New York’s healthcare system is one of the largest and most regulated in the country. With over 90,000 physicians, a Medicaid program that covers nearly 8 million residents, and a commercial market dominated by Empire BCBS, Aetna, Cigna, UnitedHealthcare, Fidelis Care, and EmblemHealth, billing correctly in New York demands deep payer knowledge. Go Medical Billing serves practices across New York City, Long Island, Westchester, upstate New York, and everywhere in between.
New York Medicaid Managed Care
New York’s Medicaid program is one of the largest in the nation, covering approximately 7.7 million residents through managed care plans including Fidelis Care, Healthfirst, MetroPlus, Molina, MVP, and United. Each plan has its own claims submission rules, authorization requirements, and billing nuances. We work with every New York Medicaid managed care plan.
Empire BCBS and the New York Commercial Market
Empire BlueCross BlueShield is the dominant commercial payer in the New York metro area. Billing Empire correctly requires understanding their specific fee schedules, prior authorization portal, and appeal timelines. We also work with Oxford (UHC), Aetna, Cigna, EmblemHealth, and all regional plans.
New York’s Surprise Bill Law
New York was a pioneer in surprise billing legislation with its Emergency Medical Services and Surprise Bills law. The state’s independent dispute resolution process has specific rules that differ from the federal No Surprises Act. Our team handles OON billing and dispute resolution under both state and federal frameworks.
Highest Compliance Standards
New York has some of the strictest healthcare regulations in the country, from the Department of Financial Services oversight of insurers to the Department of Health’s provider requirements. Our billing processes are built to meet New York’s elevated compliance standards.
Cardiology, urology, urgent care, behavioral health, orthopedics, ABA therapy, DME, laboratory, internal medicine, pain management, dermatology, and more. From Manhattan practices to Buffalo clinics, we handle the billing so you handle the patients.
Do you work with New York Medicaid plans?
Yes. We bill and credential with Fidelis Care, Healthfirst, MetroPlus, Molina, MVP, United, and every other New York Medicaid managed care plan.
Can you handle billing for my NYC practice?
Absolutely. We serve practices in all five boroughs, Long Island, Westchester, and the tri state area. Our team knows the NYC payer landscape.
What about upstate New York?
We serve practices statewide. Upstate payer mixes differ from the metro area, and we adjust our approach accordingly. Excellus BCBS, MVP, and other regional plans are all in our system.
Call 888 701 6090 for a free New York billing assessment.
