Elite Bill Care — Your Success, Our Commitment

Medical Billing Services in New York

eMedNY fee-for-service, New York's Medicaid managed care plans and the state's 90-day filing rule — billing that keeps New York pace.

New York Medicaid splits between fee-for-service billed through eMedNY and a deep bench of Medicaid managed care plans — and New York applies one of the tighter filing clocks in Medicaid. Elite Bill Care provides medical billing services in New York for practices from New York City and Long Island to the Hudson Valley, Rochester, Buffalo and the Capital Region.

Get a Free ConsultationSee All Billing Services

New York Medicaid: two systems, one practice

  • eMedNY (fee-for-service) — claims, eligibility and enrollment through the state's eMedNY system and ePACES; New York Medicaid generally requires claims within 90 days of the date of service — among the shortest windows in the country — with narrowly defined exceptions.
  • Medicaid managed care — plans such as Fidelis Care, Healthfirst, Molina, UnitedHealthcare, MetroPlusHealth and Anthem/Empire carry most members, plus specialized programs (HARP for behavioral health, MLTC for long-term care). Each plan layers its own rules over state policy.
  • Carve-outs that move — services periodically shift between FFS and managed care in New York (pharmacy and certain behavioral health services have moved in recent years); our eligibility step confirms the current biller for each service (see eligibility verification).
  • Enrollment — NY Medicaid enrollment through eMedNY, managed with Medicare PECOS and commercial credentialing as one record set.

New York commercial and Medicare

EmblemHealth, Empire/Anthem, UnitedHealthcare/Oxford, Aetna, Cigna and MVP (upstate) anchor commercial billing, with New York's surprise-billing and prompt-pay laws giving practices defined protections our appeals use explicitly. Full services on our medical billing services page.

Choosing a medical billing company in New York

Comparing medical billing companies in New York means testing two Medicaid systems at once. New York Medicaid billing runs fee-for-service through eMedNY, run by the Department of Health's Office of Health Insurance Programs, and through Medicaid Managed Care plans for most members. Ask whether a company bills both routes and knows plans such as Fidelis Care New York, Healthfirst, MetroPlus Health Plan and Molina Healthcare of New York, plus HARP and Managed Long Term Care programs where your patients sit. It should also handle eMedNY enrollment through the Provider Services Portal without prompting from your staff.

For a medical billing company in New York, Medicare discipline matters just as much. Medicare claims for New York providers are processed by Wellpoint Federal, Jurisdiction K (formerly National Government Services), and a strong team tracks that contractor's edits alongside commercial payers such as EmblemHealth and Anthem. New York also requires an ETIN before any eMedNY electronic transaction, so enrollment gaps quickly become claim delays. The best medical billing services in New York are the ones that clear those gates before the first claim is sent. Elite Bill Care works inside your practice's own EHR and focuses on up to 30% denial reduction through earlier eligibility and filing checks.

Frequently asked questions

Is the 90-day Medicaid deadline really enforced?

Yes — New York enforces timely filing strictly, with limited exceptions that must be documented (such as delayed eligibility determinations). Our workflow submits long before the deadline and treats late-eligibility cases as a special tracked category.

Do you bill HARP and MLTC plans?

Yes — specialized New York programs are billed under their plan rules as part of Medicaid managed care work.

What should New York practices look for in a medical billing company?

Look for fluency in both eMedNY fee-for-service and Medicaid Managed Care plans such as Fidelis Care, Healthfirst and MetroPlus, plus Wellpoint Federal, Jurisdiction K, Medicare billing. Elite Bill Care works inside your own EHR, keeping New York's tight filing deadlines visible in daily workflow.

Why does our practice need an ETIN before billing New York Medicaid electronically?

eMedNY requires an Electronic Transmitter Identification Number before a provider can submit claims, files or ePACES transactions, obtained through the Certification Statement for Provider Billing Medicaid. Elite Bill Care checks ETIN and enrollment status during onboarding so electronic billing is not blocked at go-live.