Clawback Protection Guarantee
Helping wound care providers protect Medicare reimbursements against clawbacks.
Shoreline Benefits
Experience financial peace of mind, confident that we’re here to support you.
Shoreline’s team of experts will review and audit clinical notes to ensure LCD compliance, protecting you from potential clawbacks
We manage the appeals process, allowing you to stay focused on positive patient outcomes.
In the event of a clawback, Shoreline handles the appeal and reimburses the physician if necessary through our Clawback Protection Guarantee.
Comprehensive coverage with a 6 year look-back period, so you can focus on what matters.
Our clawback coverage protects physicians from financial risk during the entire look-back period, ensuring they are covered in case of a potential clawback.
INNOVATIVE SOLUTIONS
Protect your practice from the financial risks of clinical notation discrepancies, through our transparent Clawback Protection Guarantee solution.
Our transparent review services ensure your clinical notes are compliant and defensible against over demand payment notices
We specialize in the skin substitute sector, providing the best Medicare clawback protection in the industry for your practice
Shoreline’s cutting-edge AI clinical validation program ensures LCD compliance for your practice with proven results
THE SHORELINE DIFFERENCE
What Sets Us Apart
Shoreline protects wound care providers from Medicare clawbacks with our Clawback Protection Guarantee. We review clinical notes for compliance within 7 business days of submission, flag discrepancies, and handle appeals. Backed by AI-driven validation, we help you get paid, stay paid, and stay focused on patient care.
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Our team actively supports you through clinical note reviews, audits and appeals.
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Shoreline’s Clawback Guarantee is designed to save your practice valuable time. While we're not a billing company, our team thoroughly reviews clinical notes to ensure they meet applicable MAC standards, flagging any issues before submission. This proactive approach protects against potential Medicare clawbacks — so providers can spend less time on paperwork and more time focused on patient care.
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Shoreline’s Clawback Protection Guarantee offers true financial security. In the event of a clawback, we manage the appeals process and reimburse the physician if necessary. Our coverage protects your practice from financial risk throughout the full Medicare look-back period — so you’re supported every step of the way.
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We stand behind our reviews and process with a proven guarantee, so you can operate with confidence.
Trusted Security & Compliance
Shoreline has attained HITRUST Certification for its platform, and we are committed to HIPAA-compliant practices to help protect sensitive healthcare information.
FAQs
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Please see our Schedule A graft list.
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No — Shoreline is not a billing company. We operate as a clinical documentation compliance partner who works alongside your team within 7 days from when billing occurs.
Medicare reimbursement for wound care is administered through regional Medicare Administrative Contractors (MACs). These MACs define the coverage requirements for services like wound grafts using national and local policies, called National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs). To qualify for payment, providers must demonstrate compliance with these standards in both documentation and medical necessity.
MACs frequently conduct post-payment audits to ensure providers adhere to these rules. When documentation falls short, they issue Overpayment Demand Letters, often requiring practices to repay funds already reimbursed, sometimes years later.
That’s where Shoreline comes in.
While we do not handle billing, we review your clinical notes and supporting records to confirm they align with the appropriate MAC’s coverage requirements before a claim is submitted. When your documentation meets the applicable standard, we issue the Shoreline Clawback Protection Guarantee — a formal commitment that if you later receive a clawback related to a case we approved, Shoreline will manage the audit response on your behalf. We will reimburse you for the full repayment if you're found liable.
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Shoreline reviews your unreimbursed wound care Medicare billings and clinical notes to ensure they are in compliance with national and local coverage standards. If we believe your billings and clinical notes are sound, we issue the Shoreline clawback protection guarantee, which means if you receive a Overpayment Demand Letter from the applicable MAC, we will defend you against the demand and reimburse either you or Medicare for the amount claimed if you are ultimately found liable for the Medicare Clawback. We do not cover misrepresentation, fraud, pricing mistakes in the medical provider’s billings, or Medicare Sequestration.
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As soon as the Medical Provider is onboarded, you may begin submitting claims and clinical notes for review.