New York City has the most complex payer landscape in the country. Revenue Synergy handles Medicaid Managed Care, NY State health plans, and commercial payers across all five boroughs.
New York State's Medicaid Managed Care program serves over 5 million members, and NYC is home to the largest municipal health system in the U.S. (NYC Health + Hospitals). Narrow network products and tight authorization rules define the market.
Our team understands referral patterns and billing entities across NYC's major systems: NewYork-Presbyterian, Mount Sinai, NYU Langone, NYC Health + Hospitals, Northwell, Memorial Sloan Kettering, and Montefiore.
Each NY MMC plan has its own claim portal, timely filing rule, and denial pattern. Our team handles them all.
Empire BCBS, Oxford, and EmblemHealth narrow networks create in-network / out-of-network denials that require payer-specific workflow.
We track NY DFS prompt payment rules, No Surprises Act coordination, and the coverage dynamics that shape NYC billing.
Every market has its own billing pain points.
Plans like Healthfirst, Fidelis, and MetroPlusHealth each have distinct claim portals, timely filing rules, and denial patterns; our team manages them all.
Empire BCBS EPO, Oxford, and EmblemHealth narrow networks create in-network / out-of-network denials that require payer-specific workflow.
NY DFS imposes prompt pay laws, no-surprises regulations, and appeal procedures that affect revenue timing if handled poorly.
Practices affiliated with NYP, Mount Sinai, NYU, or Northwell each bill into different facility structures; clean professional vs facility split matters.
A complete revenue cycle solution built for NYC's complex payer mix.
Dedicated billing teams for 22+ medical specialties.
Complex cardiac procedure coding.
Surgical and non-surgical orthopedic billing.
Mental health billing with parity compliance.
Interventional pain coding.
Endoscopy billing.
Technical/professional component billing.
High-volume E/M coding.
Facility and surgeon billing.
Common questions from NYC healthcare providers.
Revenue Synergy supports healthcare providers across the country.
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