Are you registered to vote? This blog has been updated to include new information about the final implementation date for New York's drug formulary. With ICD-10 just 30 days away, now is the time to get ready. Registrations may take up to three to five business days for processing. The summary of our joint testimony is on pages 16-17 of the report. Sign up to use the Board's Medical Portal at wcb.ny.gov/medicalportal Complete the required training courses - training must be completed before the application can be submitted Fill out the New Provider Authorization Request online application and submit to the Board It was attended by the NYSCA WC Committee. 2023 Injured Workers Pharmacy PO Box 338 Methuen, MA 01844 All Rights Reserved. Employee Attestation File Please click here to download Employee Attestation file. Webex Meetings bring your Team together, face-to-face with video conferencing, high quality audio, messaging, and screen sharing on any device. 1a. HWB Portal - Government of New York Submit Request for Decision on Unpaid Medical Bills (Form HP-1.0). Click the link titled Agreement for XML submission of CMS-1500 to accept the terms of the agreement. Here is a link to the full report: Get Ready Now: Be Sure Your Systems Are Ready, Centers for Medicare and Medicaid Services, Get Ready Now: Assess How ICD-10 Will Affect Your Practice, JLTF Pleased to Report Positive Response from WCB on Proposed New Medical Fee Schedule, NYSIF Announces Launch of Online Medical Provider Portal, CMS and AMA Announce Efforts to Help Providers Get Ready for ICD-10, Get Ready for ICD-10 with the CMS ICD-10 Infographic, Centers for Medicare & Medicaid Services (CMS), ACA Efforts Result in Federal Agency's Clarification of PPACA Language on Access to Non-MD/DO Providers, Position Paper: Workers Compensation/ No-fault Fee Schedule Proposed Update, http://assembly.state.ny.us/comm/Labor/20150504/index.pdf, Senate Clears Legislation to Prevent Medicare Payment Cuts, Attention Medicare Providers: Update on the 2015 Medicare Physician Fee Schedule Provisions that Expired on April 1, Update on the Status of Medicare Provisions Expiring on April 1, Congress Fails to Pass Legislation to Prevent Medicare Payment Cuts, Service-Specific Prepayment Review Results For CPT Codes 98940 & 98941 For September-December 2014. Overview New User Access and Administration Login with a Board-assigned username Administrator Login Payers OnBoard: Health Care Providers - NYS Workers Compensation Board New York State: XML Submission Approval for WCB, California Wizard - IBR Decision Search Explained, California Wizard - Drug Formulary Explained, California Wizard - Physician Fee Schedule Alerts Explained, California Wizard - Claims Administrator Directory Explained, New York Wizard - Claims Administrator Directory Explained, Billing Provider Settings Explained - Billing Settings - Required, Some Chubb Bills Moved to Gallagher Bassett, OWCP Provider Registration Required - EDI Submission Details, California In-Home Supportive Services claims now administered by Intercare, Pharmaceutical Billing: Invalid NDC Number, Service Line Item Posting v. Bill Posting, Identifying PPO and Discount Contracts on EORs, Request for Second Review / Appeal: Denied Bill, Request for Second Review / Appeal: Add or Change Units/Modifiers, Request for Second Review / Appeal: Partial Payment, Second Review Denial: Missing Documentation, Request for Second Review: Add New Supporting Documents, Denial Incorrect: CPT Codes 99441 - 99443 "Not Payable", Denial Incorrect: CPT Codes 98966 - 98968 "Not Payable", Incorrect Reimbursement: Misapplication of MPPR Billing Ground Rules, Incorrect Reimbursement: PPO / Network Reduction Incorrectly Applied, Incorrect Reimbursement: E/M Downcoding DOS Prior to 3/1/21, Denial Incorrect: 99070 Denied for Dispensed Pharmaceuticals, Denial Incorrect: Medical-Legal Reports and Expenses, Denial Incorrect: Services Rendered Before Liability Decision, Late Bill Submission for Automatic Authorization, Manage Billing Provider Explained - Custom Settings, Manage Billing Provider Explained - RFA Settings, Success Training #1: Organization Administrator Topics, Success Training #2: Essential Basics Topics, Success Training #3: Bill Submission Topics, Success Training #4: Bill Payment and Review Topics, Success Training #5: Reporting and Beyond Topics, NCPDP Success Training #1 Organization Admin, NCPDP Success Training #2 Essential Basics, NCPDP Success Training #4 Bill Payments & Second Review, NCPDP Success Training #5 Reporting and Beyond, daisyBill - Ambulatory Surgical Center (UB-04), UB-04 Success Training #1: Organization Administrator Topics, UB-04 Success Training #2: Essential Basics Topics, UB-04 Success Training #3: Bill Submission Topics, UB-04 Success Training #4: Bill Payment & Review Topics, UB-04 Success Training #5: Reporting and Beyond Topics, RFA Task: Scheduling Information Received, NCPDP Required Billing Information - Explained, UB-04 Settings Required Billing Information - Explained. This process will be "wizard-based," meaning it will walk users through fillable fields of a new