What Providers Need to Know - Archived Updates

May 13, 2021

Provider Registration Open for OnBoard: Limited Release

While we prepare for the Board's new business information system, OnBoard, and its early component OnBoard: Limited Release (available via the Medical Portal this summer), there are a few steps you can take now so you'll have access to the new system when it's ready.

Health care providers who will be using the Medical Portal to access OnBoard: Limited Release (or to apply for Board authorization) need an NY.gov user ID and password.

The updated Medical Portal section of the website contains all of the details and information you need regarding how to register and get a NY.gov user ID and password (and grant registration to others) to access OnBoard: Limited Release.

For additional information, including a walkthrough of the registration process, you can view a recording of the May 11, 2021 webinar for health care providers. You can also view an OnBoard: Limited Release fact sheet and FAQs for providers. Questions? Write to onboard@wcb.ny.gov.

New Dates for CMS-1500 Transition

To reduce the administrative burden on Board-authorized health care providers, the Board made the strategic decision to consolidate and eliminate certain medical billing forms and transition to using the Form CMS-1500 form. The timeline for this transition has recently been updated.

• Phase 1: Voluntary submission (happening now)
  Board-authorized providers may voluntarily transmit CMS-1500 medical bills (and required medical narratives, and/or attachments as applicable) via mail, email, web upload and XML; however, it is recommended that it is done electronically through one of the approved XML submission partners (most commonly known as 'clearinghouses').
• Phase 2: Payers mandated to accept electronic medical bills (October 1, 2021)
• Phase 3: is Mandatory submission of Form CMS-1500 by providers (July 1, 2022)
  Submitting the Form CMS-1500 in an electronic format through a clearinghouse is strongly preferred. Additionally, payers will be required to transmit electronic explanations of reimbursement and use of the recently updated Notice of Treatment Issue/Disputed Bill (Form C-8.1) and Notice to Health Care Provider and Injured Worker of a Carrier's Refusal to Pay All (or a Portion of) a Medical Bill Due to Valuation Objection(s) (Form C-8.4).

For more information, visit the CMS-1500 page or write CMS1500@wcb.ny.gov.

New Medical Treatment Guidelines

In recent months, the Board has adopted six more New York Medical Treatment Guidelines (MTGs), effective date to be announced), and has another 10 in various stages of the proposal, public comment and adoption process.

Adopted (Effective date to be announced)

• Hand, Wrist and Forearm Injuries
• Hip and Groin Injuries
• Elbow Injuries
• Foot and Ankle Injuries
• Occupational Interstitial Lung Disease
• Occupational/Work-Related Asthma

Proposed

• Knee Injuries (update)
• Mid and Low Back Injuries (update)
• Neck Injuries (update)
• Shoulder Injuries (update)
• Non-Acute Pain (update)
• Post-Traumatic Stress Disorder and Acute Stress Disorder
• Work-Related Depression and Depressive Disorders

To Be Proposed

• Traumatic Brain Injury
• Complex Regional Pain Syndrome
• Eye Disorders

Stay up-to-date on the Board's MTGs, and access associated training, by visiting the MTG section of the Board's website.

Renewing Your Authorization

If you have received a notification from the Board that your authorization has expired or will be expiring soon, you can renew your authorization online (Note: the online Authorization Renewal form works best when accessed using Google Chrome).

• Access the Medical Portal with your NY.gov account. If you do not have an NY.gov account, you must sign up for access.
• Complete and submit the WCB Authorization Renewal form.
• Attach PDF documents to form, if applicable, using the paper clip icon in the upper right corner of the form.

For more information, visit the Board's page Authorization Renewal for Health Care Providers and Independent Medical Examiners page.

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