Workers’ Compensation Electronic Claim Submission and OnBoard Initiatives

As previously reported, the NYS WCB continues to develop and refine their CMS-1500 and OnBoard electronic communication initiatives. These initiatives are designed to submit claims and related documentation, enhance communication, and will allow access to information in a transparent, streamlined manner.

Currently you have 2 ways to participate - one is a free webinar Thursday, January 28th at 2pm, the second is completing the WCBs provider survey regarding the CMS-1500 initiative. Please take advantage of these opportunities to educate yourself and voice your opinions. As always, NYSCA members may direct other questions to the NYSCA WC Committee.

Details of these 2 opportunities are detailed below:

CMS-1500 Initiative

Only 4 clearinghouses have been approved to date by the WCB.  One of those clearinghouses, Carisk Intelligent Clearinghouse, will be hosting a webinar on Thursday, January 28th at 2pm in conjunction with the Workers' Compensation Board.  This will be an excellent opportunity to learn of the benefits of electronic claim submission for your workers' compensation claims, and to have your questions on this initiative answered directly by representatives of Carisk and the NYS WCB.  Although the NYSCA Insurance Committee is not participating in this presentation, we encourage our members to register and attend.

Click here to register January 28th webinar

This change will become mandatory in July (with a grace period); however, the WCB has noted: "The Workers' Compensation Board strongly encourages providers to switch to using the CMS-1500 now, in order to become familiar with it prior to the mandatory July 2021 implementation date."  

OnBoard

For those who are new to NYSCA (Welcome!) or have not attended a NYSCA Webinar during the past year, The NYS WCB OnBoard business information system will streamline and replace much of the Board's current system.  All key stakeholders will access the same platform to report, review and process information.  This is a multi-year process that will begin to roll out during the 2nd quarter of 2021.  

The NYSCA Insurance Committee attended the provider OnBoard update this week, and has submitted questions to the WCB relative to the initial rollout.  You can learn basic information about OnBoard at this link: OnBoard: A Better System for a Better Board - YouTube, or visit the following web page: OnBoard: Building A New Web-Based Claims System (ny.gov)


Please also note the following announcement from the NYS Workers' Compensation Board:

Providers: We Need Your Feedback on Form CMS-1500

The Workers’ Compensation Board is transitioning to using Form CMS-1500, the universal claim form used by medical providers to bill the Centers for Medicare and Medicaid Services (CMS) as well as health insurers. Form CMS-1500 will streamline the medical billing process and reduce the paperwork requirements currently in the workers’ compensation system. Our goal is to reduce the administrative burden making participating in workers’ compensation easier for providers.

In a November 9, 2020 email, we outlined several requirements for providers that will be mandatory beginning in July of 2021 as part of this transition. In anticipation of this fast-approaching deadline, we want to ensure providers are aware of these changes.

To help determine your preparedness and to guide future outreach and training efforts on this initiative, we are asking you to please take a brief, 10-minute survey by accessing the link below.

PROVIDER SURVEY

Please complete the survey by Friday, January 29, 2021.

If you are not the correct person to answer questions regarding billing, we ask you to kindly forward this email to the appropriate person.

OnBoard Project

In addition to our transition to Form CMS-1500, the Board is making other improvements, too. We are currently in the process of developing a new business information system, OnBoard. OnBoard will be a Better System for a Better Board – providing an intuitive, user-friendly system, increased accuracy and quality, and paperless transactions to our system participants.

Since building a new, integrated system from the ground up takes time, we’re starting with some high-priority processes (including the prior authorization request processes and the submission of medical billing disputes [Form HP-1]), that will benefit from moving online in what we are referring to as OnBoard: Limited Release.

Visit the Board’s OnBoard webpage to learn more and stay engaged as this project progresses.


More Information

recorded presentation for providers (published September 2020) answers several of the most frequently asked questions regarding the Board's transition to Form CMS-1500 as well as the Board's implementation of the Expanded Provider Law.

The Board has developed a training video to show health care providers, and all others who will be using Form CMS-1500, how to use the form and the required narrative reports to bill for their services to workers’ compensation patients. To view the training video, follow this link: CMS-1500 Training Video.

You can visit the Board’s website for a CMS-1500 overview, news, FAQs, and more. For Form CMS-1500 feedback and questions, email [email protected]. To sign up for news straight to your inbox, visit the Board’s website and select ‘Get WCB Notifications’ on the bottom of the homepage.

Carisk webinar

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