Medical billing services in New York
New York gives you strong prompt pay protections on paper and a dense managed care market in practice. We use the first to fix the second, and we work the appeals most practices never file.
- NYBilled end to end
- 8+Plans commonly billed
- 50+Specialties covered
What actually goes wrong with New York claims
These are important areas to check when configuring a New York billing workflow. The applicable plan and date of service determine the requirements.
- Prompt pay rules worth enforcing
New York sets statutory deadlines for clean claim payment. Most practices never invoke them. We track the clock and escalate when a payer runs past it.
- Surprise billing and dispute resolution
New York has its own independent dispute resolution process for out of network and emergency situations. Used properly it recovers money that would otherwise be written off.
- Regional plans, not national ones
Upstate runs on Excellus, MVP and CDPHP. The city runs on Healthfirst, Fidelis and EmblemHealth. The rules do not transfer between them.
NY Medicaid billing
New York Medicaid, billed through the eMedNY system.
Most members sit in Medicaid Managed Care with plans such as Fidelis Care, Healthfirst or MetroPlus. eMedNY has its own submission and edit rules, and a claim clean enough for a commercial payer is not automatically clean here.
Plans a New York practice bills
These are plans operating in New York. Your account is configured for the ones you actually see, not a statewide average. If yours is not listed, ask.
Before a New York claim is submitted
Configure the work around NY Medicaid and the plans your practice actually sees.
- Confirm the member plan and billing destination for each date of service.
- Check provider enrollment, service location and authorization requirements.
- Use the applicable filing and appeal deadlines in the claim worklist.
- Reconcile payments against the relevant contract or fee schedule.
Serving practices across New York
We work remotely inside your practice management system, so where you sit inside the state does not change what we can do. These are simply where New York practices most often are.
New York billing questions
Do you bill through eMedNY?
Yes, along with the Medicaid Managed Care plans most members are enrolled in. eMedNY has its own edits, and we build claims to pass those rather than reworking them afterward.
Can you use New York prompt pay rules on our aged claims?
Where they apply, yes. Statutory payment deadlines are one of the few pieces of real leverage a practice has, and most aged A/R has never had them invoked.
We are a small practice in Brooklyn. Are we too small for you?
No. Solo and small group practices are a large part of who we work with, and they are usually where the recoverable money is most concentrated.
Do you handle out of network dispute resolution?
We work the claim and the appeal, including preparing what the dispute process requires. Where it becomes a legal question we will tell you plainly that it has.
Find out what New York payers owe you
Tell us your specialty and the billing issue you want reviewed. We will agree the scope and arrange a secure way to share any records needed.