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Revenue cycle management services in New York
in New york
Revenue cycle management for independent New York practices, from the first eligibility check to the last dollar collected. Qualigenix runs one connected process across New York Medicaid, Medicare and commercial plans, for all payers.
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How Qualigenix serves New York practices
Qualigenix takes over the revenue cycle for physician groups and solo practices across New York State through Qualigenix revenue cycle management. Most practices lose revenue in the gaps between steps: an eligibility check that missed a plan change, an authorization nobody tracked, a denial that sat in a queue. When one team owns every step, those gaps close. We work for all payers, inside your current EHR or practice management system, with 133 platforms supported. Your account gets a dedicated team and a monthly report that breaks out collections, denials and days in A/R by payer. New York adds its own layers: a 90-day Medicaid filing window, a state prompt-pay law, a Medicare contractor serving seven states and patient billing protections. Our workflows are built around each of them.
What revenue cycle management services does Qualigenix provide in New York?
Qualigenix runs the full revenue cycle for New York practices: insurance verification, prior authorizations, coding, billing, payment posting, denial management, A/R recovery and credentialing. One team works every step for New York Medicaid, Medicare and commercial payers. We charge a percentage of collections and report results by payer each month.
We maintain high first-pass acceptance rates across all regional payers in New york.
New York revenue cycle problems we solve
Revenue loss in New York practices usually starts at the front desk and shows up months later as a write-off. Qualigenix works the four points where New York rules decide whether you get paid.
Eligibility and prior authorization checked before the visit
New York Medicaid requires providers to verify eligibility through the state's verification system before rendering service, and that check also shows managed care enrollment and other coverage. For commercial plans, New York gives insurers three business days to decide a standard preauthorization once they have the information they need, and 72 hours for urgent requests. Qualigenix checks coverage for every scheduled patient and files authorizations early enough to meet those clocks. Our prior authorization team follows each request until it has a decision on file.
Claims filed inside every payer's window
New York Medicaid expects claims within 90 days of the date of service. Commercial claims are due within 120 days unless your contract gives you longer. Medicare Part B claims go to National Government Services, the contractor for New York. Qualigenix tracks each claim against its own payer's deadline from the day the visit closes, so nothing ages out while it waits for a fix. Claims are scrubbed and submitted by our medical billing team, usually within a day of coding.
Payments posted & tracked
Under New York's prompt-pay law, insurers must pay undisputed claims within 30 days when submitted electronically and 45 days on paper, or owe interest. They also have to ask for any missing information within 30 days. Qualigenix posts every payment against the amount expected for that payer and code. Claims past the 30-day mark, and payments that come in short, are flagged the same week by payment posting.
Patient balances billed correctly
New York's surprise bill protections hold patients to their in-network cost sharing for emergency services and for surprise bills from out-of-network providers. Qualigenix checks network status and the explanation of benefits before a balance reaches a statement, then sends patients clear statements and payment options. Patients understand what they owe, and your staff takes fewer billing calls.
RESULTS ACROSS 275+ PRACTICES
Results New York practices can expect
These are company-wide figures across Qualigenix client practices, not New York-only results.
98%
Claim accuracy
4.8%
Denial rate
97.7%
Net collections rate
Reduced from 54 to 36
Days in A/R
Reduced to 38%
A/R over 90 days
79%
Denials overturned
29-32%
Cash-flow improvement
$1.6B+
Total charges handled
$923M+
Accounts receivable recovered
1,400+
Providers set up nationally
PROVEN TRACK RECORDHIPAA-Compliant Revenue Cycle
275+ ClinicsGETTING STARTED
How onboarding works
Qualigenix takes over a New York practice's revenue cycle in four steps, live by day 6 on average.
01
Revenue Cycle Review
We review your billing setup, payer mix and denial trends, and sign the BAA.
02
EHR and portal setup
We set up software and portals inside your existing EHR, including payer portals and clearinghouse connections.
03
Account clean-up
We sort open claims, aged A/R and unposted payments so nothing old is lost in the handoff.
04
Live by day 6
New claims move through the full cycle while the clean-up work continues.
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WHY PRACTICES CHOOSE QUALIGENIX
Why New York practices choose Qualigenix
Independent practices across New york partner with Qualigenix for consistent cash flow and high claim accuracy.
One team from eligibility to payment
The people who check eligibility also see the denials it causes. That's how problems get fixed at the source instead of reworked forever.
Works inside any EHR
Qualigenix works in your current system and supports 133 platforms. There's no software change for your staff.
Monthly reporting by payer
You get collections, denials, days in A/R and net collections broken out by payer, with each metric defined.
6-day average onboarding
Most practices go live in about six days, with old claims cleaned up in parallel.
HAVE QUESTIONS?
Frequently Asked Questions
Frequently asked questions about our setup and support in New york.
Many revenue cycle companies work with New York practices, from national firms to local billing offices. Qualigenix is a US revenue cycle management company serving independent practices in 48 states, including New York, across 38+ specialties. Talk to a revenue cycle specialist to compare us with your current setup.
Qualigenix RCM includes insurance verification, prior authorizations, medical coding, medical billing, payment posting, denial management, A/R recovery and credentialing. One team runs every step, and you get one monthly report by payer.
Yes. Qualigenix submits and tracks prior authorizations for New York Medicaid managed care plans, Medicare Advantage plans and commercial insurers. We file early enough to meet each plan's decision timeline and keep the approval on file for billing.
We verify Medicaid eligibility before the visit and submit Medicaid claims well inside the state's 90-day window. Medicare Part B claims go to National Government Services, checked first against its coverage policies. Denials from either are appealed with corrected documentation.
We submit clean claims fast, post payments the same week and follow up on every unpaid claim daily by payer and age. Across client practices, that process has reduced days in A/R from 54 to 36.
Qualigenix charges a percentage of collections, so our fee depends on what we collect for you. The percentage depends on your specialty, volume and services. A revenue cycle specialist can quote your practice after a short review.
Qualigenix brings practices live in about 6 days on average. We set up access and payer connections, clean up open claims and aged A/R, and keep your cash flowing while the transition happens.
Yes. Qualigenix signs a Business Associate Agreement before any chart is shared. Coders work inside your EHR or over secure connections, and access is limited to the team assigned to your practice. Ask us for our security overview.