Medical Billing Services in New York
New York pairs one of the shortest Medicaid filing windows in the country — 90 days from the date of service through eMedNY — with a payer landscape unlike any other state: regional nonprofits like Healthfirst and EmblemHealth carry enormous enrollment in the city, Fidelis dominates Medicaid managed care, and upstate runs on a completely different set of Blues (Excellus) than downstate (Anthem, formerly Empire). New York's prompt-pay law is genuinely enforceable — Insurance Law §3224-a puts 12% annual interest on late-paid claims — and the state's 2015 surprise-bill law predates the federal No Surprises Act with its own dispute process. Behavioral health billing volume here is among the highest in the nation.
New York Medicaid: filing rules that decide whether you get paid
Administered by the NYS Department of Health / eMedNY
New York Medicaid fee-for-service claims must reach eMedNY within 90 days of the date of service; exceptions require documented delay reason codes and are scrutinized. Most members are in mainstream Medicaid managed care — Fidelis Care (Centene) and Healthfirst carry the largest books, alongside MetroPlusHealth, Molina and plan offerings from the commercial carriers — and plan filing limits commonly run 90–120 days. New York also layers distinct programs (HARP behavioral health plans, Managed Long Term Care) with their own billing rules, which matters enormously for behavioral health and home-care adjacent practices.
Deadlines for every major payer — including New York Medicaid — live in our timely filing limits tool, with an interactive deadline checker.
The payers we bill every day in New York
New York billing rules that move real money
Prompt pay — Insurance Law §3224-a
New York insurers and Article 43/44 plans must pay undisputed claims within 45 days of receipt (30 days for electronically submitted claims), or notify the provider in writing within 30 days of the specific reasons they aren't liable. Late payment accrues interest at the greater of the corporate-tax rate or 12% per annum. We calculate and demand this interest on chronically slow payers.
2015 surprise bill & emergency services law
New York regulated out-of-network emergency and surprise bills years before the federal No Surprises Act, with an independent dispute resolution process that still governs many state-regulated claims — knowing whether the state or federal process applies changes the strategy on every OON dispute.
Where we work in New York
We support practices across the state remotely — same-day claim submission and a dedicated team regardless of your zip code. The markets we serve most:
Credentialing & enrollment in New York
Physician licensing in New York runs through the NYS Office of the Professions (NYSED), and payer enrollment is its own workstream on top of it — state Medicaid enrollment, CAQH upkeep, and individual plan contracting each on their own timeline. Our credentialing service manages the full stack for New York providers, and our credentialing calculator estimates realistic timelines by payer.
New York billing FAQs
What is the timely filing limit for New York Medicaid?
90 days from the date of service for fee-for-service claims through eMedNY. Claims past 90 days need a valid delay reason code and documentation. Managed care plans like Fidelis and Healthfirst set their own limits, typically 90–120 days.
How does New York's prompt pay law help my practice?
Insurance Law §3224-a requires payment of undisputed claims within 45 days (30 for electronic submissions) and puts 12% annual interest on late payments. Systematically tracking payer turnaround and invoicing interest changes payer behavior — most practices never do it.
Do you handle HARP and behavioral health billing in New York?
Yes. New York routes much of behavioral health through HARP plans and carve-in managed care with specific rate codes and modifier requirements — we bill these daily and it's one of our highest-volume specialties in the state.
Which Blue Cross plan applies to my New York patients?
Downstate members typically carry Anthem BCBS (the former Empire plan); upstate members carry Excellus BCBS or regional plans like Independent Health. They are separate companies with separate provider contracts, portals and filing rules — we maintain both.
Medical billing services in other states
Ready to stop losing revenue in New York?
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