Medical Billing Services in New York for Healthcare Providers
Transcure’s medical billing services in New York help healthcare practices handle NY Medicaid (Medicaid Managed Care), NYDFS insurance regulations, and complex payer contracts across the state. We help New York practices collect more of what payers owe them by providing:
- Full NY Medicaid fee-for-service and Medicaid Managed Care eligibility verification
- NYDFS-aligned claims submission, payer follow-up, and prompt-pay enforcement
- Accurate ICD-10, CPT, and HCPCS coding for NY-specific policies
- Real-time denial detection and recovery with DEXA AI agent
- Billing support across New York State, from Manhattan to upstate rural practices
Trusted by
500+ Physicians
Catering to
40+ Specialties
1100+ Certified
Medical Billers & Coders
End-to-End
RPA Billing Solutions
Up to 98% First Pass
Clean Claim Rate
Our Success in Numbers
Results vary by practice size, specialty and payer mix. Across Transcure clients, these are typical results:
What New York Billing Laws Does Transcure Medical Billing Services Handle?
New York’s healthcare billing is among the most regulated in the country. Our medical billing services in New York keep your practice aligned with state law so you collect what you’re owed and stay clear of compliance risk.
New York Surprise Bill Law
Surprise Bill Law under Insurance Law Section 3241 bars out-of-network providers from billing patients beyond in-network cost-sharing when care is given at an in-network facility or in an emergency. Transcure audits every applicable claim and benchmarks reimbursements against the required fee schedule standards.
NY Medicaid Billing Compliance (OMIG / DOH)
New York's Medicaid program requires strict adherence to eMedNY billing guidelines, correct NPI usage, and timely filing windows. Our dedicated NY Medicaid billing team manages eMedNY eligibility verification, prior authorization requests, and denial appeals under 18 NYCRR Part 540.
NYDFS Prompt Pay Law
Under New York Insurance Law Section 3224-a, commercial insurers must pay clean electronic claims within 30 days and paper claims within 45 days, or face mandatory interest penalties. Transcure tracks payment timelines and files NYDFS complaints when insurers miss statutory deadlines, recovering interest owed to your practice.
New York SHIELD Act
The SHIELD Act (General Business Law Sections 899-aa and 899-bb) requires reasonable safeguards and breach notification for New York residents’ private information. HIPAA-compliant entities meet the safeguards rule. Transcure encrypts PHI in transit and limits access by role.
Supporting New York Healthcare Providers With Reliable Billing
Transcure currently provides medical billing services to 15+ active medical practices across New York, from Buffalo psychiatry groups to cardiology, internal medicine, and family medicine clinics in New York City. New York practices we serve include:
How Does Transcure Improve Financial Results for New York Practices?
Our medical billing company in New York improves NY Practices financially by handling Medicaid Managed Care and competitive commercial payer contracts. Transcure’s NY medical billing services give your practice a full RCM platform built around the state’s actual rules.
Which New York Cities Does Transcure Support with Their Medical Billing Services?
Transcure supports New York practices from New York City to Buffalo. Each city carries a distinct payer mix, and generic billing companies are not equipped to handle it. Our medical billing company in New York supports cities, including:
New York City
Buffalo
Rochester
View All Cities
Yonkers
Syracuse
Albany
New Rochelle
Mount Vernon
Schenectady
Which New York Billing Rules Does Transcure Apply to Your Claims?