eForm. Ensuring this information is available to DME suppliers is important for several reasons: We thank you in advance for helping us spread the word to the supplier community! As we continue to prepare forOnBoard, the Boards new business information system and its early componentOnBoard: Limited Releaseto be available via the Medical Portal this summer, there are a few steps you can take now to gain access to the new system when its ready. In support of their decision to oppose the new fee schedule, the report included specific references to testimony jointly offered by the NYSCA and the Council, who testified at a hearing in the fall, along with other specialty groups. If charts like this don't demonstrate an urgent need for PAs to get involved and start pushing for OTP and legislative parity with NPs, then I don't know what will. ii. The workload administrator will receive and assign all submitted PARs. OnBoard: Building A New Web-Based Claims System Expanded Provider Legislation - NYS Workers Compensation Board Otherwise, please contact your organization's administrator to sign up. On March 28, 2016 the NYS WCB hosted an informational webinar and feedback session regarding the web based Medical Portal they have been developing. Careers at the Board - docs.paidfamilyleave.ny.gov The Centers for Medicare & Medicaid Services (CMS) took steps to limit the impact on Medicare providers and beneficiaries by holding claims paid under the MPFS with dates of service on and after April 1, 2015. See our, To access the Medical Portal and new provider training, you must have an NY.gov ID. The Drug Formulary Prior Authorization request process is now handled through OnBoard, and is referred to as a Medication PAR. If you are new to remote work, ITS is here to help make this change easy - keeping you connected to your Team. An NY.gov User ID and temporary password will be generated for you when you register for Medical Portal access. Workload Administrators may have more than one role. You can also find information on useful tools currently available in the Medical Portal, such as the Drug Formulary and MTG Lookup Tool. Select your Registering Provider's specialty 1b. March 7th Prescription refills and renewals must comply with formulary standards. You may have already received medical treatment. Health care providers and payers are using the new system to submit and review prior authorization requests for medical treatment - all online. This page is available in other languages. OnBoard: A Recap and Preview of What's to Come, Workers Compensation Resources for Claims Administrators, modernization of the New York State Workers' Compensation Board. APIs enable independent computer systems (e.g., stakeholders' systems and the Board's) to talk to one another and exchange data, automating processes and eliminating reducing the need for stakeholders to manually enter data into web-based eForms. All submitted requests will be visible via a dashboard that will contain high-level information about each PAR and can be used by the Workload Administrator to assign the request to individual reviewers. The WCB invites you to attend and ask questions or concerns. PDF What Providers Need to Know - Government of New York OnBoard: Limited Release will allow DME suppliers to submit, Access to OnBoard: Limited Release will occur from the Medical Portal. The Online Administrators are required to maintain accurate information within the application. Be advised that the medical society to which you submit your application may charge a fee to process your application. National Government Services Medical Review Department is currently conducting a prepayment review onJKPart B chiropractic services in the states ofCTand NY. Ensure you are listed on "Listing of Providers Authorized to Submit XML Data". Sign up to Access the Medical Portal OnBoard is one of several key initiatives borne out of the Boards Business Process Re-Engineering (BPR) Program a multi-year effort designed to redefine the Boards role in the workers compensation system, improve access to quality medical care and improve the underlying technology systems that support the organization. Information Technology Services Management (ITSM), New Features of MeetNY Webex Version 42.10.6, Important Telecommuting Security Guidelines, Scheduling With Productivity Tools (WBS39 and Later). PARs will be routed using the contacts and users identified by the administrator. You will need to provide your email address. Please note this will not impact claim submission, but will change the way providers receive information about the status of their claim. For more details, please see the joint announcement on the CMS ICD-10 website. Please see Subchapter M of Chapter V of Title 12 of NYCCR Part 441.1(g) for the definition of the Carriers Physician. For questions about the registration process, call Customer Service at (877) 632-4996. Webex Meetings bring your Team together, face-to-face with video conferencing, high quality audio, messaging, and screen sharing on any device. New enhancement for PAs in NYS - Physician Assistant Forum By