Reliable Revenue Cycle Management in New York
Mediknocx runs the full revenue cycle for New York physician practices, from eligibility checks to the final payment on an appealed claim. Our workflows are built for Anthem Blue Cross and Blue Shield (formerly Empire), the state's regional Blue plans, and New York Medicaid's strict 90-day filing limit.
HIPAA Compliant
Your data stays secure
Faster Payments & Fewer Denials
Improve cash flow
Higher Reimbursement
Get the revenue you deserve
New York Billing Compliance Experts
State-specific payer knowledge
Get Your Free Revenue Assessment
Find out how much revenue your practice could be recovering with expert revenue cycle management support. No obligation, just real insights.
Reliable Revenue Cycle Management in New York: The 120-Day Rule and Its 25% Second Chance
New York Insurance Law 3224-a(g) requires commercial claims to be submitted within 120 days of service unless your contract allows longer. Miss it, and there's a narrow way back. Under 3224-a(h), a participating provider can ask for reconsideration of a claim denied only for late filing. The plan must pay if you prove the delay came from an unusual occurrence and you have a pattern of filing on time, though it can cut payment by up to 25%.
That second chance depends on a documented filing history, which most practices don't track. Coverage is also shifting under patients. On July 1, 2026, about 450,000 New Yorkers lost Essential Plan eligibility and moved toward marketplace plans with premiums and deductibles. Medicaid work requirements and twice-yearly renewals follow in 2027, so eligibility checks now matter at every visit.
Expertise
Built for local care models
Deadline Tracking
We flag at-risk claims early
Fewer Denials
Correct coding, less revenue loss
The Full Revenue Cycle We Manage in New York
- Patient Access & Eligibility Verification: Medicaid, Essential Plan, and commercial coverage confirmed before each visit, with new patient responsibility flagged early.
- Charge Capture & Coding: CPT, ICD-10, and modifiers matched to the chart.
- Claims Submission: Clean claims sent inside the 120-day commercial and 90-day Medicaid windows, with submission dates logged.
- Payment Posting: ERAs posted line by line, with late commercial payments flagged for prompt pay interest.
- Denial Management & Appeals: Denials sorted by cause, corrected, and appealed, including late-filing reconsiderations under 3224-a(h).
- AR Follow-Up: Open claims worked by payer and age, starting with those nearest a deadline.
- Reporting: Monthly reports on collections, denial trends, and days in AR.
How It Works
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 recent New York claims, timely-filing denials, and aging AR.
Custom Plan
A written plan covering your payer mix, staff handoffs, and timeline.
Seamless Transition
We connect to your practice management system with no gap in submissions.
Ongoing Reporting
Monthly reports on collections, denial rates, and AR aging, reviewed with your account manager.
Get Your FreeRevenue Cycle Audit Report
Writing off claims denied for late filing? Call +1 434-201-9720 or email info@mediknocx.com for a free revenue cycle audit.
What Makes Our New York
Revenue Cycle Management Different
Here's what we built into our New York RCM process.
One Team for Every Stage
A single team runs eligibility, coding, submission, posting, and appeals, so every claim has an owner from intake to payment. You work with one account manager who can answer questions on any claim.
Anthem and Regional Blue Rules
Anthem Blue Cross and Blue Shield serves millions of New Yorkers, and regional Blue plans set their own policies upstate. We build each plan's authorization lists and claim edits into your pre-submission checks.
Filing History on Record
New York's late-claim reconsideration rule rewards a proven pattern of timely filing. We log every submission date, so when an unusual delay happens, you already have the history the law asks for.
Two Medicaid Clocks Tracked
eMedNY expects claims within 90 days of service and rejected claims corrected within 60 days of notice. Every open Medicaid claim is tracked against both deadlines, and those nearing either one move up the queue.
Monthly Performance Reviews
Each month you receive collections, denial rates by payer, and AR aging in one report. Your account manager reviews it with you and explains which payers, codes, or providers moved the results.
Coverage Across 47 Specialties
Our billers and coders cover 47 specialties, so your claims go to people who already know that specialty's CPT families, modifier rules, and the documentation New York payers request on appeal.
RCM Support for All 47 Specialties in New York
Mediknocx manages revenue cycles for 47 medical specialties, from internal medicine to ophthalmology and psychiatry, with billers assigned by specialty.
How Does Mediknocx Ensure Compliance
With New York Medical Billing Regulations?
No Surprises Act
We apply federal balance billing protections and good faith estimate rules for uninsured and self-pay patients before any patient statement goes out.
New York Timely Filing and Prompt Pay Law
Under Insurance Law 3224-a, plans must pay undisputed claims within 30 days if submitted electronically, or 45 days on paper, with interest at 12% a year or the state corporate tax rate, whichever is higher.
New York Billing Transparency
The Fair Medical Debt Reporting Act (December 2023) bars providers from reporting medical debt to credit bureaus and voids any debt that is reported. Our patient billing never uses credit reporting.
Payer-Specific Guidelines
We follow Anthem, regional Blue plan, and New York Medicaid managed care policies. For fee-for-service Medicaid, 18 NYCRR 540.6 requires claims within 90 days of service.
Healthcare Billing Services Across New York Cities
We work with practices in New York City, Buffalo, and Rochester, along with independent groups across the rest of the state.
- New York City
- Buffalo
- Yonkers
- Rochester
- Syracuse
Nationwide Revenue Cycle Management
Mediknocx also manages revenue cycles for practices in New Jersey, Connecticut, Pennsylvania, Massachusetts, Vermont, Illinois, California, Texas, North Carolina, and Michigan.
Get New York claims filed, tracked, and paid inside every deadline. Talk to a Mediknocx revenue cycle specialist at +1 434-201-9720 or info@mediknocx.com and book your free audit.
Frequently Asked Questions
Find answers to the most common questions about our revenue cycle management services in New York.
