Medical Billing Services in New York

New York is one of the largest and most demanding practice markets in the country. A psychiatry group in Manhattan, a therapy practice on Long Island, and a family practice in Syracuse all bill into the same crowded payer environment — commercial plans, Medicare, and a Medicaid program that runs much of its volume through managed care. The clinical work differs from practice to practice. The billing problems look remarkably similar: claims that miss a filing window, denials that sit untouched for weeks, eligibility surprises discovered after the visit, and staff who spend their days on payer phone queues instead of patients.

Fastora Medical Billing Solutions works with healthcare practices across New York as a remote billing partner. We handle claims, coding, denials, and receivable follow-up so your team can stop chasing payers and get back to running the practice. This page explains how billing works in New York, where practices here lose revenue, and what we do about it.

The billing problems New York practices run into

New York practices seldom lose revenue in one dramatic failure. It leaks out slowly — a filing window missed by days, a denial left sitting, coverage found too late.

Filing deadlines arrive faster than expected. New York Medicaid’s fee-for-service window is short, and managed-care plans set their own rules on top of it. A claim that sits in a work queue for a few extra weeks can cross from payable to unbillable without anyone noticing.

The payer mix is genuinely complicated. A single practice may bill commercial plans, Medicare, Medicaid fee-for-service, and several Medicaid managed-care plans — each with different authorization requirements, claim formats, and appeal paths. Staff who bill well for one payer often get tripped up by another.

Denials outpace the follow-up. When a denial is not worked within days, it ages. Multiply that across hundreds of claims and the practice ends up writing off money it already earned. Behavioral health practices feel this sharply: session-based billing, authorization limits, and unit rules generate a steady stream of small denials that are tedious to chase one by one.

Eligibility is checked too late. Coverage changes, plan switches, and lapsed policies are common in a high-churn insurance market. Finding out after the appointment means the claim was never going to pay.

New York Medicaid and eMedNY: the deadlines that decide whether a claim pays

New York Medicaid fee-for-service claims are submitted through eMedNY, the state’s Medicaid claims system. Under state regulation (18 NYCRR 540.6), those claims generally must be initially submitted within 90 days of the date of service, and there is a two-year final ceiling on submission. Miss the window and the claim does not get paid — there is no routine workaround for a late first submission.

Most Medicaid members in New York are enrolled in managed-care plans rather than fee-for-service, and those claims follow each plan’s own filing rules instead of the eMedNY timeline. That split is where practices get hurt: a biller who applies the state deadline to a managed-care claim, or a plan deadline to a fee-for-service claim, can lose the claim either way.

Our approach is to build the calendar into the workflow. Every claim is tracked from the date of service, with submission and follow-up driven by the correct deadline for that payer — not by whoever gets to the queue first. That discipline is the core of our claims submission and follow-up process: claims go out clean and on time, and anything that stalls is worked before the window closes, not after.

Medical billing and coding services in New York

Billing and coding fail together. A claim can be submitted on time, to the right payer, and still deny because the code pairing was wrong, a modifier was missing, or the documentation does not support the level billed. Practices searching for medical billing and coding services in New York are usually dealing with exactly that overlap — which is why we treat coding as part of the billing workflow rather than a separate silo.

For New York practices, our coding and charge review focuses on the error patterns that actually drive denials: time-based behavioral health codes billed without the supporting time documentation, therapy claims with unit counts that do not match the visit, evaluation and management levels that invite downcoding, and procedure combinations that need a modifier to pass payer edits. Charges are reviewed before submission, so the fix happens while the claim is still correctable — not weeks later as an appeal.

Accurate coding also protects the practice in the other direction. Undercoding leaves legitimate revenue unbilled; overcoding creates audit exposure. A careful charge review keeps both risks in check.

What Fastora handles for New York practices

Fastora provides full-service medical billing and revenue cycle support for practices throughout New York, priced as a percentage of collections or a flat monthly fee. The work includes:

• Claims submission and follow-up — clean claims out the door quickly, with systematic tracking until each one resolves.
• Denial management and appeals — denials categorized by root cause, corrected, and appealed with the documentation payers actually ask for.
• Accounts receivable recovery — aged claims worked in priority order, oldest and highest-value first, instead of being written off quietly.
• Eligibility verification — coverage, benefits, and authorization requirements confirmed before the visit, not after the denial.
• Prior authorization support — requests submitted and tracked so scheduled services are not derailed by a missing approval.
• Payment posting and reconciliation — payments matched against contracted expectations so underpayments surface instead of slipping through.
• Coding and charge review — charges checked for accuracy and completeness before they become claims.
• Credentialing and enrollment support — help keeping provider enrollments and payer participation current as your practice hires or expands.

