Medical billing services in New York
Billing, coding, credentialing and A/R follow-up for providers in New York.
Billing in New York: what is different
New York Medicaid managed care, the Essential Plan and Child Health Plus are offered through many plans, including Fidelis Care and EmblemHealth.
Key payers and contractors in New York
- Medicare Part A/B
- National Government Services, Jurisdiction JKPortal: NGSConnex
- Medicare DME
- Noridian, DME MAC Jurisdiction ADME supplier claims only · Portal: Noridian Medicare Portal (NMP)
- Medicaid
- New York MedicaidPortal: eMedNY (ePACES)
- Blue Cross Blue Shield
- Anthem Blue Cross and Blue Shield, Excellus BCBS and Highmark BCBS of Western New York
- Medicare Advantage
- UnitedHealthcare, Humana, Aetna, Wellcare, Blue plans and others, depending on the county
Contractor assignments and plan lists change. We confirm the current setup for your practice during onboarding.
How we work with New York providers
- Medicaid enrollment with the state, then credentialing with each managed care plan you need
- Medicare enrollment through PECOS and claims with National Government Services through NGSConnex
- Credentialing and contracting with commercial and Blue plans
- Eligibility checks that confirm each patient’s plan and assigned MCO before the visit
- Prior authorization tracking by plan
- Denial, appeal and A/R follow-up under each payer’s filing limits
Medical billing in New York: common questions
Do you bill New York Medicaid and its managed care plans?
Yes. We bill New York Medicaid fee-for-service claims and each Medicaid managed care plan, after confirming the patient’s assigned plan for the date of service.
Who processes Medicare claims in New York?
Medicare Part A and B claims in New York are processed by National Government Services (Jurisdiction JK), and we submit and track them through NGSConnex. DME supplier claims go to a different contractor, Noridian (DME MAC Jurisdiction A), through the Noridian Medicare Portal (NMP).
Can you credential new providers in New York?
Yes. We handle state Medicaid enrollment, Medicare enrollment, CAQH and credentialing with the commercial and managed care plans you need in New York.
Neighboring states and key payers
Get a free billing audit for your New York practice
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.