law, we cannot accept returns of prescription products for reuse or resale. New York State Workers' Compensation Board - Government of New York Enter basic user information (along with a valid email address) and select a User ID. Following a number of delays, the NY Workers Compensation Board (WCB) announced new formulary rules will coincide with the release of OnBoard. If you are new to remote work, ITS is here to help make this change easy - keeping you connected to your Team. Display as a link instead, 5 downloads. OnBoard: Limited Release - Begin Preparing for Access Today! Slido is an online interactive polling and questions platform that enables you to create a more engaging environment. The report also specifically cited the testimony of Dr. Brown, detailing many of his concerns and objections. Upon approval, emails will be sent to each user designated in the application with their NY.gov ID, temporary password, and additional instructions related to their role. Individual reviewers will also use a dashboard to respond to their assigned requests. The medical portal will allow the prescriber, insurer, self-insured employer, and Pharmacy Benefit Manager (PBM) to request and respond to prior authorization submissions electronically and access the drug formulary and medical treatment guidelines. The following types of health care providers can request access to the Medical Portal. The Board is advancing the OnBoard program in the following areas: The Board continues to expand its use of eForms. This is embarrassing. You will need the following information from that check: check number, check date, check amount and zip code from your mailing address on the check. If you are unsure of your providers status, you can check the list of Authorized Providers here. On May 4, in a report issued by the New York State Assembly Labor and Insurance Committees regarding the proposed Workers Compensation fee schedule changes, the Assembly Majority clearly recommended that the new fee schedule not be adopted, as requested by both NYSCA and the Council. Select the user from the first table on the screen for the role they are being removed from and choose the Remove button. All health care providers must complete both the Authorization Status and Provider Information tabs. my.ny.govNY.GOV ID. Medical Portal Access and Administration: Health Care Providers Customer Service is available from 8:00am to 8:00pm EST, Monday to Friday and 8:00am to 12:00pm EST on Saturday, Toll Free: 1-888-321-7945Prescription Fax Hotline: 800-497-4276Address: 300 Federal St, Andover, MA 01810. If you have an account, sign in now to post with your account. Consistent with New York State Education Department requirements, your supervising physician will retain their role as your supervisor, but no longer needs to sign your medical reports of treatment. And here we have people fighting tooth and nail to keep "Assistant" or "Associate" in our name. . 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. PDF You were injured at work. What now? - HVCC If youd like daisyBill to automatically copy original bills to the WCB via XML on your behalf when available, read on for how to become XML approved! Physicians, PAs, NPs and other types of Board-authorized providers as well as dentists, audiologists and optometrists. Please click here to download Employee Attestation Instructions file Portal Training Videos OnBoard: Registration Guide - Payers, Pharmacy Benefit Managers and Medical Review Organizations. The NY.gov User ID and temporary password will be generated for you when you submit a request for Medical Portal access. Administrator Login. You will see a listing of the required courses by provider type with links and instructions for accessing the courses via the learning management system, CourseMill. Your link has been automatically embedded. If a payer designates an MRO, the MRO User Administrator will maintain users within their organization profile that may review requests. Online Medical Provider Portal - NYSIF In addition to the materials issued by the WCB, IWP is ready to make this transition painless for your office and workers comp patients. If you haven't, you should seek medical care as soon as possible. There are multiple roles designated within OnBoard: The Online Administrators for payers, MROs and PBMs are responsible for creating and maintaining the required contacts and appropriate users needed to review and respond to PARs. NY.gov ID Agency Assistance Contact Information Signing Up for the NYS Workers' Compensation Board Medical Portal NOTE: All Online User Administrators for the Drug Formulary system were automatically granted access to OnBoard and will use the same login credentials. If a Level 2 review is denial is issued, the prescriber may appeal for a Level 3 review to the Workers Compensation Boards Medical Directors Office within ten calendar days. Select the Level 2 Reviewer PAR type from the menu. The NYS Workers Compensation Board Medical Portal is a web-based application that enables users to view and submit medical and Workers Compensation Board information