Medical billing services in New York
New York is really several healthcare markets in one. Practices in the five boroughs and on Long Island work with a different mix of plans than practices in Rochester, Buffalo or the Capital Region, and Medicaid managed care plays a large role in many communities.
We support New York providers remotely, wherever they practice in the state. Our team works inside your EHR or practice management system, keeps track of the plans that matter in your region and gives you a dedicated account manager who can explain what’s happening with your claims in plain terms.
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Practices we support in
- New York City
- Long Island
- Buffalo
- Rochester
- Albany
- Syracuse
And everywhere else in New York. We work fully remotely.
The New York billing landscape
What makes billing here different, and what we keep an eye on for you.
Medicare through National Government Services
National Government Services is the Medicare Administrative Contractor for New York, which falls in Jurisdiction K. We follow NGS billing guidance and local coverage policies and use its portal for eligibility and claim status.
New York Medicaid and eMedNY
New York Medicaid fee-for-service claims are processed through eMedNY, while many members are enrolled in Medicaid managed care plans with their own enrollment, authorization and claims rules. Program details change over time, so we confirm current requirements with the Department of Health and each plan.
Regional commercial markets
Commercial coverage differs by region, with Empire Blue Cross Blue Shield prominent downstate and Excellus BlueCross BlueShield and other regional plans prominent upstate, alongside national carriers and plans with large Medicaid and Essential Plan memberships.
Surprise billing, workers’ compensation and no-fault
New York has its own surprise billing protections in addition to federal rules, and workers’ compensation and auto no-fault claims follow separate state processes and fee schedules. State prompt-pay rules also set deadlines for clean claims. We keep these in view and verify current requirements before relying on them.
Payer programs, contractors and plan lists change. We verify current requirements before we bill.
Our services in New York
Billing in New York: common questions
A free revenue audit for your New York practice
See where claims are stalling with your payers, and what we’d change first.