The NYS Workers' Compensation Board Medical Portal is a web-based application that enables users to submit medical information and view Workers' Compensation Board information electronically. The Medical Portal is intended to create more efficient processes and enable greater levels of self-service and tracking, and ultimately improve the performance of the NYS workers' compensation system overall.
The Medical Portal is available to multiple Board stakeholders, including health care providers, payers (which include insurance carriers, third-party administrators and self-insured employers), pharmacy benefit managers (PBMs) and medical review organizations (MROs).
Functionality within the Medical Portal is specific to an individual user's role. For example, users may use the Medical Portal to access:
- Drug Formulary Prior Authorizations
- Drug Formulary Lookup Tool
- MTG Lookup Tool*
- OnBoard: Limited Release (in development)
*if you are an insurance carrier that has previously licensed the ReedGroup Medical Treatment Guidelines in states other than New York, you may be able to access the New York State MTGs via the MTG Lookup Tool at no additional charge.
OnBoard: Limited Release
OnBoard: Limited Release is the first phase of the Workers' Compensation Board's new business information system called OnBoard, designed to move several key processes for health care providers and payers from paper to online. This includes the prior authorization request (PAR) process for treatment that falls outside of the Workers' Compensation Board's New York Medical Treatment Guidelines (MTGs).
|MTG Confirmation||Requests (previously done using the Attending Doctor's Request for Optional Prior Approval and Carrier's/Employer's response (Form MG-1)).|
|MTG Variance||Requests (previously done using the Attending Doctor's Request for Approval of Variance and Carrier's response (Form MG-2)).|
|MTG Special Services
||Requests, which only include the 12-MTG related requests on the Attending Doctor's Request for Authorization Carrier's Response (Form C-4 AUTH).
|Non-MTG Over $1000||Requests for treatment costing over $1000 for Non-MTG body parts previously done on Form C-4 AUTH.|
|Non-MTG Under or = $1000||Requests for treatment costing $1000 or less for Non-MTG body parts (new PAR type).|
|Medication||Requests (replacing the current New York Workers' Compensation Drug Formulary (Drug Formulary) prior authorization request process).|
|Durable Medical Equipment||Requests in accordance with the new Official New York Workers' Compensation Durable Medical Equipment (DME) Fee Schedule (new PAR type).|
Learn more about OnBoard.
What Should Payers Do Now To Prepare?
- Review existing optional prior approval and variance request processes (Form MG-1 and Form MG-2) to identify potential impacts.
- Modify current processes to align with the new system, particularly the PAR dashboard and PAR email notifications, which alert payers of important PAR status updates.
- Request Medical Portal access for employees who will be responsible to act on PAR requests.
- Begin planning for staff training and administrative support. The Board will be publishing training materials in the future to support the rollout of the new system.
Accessing the Medical Portal
Medical Portal access is granted using organizational profiles based on eClaims Trading Partner information.
Payers who already have access to the Drug Formulary will automatically be given access to OnBoard: Limited Release and do not need to request access. However, online administrators should ensure that Workload Administrators and Reviewers are designated for all PAR types and the email address for notifications is correct.
Get Notified about Medical Portal News
Stay informed about news on the NYS Workers' Compensation Board Medical Portal and other topics by subscribing for email updates: