Medical Billing Services in New York

Go Medical Billing serves NY practices from New York City to Buffalo and across the state. Our team knows your local payers, NY Medicaid Managed Care, and New York specific billing rules.

AAPC Certified
NY Payer Expertise
HIPAA Compliant
2.49% Starting Rate
90,000+NY Physicians
2.49%Starting Rate
6Medicaid MCOs
98%+Clean Claim Rate

Medical Billing for New York Physicians

New York's healthcare market is one of the largest in the country, with 90,000+ active physicians serving patients across the state. The commercial insurance market is led by Empire BlueCross BlueShield, with Aetna, Cigna, UHC also maintaining significant presence. NY Medicaid Managed Care covers a significant portion of the population through 6 managed care organizations, each with its own enrollment process, authorization requirements, and claims rules. Medicare claims are processed by Novitas Solutions, which has its own Local Coverage Determinations that affect what's covered in New York. The state also has specific billing regulations (NY Surprise Bill Law with IDR process) that add another compliance layer for NY practices. For practices in New York City and beyond, having a billing partner who understands these NY specific dynamics isn't optional — it's essential for maintaining healthy cash flow.

Go Medical Billing is headquartered in Miramar, Florida, and serves physician practices in all 50 states. Whether you're a solo provider in Albany or a multi-specialty group in New York City, our team handles your billing with NY specific payer knowledge and AAPC-certified coding accuracy.

New York Billing Challenges

Every state has its own billing complexities. Here are the NY specific challenges our team navigates daily.

1

Empire BlueCross BlueShield dominates the commercial market with its own specific claims processing rules, authorization requirements, and appeal timelines that differ from other carriers

2

6 Medicaid managed care plans each require separate credentialing, different authorization rules, and distinct claims submission processes

3

Novitas Solutions (the New York Medicare MAC) has specific Local Coverage Determinations that affect medical necessity and coverage for common procedures

4

NY Surprise Bill Law with IDR process adds compliance requirements beyond federal regulations

5

Finding qualified medical billing staff in the New York City job market is competitive, with salaries running $45K-$62K before benefits and overhead

New York Payer Environment

We know every major payer operating in New York and their specific billing rules.

Empire BlueCross BlueShield

Empire BlueCross BlueShield holds the largest share of New York's commercial insurance market. We process Empire BlueCross BlueShield claims daily and know their NY specific fee schedules, prior authorization portal, provider enrollment process, and appeal timelines. We also work with Aetna, Cigna, UHC, EmblemHealth, Oxford, and every other commercial payer operating in New York.

NY Medicaid Managed Care

NY Medicaid Managed Care routes beneficiaries through managed care organizations: Fidelis Care, Healthfirst, MetroPlus, Molina, MVP, United. Each MCO has its own enrollment process, authorization requirements, fee schedules, and claims submission rules. We credential and bill with every NY Medicaid Managed Care plan, handling the variation so your staff doesn't have to track each MCO's requirements.

Fidelis CareHealthfirstMetroPlusMolinaMVPUnited

Medicare (Novitas Solutions)

Medicare Part B claims in New York are processed by Novitas Solutions. Each MAC has its own Local Coverage Determinations (LCDs) that affect what's covered. We apply Novitas Solutions specific policies to every NY Medicare claim to prevent medical necessity denials.

New York Regulations

NY Surprise Bill Law with IDR process. Our team ensures your billing practices comply with both New York state law and federal No Surprises Act requirements.

Get a Free New York Billing Assessment

See how much revenue your NY practice is leaving on the table. No obligation.

98%+ clean claim rate
2.49% starting rate
Results in 30 days

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Services for New York Practices

Everything your practice needs to get paid, tailored to your state's payer market.

Medical Billing & Coding

AAPC-certified coders experienced in NY payer rules. We submit to Empire BlueCross BlueShield, NY Medicaid Managed Care, Medicare, and all NY commercial plans.

Credentialing & Enrollment

We handle NY Medicaid Managed Care enrollment, Medicare credentialing through Novitas Solutions, and all NY commercial payer applications with aggressive follow-up.

Accounts Receivable Recovery

Systematic follow-up on aging claims across New York payers. We work every age bucket until every collectible dollar is recovered.

Prior Authorization

We manage auth requirements for NY Medicaid Managed Care managed care plans and NY commercial payers, tracking deadlines and escalating delays.

Patient Billing

Clear statements and professional follow-up for New York patients. Payment plans, billing inquiries, and overdue balance management.

Eligibility Verification

Real-time insurance verification against Empire BlueCross BlueShield, NY Medicaid Managed Care, Medicare, and all NY payers before every appointment.

New York Cost Comparison

In New York, a full-time medical biller costs $45K-$62K annually in salary alone. Add benefits (30%), payroll taxes, software subscriptions, clearinghouse fees, and office space, and the true cost reaches $68K-$93K or more per employee. At 2.49% of collections, Go Medical Billing provides an entire team of AAPC-certified coders, dedicated account managers, and A/R specialists for a fraction of what a single in-house biller costs in the New York City market.

$45K-$62K

In-House Biller Salary

+ benefits, software, space

2.49%

Go Medical Billing Rate

Full team, all services included

60-80%

Typical Cost Reduction

With better results

New York Cities We Serve

We serve physician practices, urgent care centers, behavioral health clinics, surgical groups, and healthcare facilities across New York. Whether you're in New York City or a rural community, our team knows your local payers.

New York CityBuffaloRochesterAlbany+ all New York counties

Frequently Asked Questions

All major NY payers: Empire BlueCross BlueShield, Aetna, Cigna, UHC, EmblemHealth, Oxford, NY Medicaid Managed Care, and Medicare (Novitas Solutions). If a payer accepts patients in New York, we submit claims to them.
Yes. We credential and bill with all NY Medicaid Managed Care managed care organizations: Fidelis Care, Healthfirst, MetroPlus, Molina, MVP, United. Each MCO has its own rules and we manage all of them.
Most NY practices are fully transitioned within two to three weeks. We connect to your EHR, learn your workflows, and start submitting claims with no downtime in your billing.
Yes. We serve practices across every New York county, not just the major metros. Rural practices often have unique payer mix challenges (higher Medicare/Medicaid percentage) and we optimize billing for that composition.
We serve 40+ specialties in New York including cardiology, urology, urgent care, behavioral health, orthopedics, ABA therapy, DME, laboratory, internal medicine, dermatology, pain management, and more.

Ready to Fix Your New York Billing?

Call 888-701-6090 for a free billing assessment specific to your NY practice and payer mix. We'll show you exactly where revenue is leaking.