Medical Billing Company for New York Practices

Mukesh MakwanaFounder & CEO · 8+ years hands-on in medical billing & RCM · Reviewed October 1, 2026

A medical billing company for a New York practice has to work inside New York's own rules: Medicaid enrollment through eMedNY and the state's Provider Services Portal, the requirement that Medicaid managed care network providers be enrolled with the state, and New York's prompt pay law, which sets when state-regulated plans must pay, how late payments earn interest, and how quickly claims must be filed. Sterling Global Solution LLC handles billing for New York practices inside their existing systems, with the 120-day filing window tracked on every claim.

New York Medicaid enrollment

New York State Medicaid provider enrollment is run through eMedNY. According to eMedNY, new enrollment, reinstatement and maintenance for all providers are handled on the NYS Medicaid Provider Services Portal, and providers should revalidate only when notified individually to do so. eMedNY publishes enrollment guides by provider type, including applied behavior analysis and adult behavioral health home and community based services, and notes that its enrollment forms include the Provider Compliance Program requirements in 18 NYCRR Part 521.

Medicaid managed care networks

eMedNY explains that the 21st Century Cures Act requires Medicaid managed care and Children's Health Insurance Program network providers to be enrolled with the state Medicaid program. A provider who receives a letter from a managed care plan saying they are not actively enrolled with NYS Medicaid must enroll or will be removed from that plan's Medicaid network. The federal rule behind this, 42 CFR 438.602(b), requires states to screen and enroll all network providers of their Medicaid managed care plans.

In practice, joining a New York Medicaid managed care network is two jobs: state enrollment through eMedNY and credentialing with each plan.

New York prompt pay law (Insurance Law section 3224-a)

For plans subject to section 3224-a, the law sets the following, in summary:

• Payment deadline: undisputed claims must be paid within 30 days of receipt when transmitted via the internet or electronic mail, and within 45 days when submitted by other means such as paper or fax.
• Disputed claims: where the obligation to pay is not reasonably clear because of a good faith dispute, the plan must pay any undisputed portion and notify the provider in writing.
• Interest: late payments carry interest at the greater of the rate set by the Commissioner of Taxation and Finance for corporate taxes or 12 percent per annum, computed from the date payment was due.
• Filing deadline: except as otherwise provided by law, claims must be initially submitted within 120 days after the date of service to be valid and enforceable against covered plans, although contracts may set terms more favorable to the provider.

The 120-day rule is the one that catches practices out. A claim held for a week by the front desk, then rejected at the clearinghouse, can lose most of its window before anyone notices.

What this means for a New York practice

• Submit electronically, so the shorter 30-day payment clock applies.
• Track every claim against the 120-day filing window, and keep clearinghouse acceptance reports as proof of timely submission.
• Check that every provider is enrolled with NYS Medicaid before relying on a Medicaid managed care contract.
• Calculate and request interest on late payments from plans subject to section 3224-a.
• Watch for revalidation notices from eMedNY rather than revalidating early.

Specialties we bill for New York practices

We work with New York behavioral health and therapy practices, psychiatry practices, ABA providers, fertility clinics, cardiology, orthopedic and OB-GYN practices, and with private and small practices across specialties.

How Sterling Global Solution LLC works with New York practices

We verify eligibility before each visit, handle prior authorizations, submit claims electronically the same day, track each claim against the 120-day filing window and the 30-day payment deadline, request interest when it is owed, and work every denial through the right appeal route. When you add providers, we handle eMedNY enrollment and plan credentialing; new billing clients get free credentialing for 3 insurance payers. Start with our 30-Day Free Trial.

Frequently asked questions

Sources

New York State Medicaid, eMedNY Provider Enrollment: Provider Services Portal, provider-type guides, revalidation and 18 NYCRR Part 521.
New York State Medicaid, eMedNY Medicaid Managed Care Network Provider Enrollment: 21st Century Cures Act enrollment requirement.
New York Insurance Law, section 3224-a: payment deadlines, disputed claims, interest and 120-day submission.
Code of Federal Regulations, 42 CFR 438.602(b): state enrollment of managed care network providers.

This summarizes official sources and is not legal advice; check the full text and your contracts. How we verify this guidance.

Related reading

• Insurance companies not paying claims. Payment deadlines by state and how to escalate.
• AR recovery services. Recovering claims before filing limits close.
• How to get credentialed with insurance companies. Medicare, Medicaid and commercial enrollment.
• Medical billing for New Jersey practices. For practices that see patients across the Hudson.