Coding and claim mechanics are national. What changes at a state line is everything around them: who adjudicates your Medicare claims and hears your appeals, what your Medicaid program is called and whether a commercial plan sits in front of it, whether an auto injury is the health plan's problem or the auto carrier's — and how a billing company is permitted to charge you.
In New York, Medicare is administered by National Government Services (JK). Medicaid runs as New York Medicaid, delivered largely through commercial managed care plans — so most Medicaid claims are adjudicated by an insurer with its own filing window and authorization rules rather than by the state.
New York is a no-fault state. For an auto injury the auto carrier pays first, not the health plan, and billing the health plan first produces a denial that looks like a coverage problem but is really a sequencing problem.
White Glove Medical Billing is a medical billing, coding, and revenue cycle company — not a healthcare provider and not a law firm. All coding is performed by certified coders from your providers' documentation; the clinical record and the certification of medical necessity remain the provider's.
At a glance
Medicare contractor
National Government Services (JK)
Medicaid program
New York Medicaid
Medicaid delivery
Commercial managed care plans
Auto injuries
No-fault — auto carrier pays first
Appeals in New York
National Government Services (JK) is who hears the first level of appeal for a Medicare denial here. That matters practically: an appeal argument that works with one contractor generally works across every state it covers, and local coverage determinations mean the same service can be covered in New York and not one state over.
What we handle for New York practices
- Medical coding by certified coders, from your documentation
- Charge entry, claim scrubbing, and electronic submission
- Clearinghouse rejection follow-up and denial management
- Payment posting reconciled to your bank deposits
- Aged A/R worked by recoverability, not by date
- No-fault and auto-injury claims sequenced to the New York auto carrier first
- Patient statements, payment plans, and a billing support line
A note on New York business taxes
Not a service we sell, and not advice — but a practice is still a business with a state footprint, and it comes up often enough to be worth stating. New York administers sales tax through the New York State Department of Taxation and Finance. Most clinical services are not taxable, but retail sales — supplements, cosmetics, optical, DME sold rather than billed — frequently are. Employer registration runs through the New York State Department of Labor, and the entity itself is registered with the New York Department of State. Your CPA owns all of it; we mention it because the retail side of a practice is where it usually surfaces.
We work the claims. You practice medicine.
Coding, claim submission, denial management, and A/R follow-up — with nothing left for your front desk to chase.
View pricingHow It Works
Review
We look at your New York aging, denial mix, and payer panel.
Scope and price
A written scope, and the New York rate card above confirmed in writing.
Transition
Coding and submission move across without a gap.
Report
Six numbers monthly, segmented by payer and provider.
Medical billing pricing in New York
Flat monthly fee
tracks 6–8% per month
A fixed monthly fee, set from the same size bands the percentage uses so you pay close to what the identical practice pays in a percentage state. Same economics, different instrument — quoted before we start and unchanged by what we collect in any given month.
Why New York is different. New York does not permit billing companies to be compensated as a percentage of collections. Our pricing here is set accordingly — this describes what we charge, not what you are permitted to do, and it is not legal advice.
Solo
$2,000/mo
$0–$50,000 a month collected
1 provider
tracks 8%
Growing
$7,500/mo
$50,000–$150,000 a month collected
2–4 providers
tracks 7.5%
Established
$19,250/mo
$150,000–$400,000 a month collected
5–9 providers
tracks 7%
Group
$45,500/mo
$400,000–$1,000,000 a month collected
10–20 providers
tracks 6.5%
Large Group
from $60,000/mo
$1,000,000+ a month collected
20+ providers or multi-site
tracks 6%
Every ongoing engagement carries a minimum monthly fee of $500. It exists so a new or small practice can be served properly rather than quoted a percentage that does not cover the work.
What changes the work in New York
- Medicare contractor
- National Government Services (JK)
- Claims for New York providers are adjudicated here, and this is who hears the first level of appeal.
- Medicaid program
- New York Medicaid
- Delivered largely through commercial managed care plans, so most New York Medicaid claims go to a health plan rather than to the state.
- Auto injuries
- No-fault / PIP state
- In New York the auto carrier is the payer of first resort for an auto injury, not the health plan. Billing the health plan first is a denial waiting to happen.
New York shares its Medicare contractor with Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont, so an appeal that works in one usually works in the others.
Front-end services in New York
These are priced per occurrence and are the same in every state. They can be bought on their own, without a billing contract.
| Eligibility check | $5 per patient |
| Full benefits verification | $10–$14 per patient |
| Prior authorization, standard | $12 per authorization |
| Prior authorization, complex | $18–$25 per authorization |
| Patient registration audit | $4 per patient |
What we report every month
- Days in A/R — How long money takes to arrive.
- A/R over 90 days — What share of what you are owed is going stale.
- Clean claim rate — How often a claim is paid without rework.
- Net collection rate — Of what was collectable, how much we collected. The number that grades the whole engagement.
- Denial rate by reason — Grouped by cause, so it points at a fix rather than a total.
- Charge lag — Days from date of service to claim submission — often your number to fix rather than ours, which is exactly why you can see it.
New York Guides
New York Sales Tax Filing
Tracked, reconciled, and filed on the cadence New York assigns you.
Open guideNew York Tax Agency Directory
Who administers what, with rates and thresholds as of August 2026.
Open guideAll Medical Billing Services
Monthly close, cleanup, AR/AP, payroll, job costing, and more.
Open guideNew York Medical Billing by Specialty
These specialties have medical billing that genuinely differs in New York — workers compensation schedules, no-fault auto rules, or Medicaid structure.
New York — Frequently Asked Questions
Which Medicare contractor covers New York?
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National Government Services (JK). That is who adjudicates your Medicare claims, publishes the local coverage determinations that bind you, and hears a redetermination.
Is New York Medicaid managed care?
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New York Medicaid is delivered largely through commercial managed care plans. Nationally about 78% of Medicaid beneficiaries are in comprehensive managed care, and five companies account for roughly half of that enrollment — so "billing Medicaid" here usually means billing a commercial insurer.
How do you price in New York?
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New York does not permit billing companies to be compensated as a percentage of collections. Our pricing here is set accordingly — that describes what we charge, and your own position is a question for your counsel rather than for us.
Do we have to be in New York to work with you?
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No — we work remotely with practices in all 50 states and DC. What matters is that somebody is tracking New York's rules against your actual claims, which is what this page is for.
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