Medical Billing Services in New York

eMedNY, the Medicaid plan, no-fault, and the Workers' Compensation Board are different payers. The office is in Jamaica. Fee-for-service New York Medicaid is submitted through eMedNY. Title 18, section 540.6, requires that first claim within 90 days of the date of service unless a listed delay reason applies.

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What a claim follows in New York

eMedNY, the Medicaid plan, no-fault, and the Workers' Compensation Board are different payers. The office is in Jamaica.

eMedNY and the plans

Fee-for-service New York Medicaid is submitted through eMedNY. Title 18, section 540.6, requires that first claim within 90 days of the date of service unless a listed delay reason applies. A correction is due within 60 days of the notice. Healthfirst, Fidelis Care, EmblemHealth, and Molina are managed-care plans. Their claims do not go to eMedNY. Fidelis's provider sheet sets 90 days from the date of service. EmblemHealth's participating limit is 120 days unless the contract says otherwise.

National Government Services, Jurisdiction K

Medicare Part A and Part B for a New York practice go to National Government Services, Jurisdiction K, with Connecticut, Massachusetts, Vermont, New Hampshire, Maine, and Rhode Island. New Jersey is the next state south and uses Novitas Solutions, Jurisdiction L.

No-fault and the Workers' Compensation Board

A motor-vehicle injury is billed to the no-fault insurer. A work injury is billed under the Workers' Compensation Board. Those are not commercial claims and they are not eMedNY claims. Healthfirst, Fidelis Care, EmblemHealth, and Molina are payers the team already works on New York Medicaid.

The office at 15717 85th Street is in the state, so New York enrollment is the home docket. That does not make a New Jersey claim a New York claim. Managed-care timely filing follows the plan. Fee-for-service timely filing follows eMedNY. The current manual controls when a plan updates its limit.

Nearby states

New Jersey

NJ FamilyCare and Novitas. Different Medicare contractor.

New Jersey medical billing CT

Connecticut

HUSKY Health. Same Medicare contractor, National Government Services.

Connecticut medical billing US

All 50 states

The directory of state Medicaid programs and Medicare contractors.

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New York billing questions

Where does a New York Medicare claim go?

National Government Services, Jurisdiction K. A New Jersey Medicare claim goes to Novitas Solutions, Jurisdiction L.

Does a Fidelis or Healthfirst claim go to eMedNY?

No. Managed-care claims go to the plan. eMedNY is for fee-for-service New York Medicaid, which has a 90-day initial filing rule under 18 NYCRR 540.6.

Does a New York practice change the fee?

The fee is a percentage of net collections. The written rate follows volume, specialty, and how much of the cycle you hand over. There is no setup fee, and the agreement is month to month. The state is not a surcharge. How pricing is set.