Medical Billing Services in New York
As a remote-first medical billing company serving New York practices statewide, MedPrecision pairs NY-specific payer expertise with AAPC-certified billing experts. New York Insurance Law Section 3224-a requires an insurer, an Article 43 or 47 corporation or an Article 44 HMO to pay a claim within 30 days of an electronic submission and 45 days of one sent by paper or fax — the rule that shapes every clean-claim workflow for New York practices, though it does not reach self-funded employer plans. Anthem Blue Cross and Blue Shield — the Empire BlueCross BlueShield name retired on 1 January 2024 — anchors New York's commercial payer mix, which means fee-schedule mastery and timely appeals are non-negotiable for practices operating in the state. New York Medicaid requires an initial claim within 90 days of the date of service, Section 3224-a sets 120 days as the default minimum for commercial claims and lets a payer deny outright anything submitted more than 365 days after service, and commercial contracts in the state run 90-180 days — deadlines that discipline every claim queue we manage. Our remote billing team builds New York-specific workflows around these rules, with payer-level edits, MCO portal automation, and appeals templates tuned to how New York plans actually adjudicate.
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The New York Billing Landscape
New York has one of the most complex Medicaid systems in the country, with just under 7 million children and adults enrolled — 6,986,000 on the state fact sheet published by KFF and read in September 2026 — most of them in managed care plans: Healthfirst, Fidelis Care (Centene), EmblemHealth, MetroPlus and Molina Healthcare of New York, which absorbed Affinity Health Plan in 2021, among others. The state's Essential Plan provides coverage for residents who don't qualify for Medicaid but can't afford marketplace plans, adding another layer of billing complexity. The commercial side runs mainly through Anthem Blue Cross and Blue Shield (which retired the Empire BlueCross BlueShield name on 1 January 2024), UnitedHealthcare, Aetna, Cigna and Oscar Health. New York's prompt-pay law requires payment within 30 days for an electronically transmitted claim and 45 days for one sent by paper or fax, with interest at the greater of 12% per annum or the corporate-tax rate set by the New York Commissioner of Taxation and Finance. The state's surprise billing law (in effect since 2015, before the federal NSA) established an independent dispute resolution process. New York City practices operate in one of the most competitive, high-overhead markets in the nation, with NYU Langone, Mount Sinai, NewYork-Presbyterian, and Northwell Health shaping contracting dynamics. Upstate New York is markedly different — Rochester, Buffalo, and Syracuse have regional health systems and lower reimbursement rates, while rural communities face provider shortages. New York mandates telehealth parity and applies its own behavioral health parity requirements on top of the federal ones.
Who We Serve in New York
Our New York client mix skews toward solo practices, group practices, multi-specialty clinics , plus behavioral health practices and telehealth providers. We work with providers in New York City, Buffalo, Rochester and across the rest of the state, all remotely.
Major Metros Served
What billing costs in New York
We publish one national rate card and bill New York practices on exactly the same terms as everywhere else — there is no regional markup and no quote-only tier below enterprise. You pay a percentage of what we actually collect, so if we do not collect, you do not pay.
| Practice size | Rate | Basis | Note |
|---|---|---|---|
| Solo practice | 7.0% | of monthly collections | Monthly minimum applies |
| Group practice | 6.0% | of monthly collections | Volume discounts available |
| Enterprise | Custom | tiered pricing | Scoped per engagement |
- No setup or implementation fee
- No per-claim charge
- No software fee and no markup on third-party costs — clearinghouse fees, postage and payer application fees are passed through at cost
- 12-month initial term, then month-to-month — 60 days' notice either way, no early-termination penalty
Payer Landscape in New York
New York Medicaid Managed Care routes members through Fidelis Care, Healthfirst, MetroPlus Health Plan and 3 more plans, each with its own authorization rules and fee schedule. On the commercial side, Anthem Blue Cross and Blue Shield (formerly Empire BlueCross BlueShield), UnitedHealthcare, Aetna drive the bulk of New York claim volume, so we maintain payer-specific denial playbooks and appeal templates for each. Claim clocks in New York run 365 days for Medicaid and 90-180 days for commercial payers — deadlines our A/R queues are built around. New York's prompt-pay statute: New York Insurance Law Section 3224-a requires an insurer, an Article 43 or 47 corporation or an Article 44 public health law HMO to pay a claim within 30 days of receipt when it is transmitted electronically and within 45 days when it arrives by paper or fax, unless the obligation to pay is not reasonably clear or there is a specific, reviewable basis to suspect fraud. An overdue amount carries interest at the greater of the rate the New York Commissioner of Taxation and Finance sets for corporate taxes under Tax Law Section 1096(e)(1) or 12% per annum, computed from the date payment was due; interest under two dollars need not be paid. Statute text read at the New York State Senate's published consolidated laws, revision in effect 19 September 2025, on 17 September 2026.
