Medical Billing Services in New York
New York practices bill Wellpoint Federal (formerly National Government Services) for Medicare Part A and B, eMedNY and Medicaid managed care plans for Medicaid, and regional commercial payers. We help keep claims inside New York's tight deadlines. We support practices in New York remotely across 15+ specialties.
Who Pays Medical Claims in New York
The payer groups our team works with every day for New York practices.
Jurisdiction JK
New York Medicare Part A and Part B claims go to Wellpoint Federal. Medicare DME claims go to DME MAC Jurisdiction A (Noridian Healthcare Solutions).
New York State Medicaid
Run by the New York State Department of Health, with fee-for-service claims processed through eMedNY.
Managed care plans
Most New York Medicaid members are enrolled in Medicaid Managed Care, including mainstream plans, Health and Recovery Plans (HARPs) and Managed Long Term Care (MLTC). Each plan sets its own authorization and claims rules. We bill and follow up with the state’s Medicaid managed care plans under each plan’s own rules.
Plan lists change. We confirm each patient's current plan at eligibility check. Commercial and Medicare Advantage plans are billed under their own contracts.
New York Medicaid Billing Rules to Know
Taken from the state program's published provider guidance. Manuals change, so we confirm current rules before each submission.
90-day filing limit
Claims must be initially submitted within 90 days of the date of service, unless the delay was outside the provider's control. Late claims need a HIPAA delay reason code and must be sent within 30 days of the delay ending.
60-day resubmission
A rejected or denied claim must be corrected and resubmitted within 60 days of the notification. Paid claims that need correction are sent as adjustments within 60 days.
Two-year outer limit
All claims must be finally submitted to the fiscal agent and be payable within two years from the date of service.
Source: eMedNY Information for All Providers: General Billing; eMedNY FOD 7001, Submitting Claims over 90 Days from Date of Service (2/19/2026).
What Makes New York Medical Billing Different
What we watch for on New York accounts.
Why New York billing gets complicated
New York Medicaid's 90-day filing limit and 60-day resubmission window leave little room for rework. Payers also vary by region, so a practice serving New York City and upstate may work with very different plans in the same week. With so little room for rework, charge entry has to be right the first time.
What We Handle for New York Practices
Take the full revenue cycle or just the parts you need help with.
Eligibility and benefits checks before the visit
Prior authorization requests and tracking
Medical coding and charge review
Claim submission to Medicare, Medicaid and commercial payers
Denial management, appeals and A/R follow-up
Payment posting, patient statements and monthly reporting
Specialties We Support in New York
15+ specialties served. Pick yours to see how we bill it.
New York Medical Billing Questions
Short answers to questions we hear from practices.
Who is the Medicare Part A and B contractor for New York?
New York is in A/B MAC Jurisdiction K (JK). CMS lists the contractor as Wellpoint Federal, the company formerly known as National Government Services. Medicare DME claims go to the Jurisdiction A DME MAC, Noridian Healthcare Solutions.
How long do I have to submit a New York Medicaid claim?
Claims must be initially submitted within 90 days of the date of service, unless a HIPAA delay reason applies. All claims must be finally submitted and payable within two years of the date of service.
What happens if a New York Medicaid claim is denied?
It must be corrected and resubmitted within 60 days of the denial notification. We work eMedNY remittances quickly so those windows are not missed.
Which specialties do you support in New York?
We support 15+ specialties, including behavioral health, laboratory, home health, hospice, infusion, sleep medicine, DME, dental, vision and ENT.
Can you bill for my New York practice without a local office?
Yes. We support practices in New York remotely and work inside your existing billing software.
See Where Your New York Claims Are Getting Stuck
Start with a free billing audit. We review your recent claims, denials and A/R, then tell you what we found.