New York practices bill under state insurance law, Medicaid rules, and federal requirements at once. Transcure reviews claims against the rules below before they reach the payer.
| Law or Rule | What It Requires | How Transcure Handles It |
|---|---|---|
| NY Prompt Pay Law | Insurance Law Section 3224-a requires insurers to pay clean claims within 30 days (electronic) or 45 days (paper), or owe interest. | We track payment deadlines and file NYDFS complaints and interest requests when insurers miss them. |
| NY Surprise Bill Law and No Surprises Act | Protects patients from out-of-network balance billing at in-network facilities and in emergencies. Self-funded plans follow federal law. | Bills the health plan correctly and follows the applicable NYDFS or federal IDR process. |
| NY No-Fault (Insurance Law Article 51) | Article 51 and 11 NYCRR Part 65 set no-fault billing rules, including a 45-day provider submission window. | Submits no-fault claims within the deadline and follows up on insurer decisions. |
| NY Medicaid Timely Filing | Medicaid fee-for-service claims generally must be filed within 90 days of the date of service. Managed Care plans set their own windows. | Submits Medicaid claims promptly and monitors each plan’s timely-filing deadline. |
| NY Workers’ Compensation Board Rules | Establishes workers’ compensation billing, fee schedule, and documentation requirements for medical providers. | Processes workers’ compensation claims according to applicable WCB guidelines. |
| HIPAA and NY SHIELD Act | Requires covered entities and business associates to protect health information and the private information of New York residents. | Uses HIPAA-compliant processes and encrypts PHI in transit. |
In Which New York Counties Does Transcure Provide Medical Billing Services?
New York’s 62 counties span some of the most medically active urban ZIP codes in the country. Transcure supports practices across New York State, including:
Kings County (Brooklyn)
Queens County
New York County (Manhattan)
Suffolk County
Bronx County
Nassau County
Westchester County
Erie County
Monroe County
How Transcure Helped Family Health Care PLLC in New York
In 2023, this New York family medicine practice collected 60K a month. Coding errors, slow payment posting, and weak AR follow-up held revenue down. Transcure took over billing and rebuilt the revenue cycle around proper coding and streamlined claim submission.
Today, monthly collections range from 200K to 250K. Accurate payment posting, active payment hunting, and tight AR control drove the gain. The practice now collects roughly four times its 2023 baseline.
CEO Kamran Ahmed
Family Health Care PLLC
Streamlined billing and disciplined AR control quadrupled what we collect. If you run a family medicine practice in New York, this is what competent medical billing actually looks like.
What are the Major New York Medical Specialties Billed by Our Medical Billing Services?
Transcure applies specialty-precise coding expertise and full New York regulatory compliance for practices across all major disciplines. Our NY medical billing expertise includes:
How Much Can New York Practices Save by Outsourcing NY Medical Billing to Transcure?
Based on ZipRecruiter data from March 2026, the average salary for a Medical Billing Specialist in New York is about $46,685 per year. Benefits, taxes, software, and onboarding bring the full cost of one in-house biller to about $80,000 per year. Transcure charges 5% of collected revenue. For example, a New York practice collecting $600,000 per year pays about $30,000 at 5%. That is about $50,000 less than one full-time biller.
A New York practice collecting $600,000 annually pays Transcure approximately $30000, saving over $120,000 per year compared to keeping one full-time in-house billing team. Instead, you get a full team of certified billing specialists, AI RCM agents, and New York compliance expertise built into every claim.
$600K Annual Collections - NY Practice Example
In-House Billers
$80,000
Salary + benefits + overhead + software + training
Transcure (5% fee)
$30,000
Full team + AI tools + NY compliance + denials management
You Save $50,000+ Per Year
Plus a typical 20%+ revenue improvement from better collections
Why Do New York Practices Choose Transcure for Medical Billing?
Practices in New York operate under some of the most detailed billing rules in the country. Transcure combines a dedicated compliance team with automated claim workflows to keep yours accurate.
NY-Exclusive Compliance Desk
Our dedicated NY regulatory team monitors DOH Medicaid bulletins, NYDFS insurance circulars, and pending healthcare legislation in real time. Billing protocols are updated before new requirements take effect so your practice is never caught off guard.
AI RCM Agents
Transcure's AI RCM agents, ELIXA, CODIN, and DEXA, automate eligibility verification , medical coding, and denial management across the payers our clients bill. The result is a first-pass clean claim rate of up to 98% across Medicaid, Medicare, and commercial accounts.
