What Providers Need to Know - Archived Updates
May 12, 2022
OnBoard: Limited Release Updates
Phase Three of OnBoard: Limited Release (OBLR) is now live! OBLR has moved several important paper-based workers' compensation processes online, improving accuracy, efficiency and ultimately timeliness of benefits for injured workers.
To assist health care providers with OBLR, the Board has compiled useful information, such as training guides, webinar recordings, and other resources.
As you continue to navigate the new system, do not hesitate to reach out if you need assistance.
- Ensure you meet the minimum system requirements to use OBLR.
- For assistance with Medical Portal registration, contact Customer Support at WCBCustomerSupport@wcb.ny.gov
- For general questions about OnBoard or OBLR, email OnBoard@wcb.ny.gov.
For any other questions, contact Customer Service at (877) 632-4996.
New/Updated Medical Treatment Guidelines Take Effect
In recent months, the Board has adopted more than a dozen new or updated MTGs. These all became effective with Phase Three of OBLR.
The Board has training available on the new and updated MTGs. Each training provides an overview of the General Guideline Principles, diagnoses associated with the body part or condition, as well as diagnostic and treatment recommendations. Each training carries CME credit for health care providers. There is also a non-CME version of each training for administrative and other non-medical professionals.
New Maximum Weekly Benefit Rate Effective July 1, 2022
The maximum weekly benefit rate will be $1,125.46 for compensable lost time for workers' compensation claims with dates of injury during the period from July 1, 2022, through June 30, 2023. Read more in Subject Number 046-1514.
Emergency Adoption and Proposal of Amendments to 12 NYCRR 324.3(a)(1) (Special Services)
The Chair has adopted, on an emergency basis, and proposed amendments to 12 NYCRR 324.3(a)(1) to ensure that sacroiliac joint (SIJ) fusion and peripheral nerve stimulation are not performed unnecessarily, and that if it is medically necessary, then prior authorization has been obtained. Read more at Subject Number 046-1518.
Resources on COVID-19 and Workers' Compensation
Since February, the Board has been hosting a series of webinars to aid workers with long-haul COVID-19 workers' compensation claims. You can view the slides and the recorded webinar. Visit the Board's COVID-19 web page for additional resources, including downloadable fact sheets you can share with patients.
Additional webinar dates are now available!
The Chair has adopted, on an emergency basis, amendments to 12 NYCRR 325-1.8, 329-1.3, 329-4.2, 333.2, and 348.2 to allow telemedicine in some circumstances. These amendments supersede the previous emergency telemedicine adoption to keep telemedicine in effect during the regulatory process for the permanent telehealth proposal. You can read more in Subject Number 046-1513.
Reminder and Clarification Regarding Form Submission Guidelines
To further improve customer service for all stakeholders and to reduce system costs, the Board issued some important updates to the guidelines on submitting forms and other documents that was originally provided in Subject No. 046-909 dated January 4, 2017. You can read the updates in Subject Number 046-1106R.
The July 1, 2022, implementation date for the Board's transition to the CMS-1500 universal medical billing form is quickly approaching, and we want to make sure you are prepared. Please review the April 18, 2022, GovDelivery for more details.
Read more about the CMS-1500 initiative and send your questions to CMS1500@wcb.ny.gov.
Change to Form C-8.4
The Board has made a change to the July 1, 2022, version of the 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) to remove the preferred provider organization (PPO) objection. You can read more in the GovDelivery that was distributed on May 3, 2022.
Medical Narrative Report Template Reminder
Effective July 1, 2022, health care providers are required to include the injured worker's
- work status,
- the causal relationship of the injury, and
- temporary impairment percentage
either at the top of, or prominently displayed on the medical narrative that accompanies the CMS-1500 form.
Important: If any of these elements are missing or not prominently displayed, the medical narrative report may be found legally defective, which means injured workers may not receive their needed treatment and/or benefits, and you may not be paid. Bills for ancillary services such as radiology, anesthesiology or surgery have unique attachment requirements.
To ensure the CMS-1500 form is accepted, the Board has developed a medical narrative report template that can be used to create the medical narrative report that accompanies provider submissions of the CMS-1500 form.
Check out the Board's Health Care Providers Recorded Webinars web page for past webinars.
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