Medicaid Program
New York Medicaid Managed Care
Managed Care Organizations
Key Commercial Payers
Timely Filing Deadlines
Prompt Pay Law
New York Insurance Law Section 3224-a requires an insurer, an Article 43 or 47 corporation or an Article 44 public health law HMO to pay a claim within 30 days of receipt when it is transmitted electronically and within 45 days when it arrives by paper or fax, unless the obligation to pay is not reasonably clear or there is a specific, reviewable basis to suspect fraud. An overdue amount carries interest at the greater of the rate the New York Commissioner of Taxation and Finance sets for corporate taxes under Tax Law Section 1096(e)(1) or 12% per annum, computed from the date payment was due; interest under two dollars need not be paid. Statute text read at the New York State Senate's published consolidated laws, revision in effect 19 September 2025, on 17 September 2026.
New York Billing Regulations & Compliance
The New York State Department of Financial Services (DFS) sets the rules our New York billing workflows have to satisfy. Surprise billing in New York: New York's surprise bill protections (Financial Services Law 603) predate the federal No Surprises Act, protecting patients from balance billing for emergency and inadvertent out-of-network services with an independent dispute resolution process. Telehealth parity: New York requires insurers to cover telehealth services on the same basis as in-person visits. Medicaid covers telehealth including audio-only and telephonic services.
State Insurance Regulator
New York State Department of Financial Services (DFS)
Surprise Billing Protection
New York's surprise bill protections (Financial Services Law 603) predate the federal No Surprises Act, protecting patients from balance billing for emergency and inadvertent out-of-network services with an independent dispute resolution process.
Telehealth Billing Parity
New York requires insurers to cover telehealth services on the same basis as in-person visits. Medicaid covers telehealth including audio-only and telephonic services.
Common Questions
Common questions about medical billing services in New York.
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Get a Free Billing AuditHow do you handle New York Medicaid Managed Care?
New York Medicaid Managed Care runs through plans certified by the state Department of Health — Fidelis Care, Healthfirst, MetroPlus Health Plan, Molina Healthcare of New York and Anthem HealthChoice among them. Each has different billing rules, prior auth requirements, and appeal timelines. Our team manages the payer-specific workflows for your contracted plans.
What about billing differences between NYC and upstate practices?
NYC practices typically deal with higher Medicaid managed care volume and more complex multi-payer environments. Upstate practices often have a heavier commercial and Medicare mix. We adjust billing strategy based on your specific payer profile.
How does New York's surprise billing law affect us?
New York's out-of-network billing protections predate the federal No Surprises Act. We ensure compliant billing for both in-network and out-of-network claims, and manage IDR when needed.
What specialties do you support in New York?
We bill mental health, primary care, cardiology, orthopedic and urgent care work. The specialty decides the coding and prior-authorization detail; New York decides the prompt-pay clock, the filing deadlines and the out-of-network process that sit on top of it, and we set both up before the first claim goes out.
What happens if a payer misses the New York prompt-pay deadline?
New York Insurance Law Section 3224-a gives an insurer, an Article 43 or 47 corporation or an Article 44 HMO 30 days to pay an electronically transmitted claim and 45 days to pay one submitted by paper or fax. Late payment carries interest at the greater of the rate the New York Commissioner of Taxation and Finance sets for corporate taxes under Tax Law Section 1096(e)(1) or 12% per annum, running from the date payment was due, and nothing is owed where the interest works out to less than two dollars. The clock does not run where the obligation to pay is not reasonably clear or where the payer has a specific, reviewable basis to suspect fraud, and the section does not reach self-funded employer plans. We track claims against those dates, flag stalled payments in our A/R reports, and escalate to the New York State Department of Financial Services (DFS) when a payer defaults. On filing: New York Medicaid wants an initial claim within 90 days of service, and Section 3224-a treats 120 days as the default minimum for commercial claims while allowing outright denial past 365 days. Statute text read at the New York State Senate's published consolidated laws, revision in effect 19 September 2025, on 17 September 2026.
How do I choose a medical billing company in New York?
Prioritize a billing company that already works with New York Medicaid Managed Care and the major commercial payers in New York — payer-specific edits and timely-filing windows are where most NY revenue leaks start. Ask about AAPC-certified coders, transparent pricing, and denial-rate and days-in-A/R reporting before you sign. Because billing is delivered remotely, a company's New York payer experience matters more than a local office address.
Services for New York practices
Specialties we bill for
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Billing help for your New York practice
Tell us the specialty and we will come back on what your New York payer mix actually changes — filing windows, the state's prompt-pay clock, and which plans your claims are going to. Written findings in 3–5 business days.
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A billing specialist will review your practice details and reach out within 1 business day. No confirmation email is sent — if you need to reach us sooner, call +1-872-297-2815.
Services in New York
Specialties in New York
Other Locations We Serve
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See where denials, follow-up delays, or workflow gaps may be hurting your New York practice's collections.
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