Medical Billing Services in New York

New York practices bill Medicare through National Government Services, Medicaid through eMedNY and a large managed care network, and commercial plans that change from region to region — Anthem and EmblemHealth downstate, Excellus and MVP upstate.

Medicare Part B contractorNational Government Services (NGS) — Jurisdiction K (JK)

Medicaid programNew York Medicaid, run by the New York State Department of Health through eMedNY

Medicaid managed careMedicaid managed care plans such as Fidelis Care, Healthfirst and MetroPlusHealth

Major commercial payersAnthem Blue Cross Blue Shield (formerly Empire), Excellus BlueCross BlueShield, EmblemHealth, MVP Health Care and UnitedHealthcare

How Medical Billing Works in New York

Every state has its own mix of payers and rules, and New York is no exception. These are the points that most often decide whether a New York claim is paid on the first pass:

Most New York Medicaid members are in managed care plans, and since 2023 Medicaid pharmacy benefits run through NYRx — so we confirm which plan covers which service before billing.
New York has its own surprise-bill and independent dispute resolution rules on top of the federal No Surprises Act, which matters for out-of-network and emergency claims.
New York is divided into several Medicare payment localities (Manhattan, the NYC suburbs and Long Island, Queens and the rest of the state), so expected payments differ by location.

Our Medical Billing Services in New York

We run the complete revenue cycle for New York practices, remotely and inside your existing EHR or practice management system:

Insurance eligibility and benefits verification before each visit
Medical coding (CPT, ICD-10-CM, HCPCS and modifiers) by certified coders
Charge entry and claim scrubbing to catch errors before submission
Electronic claim submission to Medicare, New York Medicaid plans and commercial payers
Denial management and appeals with root-cause tracking
A/R follow-up on aging claims, worked daily
Payment posting from ERAs and EOBs, including underpayment checks
Credentialing and payer enrollment, including eMedNY provider enrollment
Monthly reporting on collections, denials and days in A/R

Who We Work With

Our New York clients include primary care and internal medicine practices, specialty groups such as clinical billing, gastroenterology billing and toxicology billing, independent laboratories and multi-location clinics. Whether you are in New York City, Buffalo or a smaller community, you get the same certified coders, the same daily A/R follow-up and the same transparent reporting.

Cities We Serve in New York

New York CityMedical billing services BuffaloMedical billing services YonkersMedical billing services RochesterMedical billing services SyracuseMedical billing services AlbanyMedical billing services New RochelleMedical billing services Mount VernonMedical billing services SchenectadyMedical billing services UticaMedical billing services

Specialties We Bill For in New York

Neurology Cardiology Pathology Gastroenterology Laboratory Dental Physician Internal Medicine Toxicology Molecular Clinical Endocrinology Otolaryngology (ENT) Hematology Radiation Oncology Rheumatology

Frequently Asked Questions

Who processes Medicare claims in New York?

Medicare Part B claims for New York are processed by National Government Services (NGS) (Jurisdiction K (JK)). We submit, track and follow up on those claims for you, including Medicare Advantage plans, which are billed to the private plan instead.

How do you bill New York Medicaid?

New York Medicaid is run by the New York State Department of Health through eMedNY, and most members are enrolled in Medicaid managed care plans such as Fidelis Care, Healthfirst and MetroPlusHealth. We verify the member's plan before the visit and send each claim to the right plan with the right edits.

Which commercial payers do you work with in New York?

We bill all major commercial payers in New York, including Anthem Blue Cross Blue Shield (formerly Empire), Excellus BlueCross BlueShield, EmblemHealth, MVP Health Care and UnitedHealthcare, plus regional and employer plans.

Which New York cities do you serve?

We serve practices throughout New York, with dedicated pages for New York City, Buffalo, Yonkers, Rochester, Syracuse, Albany, New Rochelle, Mount Vernon, Schenectady and Utica. Because billing is done remotely, practices anywhere in the state can work with us.

How do we get started?

Request a free billing audit. We review a sample of your claims, denials and A/R, show you where revenue is being lost and give you a fixed quote — with no obligation.