Medical Billing Services in New York
From Manhattan specialists to upstate primary care, New York billing means managed Medicaid, powerful regional plans, and payers that deny first and pay later. We bill it every day, and we appeal what NY payers get wrong.
Get a Free NY Revenue AnalysisPRMS Billing Solutions runs complete revenue cycle management for New York providers, from NYC group practices and ambulatory centers to Long Island, Westchester, and upstate clinics. New York's payer market is unlike anywhere else: a huge managed-Medicaid population, strong regional plans like Healthfirst and MVP, and a commercial market anchored by Anthem. Our teams work this mix daily: eligibility, coding, submission, denials, AR, and credentialing, end to end.
Medicare billing in New York
New York Part B claims run through National Government Services (NGS), the Medicare Administrative Contractor for Jurisdiction K. We file to NGS electronically, apply its local coverage determinations in pre-submission scrubbing, and track the 12-month federal filing limit on every claim. New York also has one of the nation's largest Medicare Advantage populations, led by Healthfirst, UnitedHealthcare, Humana, and Anthem, and we confirm MA enrollment at eligibility so claims never bounce off original Medicare.
New York Medicaid (eMedNY) billing
New York Medicaid is administered through eMedNY, and its timely-filing rule is one of the tightest in the country: initial claims are generally due within 90 days of the date of service. Most members sit in managed-care plans, Fidelis Care, Healthfirst, MetroPlusHealth, UnitedHealthcare Community Plan, Anthem HealthPlus, Molina, each with its own portal and prior-auth rules. We verify plan enrollment before the visit and file inside the window, because a late eMedNY claim is usually gone for good.
Commercial payers we bill in New York
The commercial anchor is Anthem Blue Cross Blue Shield (the former Empire plan) downstate and Excellus BCBS upstate. Around them sit EmblemHealth (GHI/HIP), UnitedHealthcare/Oxford, Aetna, Cigna, Healthfirst's commercial products, and MVP Health Care in the Capital Region and Hudson Valley. New York claims also mean workers' compensation and no-fault volume through the NY Workers' Compensation Board fee schedules, which we bill and follow up correctly.
Specialties we serve across New York
We bill 25+ specialties across New York, with deep benches in the ones that dominate the NY market: mental and behavioral health (a huge and heavily managed segment in NY), cardiology, gastroenterology, physical therapy, radiology, pain management, and urgent care.
Why New York practices choose PRMS
New York practices lose revenue in three predictable places: eMedNY's 90-day window closing on unfiled claims, managed-care plans denying for authorization that nobody obtained, and high-deductible commercial patients whose balances are never collected. We close all three gaps with front-end verification, plan-specific auth tracking, and disciplined AR follow-up, with weekly reporting so you always see where the money is. Credentialing with NY payers, including eMedNY enrollment, is free for billing clients.
New York medical billing FAQs
What is the timely filing limit for New York Medicaid?
Initial eMedNY claims are generally due within 90 days of the date of service, one of the shortest windows in the country. Managed-care plans set their own limits, often 90 to 180 days. We track every claim against its specific deadline so nothing ages out.
Do you bill Healthfirst, Fidelis, and EmblemHealth?
Yes. New York's regional plans, Healthfirst, Fidelis Care, MetroPlusHealth, EmblemHealth (GHI/HIP), and MVP, are core payers for NY practices, and we work their portals, auth rules, and appeal processes daily.
Which Medicare contractor handles New York?
National Government Services (NGS), Jurisdiction K, processes New York Part B claims. We build NGS coverage policies into our claim scrubbing.
Do you serve practices outside New York City?
Yes. NYC, Long Island, Westchester, the Hudson Valley, the Capital Region, and Western NY, our service is fully remote and works in your existing EHR, wherever in the state you practice.
Related services
Explore our full medical billing & RCM services, denial management, and provider credentialing & payer enrollment (free for billing clients), or browse all 25+ specialties we bill and other states we serve.
See what your New York practice is leaving on the table
Get a free, no-obligation revenue analysis. We measure your denial rate, days in AR, and recoverable revenue, specific to your payers.