Specialties we support across New York

New York’s practice mix is unusually deep in behavioral health, and that is where much of our New York work concentrates. The New York City metro has a psychiatry and psychology density found nowhere else in the country, and Medicaid behavioral-health volume is large statewide.

Our psychiatry billing support covers the realities of psychiatric practice: medication management visits paired with therapy add-on codes, telehealth sessions billed with the correct place of service and modifiers, and authorization tracking for ongoing treatment plans. For psychology and counseling practices, we handle session-based billing, testing codes, and the supervision and credentialing details that often decide whether a claim pays.

Beyond behavioral health, we support ABA therapy providers working through authorization-heavy treatment plans, cardiology practices billing diagnostic testing and procedures across hospital and office settings, and physical, occupational, and speech therapy practices managing visit limits, unit billing, and plan-specific caps. Whatever the specialty, the work is the same at its core: verify coverage, bill accurately, follow up relentlessly, and report clearly.

Serving practices across New York

New York City and the metro region

The five boroughs, Long Island (Nassau and Suffolk), and Westchester together form the densest practice market in the state. Group practices here often bill a dozen or more payers, employ providers at several sites, and carry the patient volume to match. The billing challenge is scale: thousands of claims a month, a heavy behavioral health caseload, and little tolerance for a backlog. We work with metro practices that have outgrown an in-house biller — or a small billing team that cannot keep pace with denial follow-up on top of daily submissions.

Buffalo and Western New York

Buffalo anchors healthcare for the western end of the state, with large hospital systems, multi-specialty groups, and independent practices serving patients well beyond Erie County. Practices here often depend on a small administrative team wearing many hats, which makes billing the first thing to fall behind when the front desk gets busy. Outsourced follow-up — particularly on aged receivables — tends to be where Buffalo practices see the fastest relief.

Rochester

Rochester’s economy runs substantially on healthcare, and its practice community ranges from academic-affiliated groups to small therapy and counseling practices across Monroe County and the Finger Lakes. The billing profile is mixed: high commercial volume alongside significant Medicaid managed care.

Albany and the Capital Region

As the state capital, Albany’s patient base includes a large population of state employees and their families, alongside the usual commercial and Medicaid mix of the Capital Region. Practices in Albany, Schenectady, and Troy often serve patients who travel in from rural counties, which complicates eligibility and referral patterns. Clean intake verification matters here as much as claims work does.

Syracuse and Central New York

Syracuse is the referral center for Central New York, drawing patients from a wide rural catchment. Specialty and therapy practices here frequently balance hospital-based referrals with their own direct caseloads, and billing has to keep both streams straight. For smaller Central New York practices without a dedicated billing department, a remote billing partner replaces the single point of failure that one in-house biller represents.

Frequently asked questions

How quickly do New York Medicaid claims have to be filed?

Fee-for-service claims submitted through eMedNY generally must be initially submitted within 90 days of the date of service under 18 NYCRR 540.6, with a two-year final ceiling. Claims for members in Medicaid managed-care plans follow the filing rules of the member’s plan instead, which vary by plan.

Do you only work with practices in New York City?

No. We support practices across the state — the New York City metro, Long Island, Westchester, Buffalo, Rochester, Albany, Syracuse, and smaller communities in between. Because the work is done remotely, your practice’s location within New York does not limit the support you receive.

Which specialties do you bill for in New York?

Our New York work is strongest in psychiatry, psychology and counseling, behavioral health, and ABA therapy, and we also support cardiology and physical, occupational, and speech therapy practices, among others. If your specialty is not listed here, ask us — the underlying billing workflow transfers across most outpatient specialties.

How does Fastora charge for billing services?

Either a percentage of collections or a flat monthly fee — only two models, quoted from your volume and the scope you choose, never a tier chart. The free initial billing audit comes first: see what is involved before you commit.

Can you help with old, unpaid claims?

Yes — recovering receivables is core work for us, and in New York it starts with the calendar: we sort the backlog against eMedNY’s two-year ceiling and each plan’s filing rules, work the recoverable claims first, and tell you which are past saving.

Does Fastora work with practices outside New York?

Yes. Fastora supports practices nationwide, and this page covers only our New York work. You can read more about our medical billing services across the United States if your practice has locations in other states or you are comparing coverage by region.

Start with a free initial billing audit

If claims are aging, denials are piling up, or you simply cannot tell where your practice’s revenue is leaking, the clearest first step is a review of what is actually happening in your billing. Fastora offers a free initial billing audit: we look at your claims, denials, and receivables, and give you a straight account of what we find and what we would do about it.

Request your free initial billing audit and see what your billing should be collecting.

If you are comparing providers in New York, our guide to the best medical billing companies in New York applies the same criteria to every company, including us.