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NY · New York State

Medical Billing & RCM
Services in New York

ParaMed Billing Solutions delivers expert revenue cycle management to New York healthcare providers — navigating state-specific Medicaid programs, commercial payer networks, and compliance requirements with proven precision-coded billing and aggressive denial management.

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New York Performance

98%+Clean Claim Rate
+27%Revenue Uplift
15dFaster A/R Days
92%Denial Recovery

New York Payer Landscape & Coverage

We bill every major payer operating in New York — including all Medicaid managed care plans, Medicare Advantage networks, and commercial carriers active in the five boroughs and upstate markets.

Major Payers We Bill

  • Horizon BCBS
  • UnitedHealth Group / UnitedHealthcare
  • Aetna / CVS Health Plans
  • Cigna Healthcare
  • EmblemHealth / GHI / HIP
  • Excellus BlueCross BlueShield
  • CDPHP — Capital District Physicians Health Plan
  • Fidelis Care New York

Medicaid & Public Programs

  • NY Medicaid FamilyCare & Managed Long-Term Care — Full managed care & fee-for-service billing
  • Medicare Part A, B & Medicare Advantage plans in New York
  • New York CHIP children's health program billing
  • Dual-eligible (Medicare + Medicaid) crossover claims
  • Workers' Compensation & liability billing in New York
  • No-fault / PIP auto insurance billing
  • Medicaid Managed Care (MMC) — all 15+ NY managed care organizations

Our Billing Process for New York Providers

From your first call to first payment — a proven four-step process designed specifically around New York payer requirements and state-mandated timelines.

Practice Audit & Onboarding

We start with a free revenue cycle audit to identify leakage points specific to New York payers and your specialty, then onboard in 5–10 business days with zero billing disruption.

Credentialing & Enrollment

Rapid enrollment with all New York commercial, Medicaid, and Medicare payers — including CDPHP, EmblemHealth, and Fidelis Care — typically completed in 30–60 days.

Claim Submission & Tracking

Clean claim submission within 24 hours of service with real-time tracking across all New York payer portals and state eMedNY Medicaid system.

Denial Management & AR

Aggressive follow-up on every denied or unpaid claim — targeting New York's most common denial patterns for maximum recovery and systematic root-cause prevention.

Specialties We Serve Across New York

From New York City's hospital-affiliated practices to upstate independent clinics — we handle the full spectrum of specialty billing across all five boroughs and beyond.

Specialty

Internal Medicine & Primary Care

E&M coding, preventive wellness visits, chronic care management — optimized for NYC's high-volume primary care practices and PCMH models.

Specialty

Cardiology & Cardiovascular

Cardiac catheterization, echocardiography, nuclear stress testing, and device management billing — with full NY Medicaid cardiac procedure coverage expertise.

Specialty

Orthopedics & Spine Surgery

Surgical procedure coding, implant billing, post-operative care, and workers' compensation orthopedic billing under New York WC fee schedules.

Specialty

Behavioral Health & Psychiatry

New York Mental Health Parity Law compliance, OMH-licensed practice billing, telehealth psychotherapy, and OASAS substance use treatment billing.

Specialty

Urgent Care & Emergency Medicine

Level-of-service coding, facility vs. professional fee splitting, and NY-specific urgent care licensing billing requirements across all payer types.

Specialty

Hematology & Oncology

Infusion therapy hierarchy coding, chemotherapy administration, drug wastage billing (JW modifier), and NY Cancer Services Program coordination.

New York Billing Challenges We Solve

New York has some of the most complex medical billing regulations in the country. Our specialists navigate these daily — so your practice never misses a dollar.

NY eMedNY Medicaid System Complexity

New York's eMedNY system has unique claim submission formats, prior authorization workflows, and retroactive eligibility rules that regularly trip up out-of-state billers. Our team bills eMedNY daily and navigates it with zero learning curve.

NY OMIG Audit Exposure

New York's Office of Medicaid Inspector General (OMIG) conducts aggressive provider audits. We maintain OMIG-compliant documentation standards and provide proactive audit readiness reviews for all Medicaid-billing clients.

Workers' Compensation Fee Schedule Navigation

New York WC has one of the most complex fee schedules in the country with separate schedules by provider type, treatment category, and region. Our WC billing specialists ensure correct schedule application and maximum reimbursement.

No-Fault & PIP Auto Insurance Billing

New York is a no-fault state — a high-volume, high-denial billing environment that requires specific claim forms, strict 45-day filing deadlines, and expert dispute resolution. We handle the full NF billing lifecycle.

HIPAA-Compliant & New York State Regulation Ready

Every claim we process follows full HIPAA Privacy & Security Rule standards, New York State Department of Health billing guidelines, and NY OMIG compliance frameworks — protecting your practice from regulatory risk at every step.

HIPAA Certified SOC 2 Type II CPC Certified Coders NY OMIG Compliant OIG Excluded Provider Screening
0
Data Breaches
in 15+ Years
100%
BAA Executed
Every Client

Why New York Providers Choose ParaMed

From solo practices in the Bronx to multi-location groups across Long Island — we bring the same specialist-grade billing expertise to every New York practice we serve.

New York State-Specific Compliance

Deep expertise in NYC multi-borough payer nuances, eMedNY Medicaid system requirements, NY OMIG audit standards, and borough-specific credentialing timelines.

