Full-cycle claims submission and payment posting built around eMedNY, Empire BlueCross BlueShield, and Excellus BlueCross BlueShield filing rules.
New York Medical Billing Specialists
Medical Billing Services in New York
A nationwide billing specialist trusted by New York practices to get eMedNY, Empire BlueCross BlueShield, and Excellus BlueCross BlueShield claims paid without the back-and-forth.
Thrive delivers the medical billing services New York practices need to navigate a payer market split between downstate and upstate rules, without adding a local vendor to your list of contacts. We are not a billing software company. Our team manages coding, submission, and appeals for every claim, backed by verified performance data across every practice we serve.
- HIPAA-Compliant Workflows
- Certified Billing & Coding Support
- Complete RCM Services
🔒 100% confidential. We never sell your data. Privacy Policy
What We Handle
Full-Service Medical Billing and Coding for New York Practices
Every service below is delivered by our own billing team, not routed through a platform you have to manage yourself.
Medical Billing Services
Medical Coding Services
Specialty-specific CPT, ICD-10, and HCPCS coding that reflects how New York’s downstate and upstate payers actually adjudicate a claim.
Consultation and Audit
A structured review of your current billing performance, denial patterns, and coding accuracy before we take over a single claim.
Denial Management
Root-cause analysis and appeals for denied claims, with corrections applied upstream so the same denial reason stops recurring.
Revenue Cycle Management
End-to-end oversight from patient registration through final payment, keeping AR days low and cash flow predictable.
Credentialing and Enrollment
Payer enrollment and re-credentialing across eMedNY, Medicaid managed care plans, Empire BCBS, Excellus BCBS, and MVP Health Care, managed remotely.
Patient Billing and Collections
Clear, accurate patient statements and a collections process that protects your practice’s reputation while recovering what’s owed.
Eligibility and Verification
Real-time eligibility and benefits verification before the appointment, not discovered after a claim has already been filed.
Market Context
How New York's Payer Mix Shapes Reimbursement
New York runs a split Medicaid system. Fee-for-service claims route through the state’s eMedNY platform, while a large share of members sit inside Medicaid Managed Care plans such as Healthfirst, Fidelis Care, MetroPlus, and EmblemHealth, each with its own credentialing and claim rules. Commercial coverage splits geographically too. Empire BlueCross BlueShield and UnitedHealthcare lead downstate, while Excellus BlueCross BlueShield and MVP Health Care dominate upstate counties, so a practice billing across both regions is really managing two different payer landscapes at once.
MEDICAID MODEL
Fee-for-service through eMedNY, or managed care through plans like Healthfirst and Fidelis Care.
REGIONAL SPLIT
Downstate leans Empire BCBS and UnitedHealthcare. Upstate leans Excellus BCBS and MVP Health Care.
TIMELY FILING
Medicaid fee-for-service claims must be filed within 90 days, among the shortest windows nationwide.
Where Revenue Gets Lost
Common Billing Issues Affecting New York Claims
Downstate and Upstate Payer Fragmentation
A rule that works with Empire BCBS in New York City can fail with Excellus BCBS in Rochester. Cross-regional practices need coding that accounts for both.
Fee-for-Service vs. Managed Care Routing
Whether a claim goes to eMedNY or a managed care plan depends on member enrollment. Billing it to the wrong track causes an automatic rejection.
HARP and Behavioral Health Carve-Outs
Health and Recovery Plans carve behavioral health benefits into a separate credentialing and billing track, which catches many practices off guard.
A Narrow Medicaid Filing Window
A 90-day deadline on fee-for-service Medicaid claims leaves little room for a backlog or a delayed submission to slip through.
Our Approach
Why New York Practices Partner With Thrive
Practices across the state work with our medical billing experts in New York because eMedNY, Empire BCBS, and Excellus each play by different rules, and getting all three right takes more than local familiarity.
Specialist, not local vendor
Our coding expertise is built around specialty and payer complexity, not zip codes, which is exactly what a state split between two payer regions requires.
A team, not a software platform
You get a dedicated billing team handling submission, appeals, and AR follow-up. There is no dashboard to learn and no license to manage.
Remote credentialing, no local office needed
Our credentialing team enrolls practices with eMedNY, Medicaid managed care plans, and commercial payers the same way regardless of where our team sits.
The same verified standards, everywhere
95%+ clean claim rate, 98.2% first-pass resolution, and sub-30-day AR are not regional promises. They're the standard we hold in every state we work in.
Specialty Coverage
Specialty Billing Coverage Across New York
Each specialty carries its own coding rules, modifiers, and payer quirks. Our teams are trained specifically in yours.
Primary & Family Care
Behavioral & Mental Health
Surgical & Procedural
Specialty Medicine
Therapy & Rehabilitation
Facility & Ancillary Services
Getting Started
From Onboarding to Reimbursement: Our Process
Free Practice Revenue Review
We audit your current claims, denial trends, and AR aging to show exactly where revenue is being lost, at no cost.
Onboarding and Payer Credentialing
We enroll your practice with eMedNY, the relevant Medicaid managed care plans, Empire BCBS, Excellus BCBS, and MVP Health Care, depending on your patient base.
Coding and Claims Submission
Specialty-specific coding and clean claim submission, typically within 48 hours of the encounter reaching our team.
Denial Management and AR Recovery
Appeals, resubmission, and aged AR cleanup handled by the same team that submitted the original claim.
Reporting and Ongoing Optimization
Monthly performance reporting and proactive updates as eMedNY or payer policy changes affect your practice.
Common Questions
Questions New York Practices Ask Before Switching Billers
Do you provide medical billing services in New York if your team isn't physically located here?
Yes. We work with New York practices through remote onboarding and electronic credentialing with eMedNY, Medicaid managed care plans, and commercial payers. The same clean claim rate and turnaround standards apply regardless of where our team sits.
Can you bill both eMedNY fee-for-service and Medicaid managed care claims?
Yes. We route each claim to the correct track based on the member's enrollment, whether that means fee-for-service through eMedNY or a managed care plan like Healthfirst, Fidelis Care, MetroPlus, or EmblemHealth, so claims aren't rejected for hitting the wrong system.
What does a medical billing company in New York actually handle for my practice?
Claims submission, specialty-specific coding, denial management, payer credentialing, patient billing, eligibility verification, and revenue cycle reporting are all part of the service. Nothing is sold separately as a software add-on.
Do you credential providers with Empire BlueCross BlueShield and Excellus BlueCross BlueShield?
Yes. Our credentialing team enrolls practices with both downstate payers like Empire BlueCross BlueShield and UnitedHealthcare, and upstate payers like Excellus BlueCross BlueShield and MVP Health Care, depending on where your patients are covered.
How do you handle New York's short Medicaid filing deadline?
Claims are typically coded and submitted within 48 hours of the encounter reaching our team, well inside the state's 90-day fee-for-service filing window, so a backlog never becomes a missed deadline.
How much does it cost to outsource medical billing in New York?
Pricing depends on claim volume, specialty, and scope of service rather than a flat statewide rate. We provide an exact number after reviewing your current billing performance in the free Practice Revenue Review.
Free Revenue Analysis
Ready to Stop Leaving New York Revenue on the Table?
Get a no-cost, no-obligation review of your practice’s billing performance and a clear roadmap to recover it.
- HIPAA Compliant
- Certified Billing & Coding Support
- Works With Most Billing Software
- Nationwide Support