New York Provider Enrollment
Our team manages full CAQH enrollment, eMedNY Medicaid provider registration, and payer-specific credentialing applications for every major NY insurer. We track re-credentialing deadlines with notice before new requirements take effect.
Certified New York Billing Specialists
Every Transcure biller on New York accounts holds CPC, CCS, or CPMA certification and completes annual training covering eMedNY, NYDFS prompt-pay enforcement, and NY SHIELD Act compliance requirements.
Our Certifications
We strictly adhere to compliance and state regulations and our certifications exhibit that well.
What EHR Systems Are Supported by Transcure for New York Billing?
Our team is trained in the EHR platforms below, such as NextGen, eCW, and Practice Fusion, so you never have to switch systems to work with Transcure.
Nationwide Reach with Transcure's Medical Billing Services
Transcure serves all 50 states across the United States including:
What Practices Say About Working With Transcure?
New York practices across every region and specialty have trusted Transcure to recover revenue and bring order to their revenue cycle. Here is what some of them have to say.
Ospina Medical
Practice Manager
Wilson Creek Internal Medicine
Transcure catches prior authorization gaps on our injection procedures before claims go out. Our New York pain management practice now sees fewer denials, and monthly collections keep climbing steadily.
Shafiq Rehman
Pace Cardiology PC
Being told about problems while they’re still fixable makes a real difference. Transcure controls our AR and keeps our New York cardiology practice properly updated. Monthly payments keep growing.
Junno Park, DPM LLC
Livingston Podiatry Associates
Patient volume is up, and claims are reimbursed consistently. Transcure handled our credentialing and enrollments properly at the start, and their podiatry billing support in New York has scaled with us.
Frequently Asked Questions About Medical Billing Services in New York
Get answers to the most common questions New York healthcare providers ask about our billing services, compliance, and New York-specific regulations.
What is the New York Surprise Bill Law, and how does it affect NY medical billing?
New York’s Surprise Bill Law, under Insurance Law Section 3241 and Financial Services Law Article 6, protects patients from unexpected out-of-network bills at in-network facilities and in emergencies. Providers cannot balance bill beyond the patient’s in-network cost-sharing. Disputed reimbursements go through the NYDFS Independent Dispute Resolution process. Self-funded employer plans fall outside state law. They follow the federal No Surprises Act (Public Health Service Act Sections 2799A-1 and 2799A-2) and its federal IDR process.
How does Transcure handle NY Medicaid billing compliance?
Transcure maintains a dedicated NY Medicaid compliance desk staffed by billers trained in eMedNY billing requirements and OMIG audit standards. We manage eligibility verification through the eMedNY portal, prior authorization submissions for all NY plans, and denial appeals under 18 NYCRR Part 540.
What should a New York practice look for in a medical billing company?
Look for eMedNY experience, NYDFS prompt-pay enforcement, and OMIG audit readiness. Check whether the company bills Medicaid Managed Care plans and commercial payers under New York rules. Ask for certified coders with CPC or CCS credentials. Transcure combines these capabilities with AI-driven denial recovery through AI agent DEXA.
How quickly can Transcure start billing for our New York practice?
Most New York practices are fully onboarded and billing through Transcure within 5 to 7 business days. Our onboarding team handles EHR integration, eMedNY enrollment verification, CAQH profile updates, and NY-specific payer workflow configuration in parallel so there is no billing gap during the transition.
What is the timely filing limit for NY Medicaid?
NY Medicaid fee-for-service requires claims to be submitted within 90 days from the date of service for most claim types. NY Medicaid Managed Care Organizations have their own timely filing windows, which vary by plan and typically range from 90 to 180 days.
What does OMIG do, and why does it matter for NY billing?
The Office of the Medicaid Inspector General (OMIG) conducts audits, investigations, and compliance reviews for New York Medicaid providers. Practices that do not meet OMIG compliance program requirements risk repayment demands, exclusion from the Medicaid program, and civil monetary penalties.
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