Faster Reimbursements

Claims submitted within 24 hours with a 98%+ first-pass acceptance rate across all NY payers — including CDPHP, Excellus, and EmblemHealth — cutting your A/R days by an average of 15 days.

CPC-Certified Expert Coders

AAPC-certified coders with subspecialty credentials — trained on NY Workers' Compensation fee schedules, no-fault billing, and Medicaid managed care coding requirements.

Real-Time RCM Analytics

Live dashboard with claim-by-claim visibility, denial trend tracking, A/R aging by payer, and monthly NY OMIG audit readiness reporting — full transparency into your revenue cycle.

New York Billing Regulations We Navigate

Staying compliant in New York requires expert knowledge of state-specific regulations beyond standard HIPAA requirements.

NY Insurance Law §§ 3216, 3221 & 4303

Mental health and substance use parity requirements — ensuring behavioral health claims are billed at parity with medical/surgical benefits across all NY commercial plans.

NY OMIG Compliance Program Requirements

Mandatory compliance program requirements for NY Medicaid providers — we ensure your billing practices satisfy OMIG's eight compliance elements at all times.

NY WC Board Fee Schedule (12 NYCRR Part 442)

New York Workers' Compensation Board medical fee schedule — provider-type specific, with separate schedules for acute care, surgery, diagnostics, and physical medicine.

No-Fault Insurance Regulation (11 NYCRR Part 65)

NY no-fault billing rules including 45-day claim filing deadlines, fee schedule compliance, EUO requirements, and IME dispute resolution procedures.

15+
Years Billing in
New York State
400+
NY Providers
Currently Served
$42M+
NY Revenue
Recovered 2025

What New York Providers Say

Real results from real practices across New York State — from Manhattan to Buffalo.

★★★★★

ParaMed's knowledge of New York's no-fault billing rules is exceptional. They cut our NF denial rate from 28% to under 6% in two billing cycles. The 45-day filing deadline tracking alone has saved us tens of thousands in lost claims.

Dr. Richard,

Orthopedic Surgery — NY

★★★★★

Switching to ParaMed was the best financial decision for our behavioral health practice. They understood NY Mental Health Parity Law compliance from day one and our collections increased 31% within 90 days of going live.

Jennifer,

Behavioral Health Group — NY

★★★★★

After two billing companies failed to navigate NY Medicaid eMedNY correctly, ParaMed solved every issue in the first month. Our Medicaid denial rate went from 22% to 3.8%. These people genuinely know New York billing.

Dr. Aisha,

Internal Medicine — NY

New York Free Audit

Get Your Free
New York Billing Audit

Find out exactly how much revenue your New York practice is leaving on the table. Our specialist will analyze your payer mix, denial patterns, and coding accuracy — delivering a detailed audit report within 48 hours at zero cost.

NY Denial Rate AnalysisIdentify your top denial causes across NY payers including eMedNY, EmblemHealth, and Fidelis
OMIG Audit Readiness CheckReview your Medicaid billing practices against current NY OMIG compliance standards
Revenue Gap ReportDollar estimate of recoverable revenue across your NY payer mix — delivered in 48 hours
Zero Cost. Zero Obligation.No contracts, no pressure — just expert New York billing advice from a specialist
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A New York billing specialist will respond within 48 hours.

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A ParaMed New York billing specialist will contact you within 48 business hours with your free revenue audit.

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Frequently Asked Questions

Common questions from New York healthcare providers considering a billing partner.

Yes — New York's eMedNY Medicaid system is a core competency for our team. We handle all aspects of NY Medicaid billing including claim submission through eMedNY, prior authorization workflows, retroactive eligibility checks, managed care plan billing across all 15+ Medicaid MCOs, and Medicaid fee-for-service claims. We also maintain OMIG compliance standards for all Medicaid-billing clients.

Absolutely. New York no-fault billing and Workers' Compensation are specialized areas we handle every day. For no-fault, we manage the full billing lifecycle including the strict 45-day filing deadline, NY fee schedule application, EUO documentation support, and dispute resolution. For WC, we apply the correct NY Workers' Compensation Board fee schedule by provider type and treatment category to maximize reimbursement.

Most New York practices are fully onboarded and billing within 5–10 business days. Our onboarding team handles EHR integration, NY payer enrollment updates, eMedNY access setup, and workflow configuration simultaneously — with zero gap in your billing submissions during the transition.

Yes — we provide complete provider credentialing and payer enrollment services for all New York commercial payers, Medicaid MCOs, and Medicare. This includes EmblemHealth, Fidelis Care, CDPHP, Excellus, and all major NY commercial carriers. New York credentialing typically takes 30–60 days and we manage the entire process.

ParaMed operates on a percentage-of-collections model — you only pay when we successfully collect revenue for your practice. There are no setup fees, no monthly minimums, and no long-term contracts. Our free audit typically shows NY practices netting 25–35% more revenue even after our fee compared to what they were collecting before.

Yes — NY OMIG compliance is a critical part of our Medicaid billing service. We maintain billing practices that align with OMIG's eight compliance program elements, conduct proactive documentation reviews for high-risk billing areas, and provide quarterly OMIG audit readiness assessments for all Medicaid-billing clients.

Ready to maximize revenue for your New York practice?
Get a no-obligation free audit — results in 48 hours, zero cost.

New York Practices: Get your free billing audit — 48-hr results, zero cost.

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