Laboratory Billing Services in New York
Laboratory billing in New York requires precision, compliance, and efficiency to maintain a smooth revenue cycle. Our laboratory billing services help diagnostic labs, pathology groups, and medical testing facilities navigate state regulations, insurance complexities, and claim processing challenges.
By combining advanced billing technology, expert claim management, and following New York payer guidelines, we ensure faster payments, fewer denials, and a seamless revenue cycle.
Why Choose Our Laboratory Billing Services in New York?
100% New York-Compliant Billing Practices
Our team ensures full compliance with: New York Medicaid (eMedNY) fee-for-service reimbursement guidelines, NYSDOH laboratory billing regulations, CLIA, HIPAA, and out-of-network billing laws. We prevent audit risks, billing errors, and claim denials by applying state-specific coding and regulatory requirements.
Insurance & Payer Expertise
We specialize in billing and reimbursement for major New York insurers, including Empire BlueCross BlueShield, Fidelis Care, Aetna Better Health of NY & Healthfirst. We handle pre-authorizations, eligibility verification, and appeals, ensuring accurate claims processing and maximum reimbursements.
Seamless Revenue Cycle Management
We optimize laboratory revenue cycle management (RCM) in New York by:
- Automating claims submission & scrubbing for accuracy
- Reducing denials through CPT & ICD-10 coding precision
- Handling appeals & resolving aged claims for faster payments
- Managing out-of-network reimbursements in NYC and beyond
Statewide Service Coverage
We provide dedicated billing support for laboratories across New York State, including:
- New York City (Manhattan, Brooklyn, Queens, Bronx, Staten Island)
- Long Island, Westchester, Hudson Valley, and Upstate New York
- Independent diagnostic labs, hospital-affiliated laboratories, and specialty testing facilities
Laboratory Billing Challenges in New York
Stringent State Regulations & Compliance Risks
- New York Medicaid requires strict adherence to eMedNY billing rules
- NYSDOH audits and compliance checks require accurate coding & documentation
- Failure to comply results in denied claims, payment holds, or penalties
High Claim Denials & Out-of-Network Billing Issues
- New York insurance companies enforce strict prior authorization policies
- Out-of-network laboratory claims in NYC face complex reimbursement rules
- Billing errors cause delays in revenue collection and rejected claims
Insurance & Payer-Specific Challenges
- Medicaid Managed Care Organizations (MCOs) have different reimbursement guidelines
- Medicare Advantage plans require detailed documentation for approvals
- Fidelis Care, Empire BCBS, and Healthfirst have specific claim processing requirements
EHR & LIS Integration for Efficient Billing
- Our billing services integrate with leading Laboratory Information Systems (LIS)
- We streamline insurance claim processing through AI-powered automation
- Real-time reporting and tracking improve billing transparency
Get In Touch
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Quick answers to questions you may have. Can't find what you're looking for? Get in touch with us.
New York requires laboratories to comply with NYSDOH, eMedNY Medicaid, and out-of-network billing laws. We ensure full compliance to prevent claim denials and maximize reimbursements.
We handle billing for Empire BlueCross BlueShield, Fidelis Care, MVP Health Care, Aetna Better Health of NY, Healthfirst, Medicare Part B, and New York Medicaid.
Yes. We specialize in laboratory billing services for independent diagnostic labs, pathology groups, and hospital-based testing centers.
We scrub claims for errors, appeal denied claims, and negotiate with insurance providers to recover lost revenue.
Contact our billing specialists today for a free consultation. We’ll assess your lab’s billing challenges and implement customized revenue cycle solutions to increase cash flow.