinet-level agency for overseeing all the public health, social service, and Medicaid programs in Delaware including DMMA, long-term care, mental health, and other related health initiatives.

DMAP (Delaware Medical Assistance Program)

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The umbrella program which includes Medicaid, CHIP, waiver programs, long-term care, and other related medical assistance initiatives for the state of Delaware.

Division of Medicaid and Medical Assistance (DMMA)

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The division that administers the Medicaid program for the state of Delaware. It is responsible for handling policies, reimbursement rules, EVV oversight, prior authorization rules, and provider enrollment requirement.

Diamond State Health Plan (DSHP)

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The primary Medicaid Managed Care Program delivered through contracted MCOs. It covers most of the Medicaid member from both adults and children in Delaware.

Electronic Visit Verification (EVV)

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The mandatory system for verifying the in-home services like personal care, attendant care and HCBS. It keeps a track of the caregiver’s time, location, and visit logs which is required for payment of claims.

Home and Community-Based Services (HCBS)

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The services funded by Medicaid that helps eligible members to receive long-term care at home instead of an institutional setting. It is a highly regulated service with strict EVV and documentation requirements.

Our Services

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

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Testimonials

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We Care

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From electronic health records, billing services and practice management tools-Shoreline has you covered! In addition to being an 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 Delaware understands how to navigate today’s complex healthcare revenue environment.

Ready to Optimize Your Medical Billing?

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Get your free consultation and discover how much you could save with our Delaware -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 Delaware support team