Medical Billing Services in New York
Built for EmblemHealth, Excellus & NY Medicaid
Mediknocx provides medical billing services for New York practices that bill against a genuinely fragmented payer landscape, from EmblemHealth in the New York City metro area to Excellus BlueCross BlueShield upstate, plus the state's Medicaid managed care program. Independent physicians and small practice groups across the state work with our team to cut denials, speed up reimbursement, and keep claims moving under New York's Prompt Pay Law. From Buffalo to Rochester to New York City, we handle the billing work so providers can focus on patient care.
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Faster Payments & Fewer Denials
Improve cash flow
Higher Reimbursement
Get the revenue you deserve
New York Billing Compliance Experts
State-specific payer knowledge
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Medical Billing Services in New York: Built for a Multi-Payer, Multi-Region State
New York doesn't have a single BCBS plan covering the whole state the way many states do. EmblemHealth, formed from the 2006 merger of Group Health Incorporated and HIP, is the largest health insurer headquartered in New York, serving more than 3 million people concentrated in the New York City metro and tristate area. Upstate and central New York run largely on Excellus BlueCross BlueShield instead. Whichever payer dominates a given region, every claim we submit is tracked against New York Insurance Law Section 3224-a, the state's Prompt Pay Law, which requires insurers to pay undisputed claims within 45 days of receipt, or 30 days if submitted electronically, with 12% annual interest owed on late payments.
On the Medicaid side, New York runs one of the largest and most complex Medicaid managed care systems in the country, with more than a dozen participating MCOs. Fidelis Care, a Centene subsidiary, is the largest, covering more than 1.5 million New York Medicaid members. Each MCO sets its own prior authorization rules, so New York billing work means knowing which of several plans a given patient carries before a claim ever goes out.
Expertise
Built for local care models
Deadline Tracking
We flag at-risk claims early
Fewer Denials
Correct coding, less revenue loss
What's Included in Our New York Medical Billing Services
- Claims submission and follow-up tracked against New York's 45-day paper / 30-day electronic Prompt Pay Law deadlines
- Credentialing and enrollment support across EmblemHealth, Excellus BlueCross BlueShield, Fidelis Care, and other major New York payers
- Denial management built around New York's Emergency Medical Services and Surprise Bills Law
- Itemized billing support aligned with the New York hospital Patients' Bill of Rights (10 NYCRR 405.7)
- Monthly reporting on collections, denials, and days in A/R
- Coding support across CPT, ICD-10, and HCPCS for all 75+ specialties we serve
From Audit toFaster Payments in 4 Steps
A simple, proven process to streamline your revenue cycle and maximize reimbursements in New York.
Free Audit
We review your current claims, denial patterns, and payer mix, including how your regional payer and Medicaid MCO claims are performing against New York's Prompt Pay Law deadlines.
Custom Plan
We build a billing plan around your specialty, patient volume, and the specific New York payers you work with most, whether that's EmblemHealth, Excellus, or a Medicaid MCO.
Seamless Transition
Your practice moves to Mediknocx with minimal disruption to current claims, patient billing, or staff workflow.
Ongoing Reporting
You get monthly reports on collections, denials, and days in A/R, not a real-time dashboard, so your team always has a clear, accurate picture.
Get Your FreeMedical Billing Audit Report
Uncover hidden revenue opportunities.
Improve accuracy. Ensure compliance.
What Makes Our New York
Medical Billing Services Different
New York's billing environment looks different from most states, and our approach reflects that.
Multi-Payer, Multi-Region Expertise
New York doesn't run on one dominant payer. Our billers track EmblemHealth in the metro area, Excellus BlueCross BlueShield upstate, and know which region's rules apply to your practice before a claim goes out.
Prompt Pay Law Tracking
We track every claim against New York's Prompt Pay Law, 45 days for paper submissions and 30 for electronic ones, so 12% annual interest works in your favor when a carrier runs late.
Fidelis Care and Medicaid MCO Depth
Fidelis Care, New York's largest Medicaid managed care plan, covers more than 1.5 million members, but it's one of over a dozen MCOs statewide. We track each plan's prior authorization rules separately.
Surprise Bills Law Compliance
New York's Emergency Medical Services and Surprise Bills Law caps patient liability at in-network cost sharing and gives providers access to independent dispute resolution. Our claims process is built around that rule.
47-Specialty Coding Depth
Our team codes and bills for all 75+ specialties we support, from cardiology to behavioral health, so New York practices get billers who already know their specialty's CPT and ICD-10 patterns.
Itemized Billing Turnaround
New York's hospital Patients' Bill of Rights guarantees an itemized bill and explanation of all charges on request. We build that turnaround into our billing workflow so requests get answered fast and accurately.
Specialty Expertise That Works for You
Mediknocx bills for all 75+ specialties, from cardiology and orthopedics to behavioral health and pain management. Whatever your New York practice treats, our coders already know the CPT and ICD-10 code families specific to that specialty, so claims go out clean the first time.
How Does Mediknocx Ensure Compliance
With New York Medical Billing Regulations?
No Surprises Act
Federal balance billing protections apply to emergency services and certain non-emergency care at in-network facilities. New York's own Emergency Medical Services and Surprise Bills Law, in effect since 2015, predates the federal law and separately requires disclosure of network status under Public Health Law Section 24, plus an Independent Dispute Resolution process under Financial Services Law Article 6.
New York Timely Filing Law
Insurance Law Section 3224-a, the Prompt Pay Law, requires insurers to pay undisputed claims within 45 days of receipt, or 30 days if submitted electronically, with 12% annual interest owed on late payments. We track this deadline on every claim we submit.
New York Billing Transparency Law
The hospital Patients' Bill of Rights under 10 NYCRR Section 405.7 gives every patient the right to an itemized bill and explanation of all charges, along with a list of the hospital's standard charges.
Payer-Specific Guidelines
We follow the specific billing and prior authorization rules for EmblemHealth, Excellus BlueCross BlueShield, Fidelis Care, and the other major payers and Medicaid MCOs operating in New York, rather than applying a one-size-fits-all process across payers.
Healthcare Billing Services Across New York Cities
Mediknocx supports independent practices and physician groups in New York City, Buffalo, and Rochester, along with providers throughout the rest of the state. Wherever your practice is located in New York, our billing team works within the same state-specific rules covered above.
- New York City
- Buffalo
- Yonkers
- Rochester
- Syracuse
Nationwide Medical Billing Services
Mediknocx serves independent practices nationwide, including providers in Arizona, Colorado, Georgia, Indiana, Wisconsin, Minnesota, Missouri, Tennessee, Kentucky, and Louisiana.
Frequently Asked Questions
Find answers to the most common questions about our medical billing services in New York.