electronically. Select the Online Administrators from the menu. New York has joined the list of states that have passed a Workers' Compensation drug formulary for the prescribing and treatment of injured workers. At IWP, we have an experienced team of workers compensation professionals who are ready and available to make this transition as smooth as possible for your office. How to Become a NYS Workers' Compensation Board Authorized Provider 150 Broadway, Suite 195. However, online administrators should ensure that Workload Administrators and Reviewers are designated for all PAR types and the email address for notifications is correct. When used correctly, APIs will be transformational in terms of providing faster, more efficient workflows compared to current paper-based form processes. This should be the county where you practice the majority of your time. Step 1. However, if you feel we have made an error in filling the, prescription, please call Customer Service toll-free, at, We will request special authorization for a return of the prescription. administration details to prepare for OnBoard: Limited Release. Renew Board authorization and/or update practice information. The prescriber will initially seek prior authorization through a Level 1 review to the insurer/self-insured employer by requesting a specific quantity and number of refills, as well as providing information on why a non-formulary medication should be approved for the injured worker. 1a. As we expand OnBoard to include more processes and stakeholders, the goals are to create a system that improves and expands access to real-time claim data, offers new electronic self-service features for interacting with the Board, and reduces the amount of paper forms used in the workers' compensation system. Insurance Compliance Inquiry. Questions regarding coverage and penalties should be sent to ICUwebmail@wcb.ny.gov. This same email address should be used to apply for authorization and to access required training through the learning management system, CourseMill. The request must be approved, denied, or partially approved within four calendar days this includes holidays and weekends. To ensure that the DME suppliers you interact with are aware of the changes coming with OnBoard: Limited Release, we encourage you to share this communication with them, and urge your suppliers to subscribe forDME supplier notificationsso they can directly receive these updates in the future. Once you have access to the Medical Portal, and before applying for Board authorization, you must complete the following training modules required for PAs: This training is delivered through the CourseMill learning management system, which you will access through the Medical Portal. The system will roll out in multiple phases to best serve injured workers and relevant stakeholders. Clear editor. 2022 12/29/2022 - Update Regarding the Adoption of Amendment of Workers' Compensation Law (WCL) 24 (Attorney's Fees) 12/23/2022 - IMPORTANT DEADLINE: Medical Treatment Guidelines - Training for health care providers 12/14/2022 - Attorney's fees in 2023 11/08/2022 - Additional Change to Schedule Loss of Use (SLU) / EC-81.7 Process The Board will then review your application, notify you whether you have been approved for authorization to treat injured workers, and advise on next steps. While states like Texas and Tennessee have opted for the Official Disability Guidelines (ODG), New York took a much different approach and created a state-specific formulary, with features like step therapies and phases of treatment. 2018 PhysicianAssistantForum.Com. Contact the NYS Workers' Compensation Board Help Desk Enter the requested users information and submit. For chiropractors, authorizations and responses will be primarily centered around variances requests (MG-2 & MG-2.1). Prior authorization requests (PARs) for durable medical equipment (DME) will be part of the new system, along with aDME fee schedule. Upon any Level 1, 2 or 3 prior authorization approval, the payer would be liable for payment of the approved medication, however, upon any prior authorization denial, the party can deny payment of the requested medication. New York State Workers' Compensation Board. In the absence of additional legislation to avert the negative update, CMS must update payment systems to comply with the law, and implement the negative update. Log In. The second table will display a list of users assigned to the organization who are not Workload Administrators for that PAR type. ONBOARD Logo - Navigate to Home. NYS WCB Online Medical Portal Update. When a payer logs into OnBoard, their dashboard "home screen" will display all active requests in need of a response. Pharmacy (Single Prescription) Calculator, Pharmacy (Compound Pharmaceuticals) Calculator, Physicians Services OMFS Calculations Explained, Physicians Services Detailed Explanation Explained, BR - Reimbursement for By Report' Procedure Codes, California Explanation of Fee Schedule (EOFS), Outpatient ASC Detailed Explanation Explained, View / Edit / Delete Physician Fee Schedule Alerts, Wizard Subscription Manage Users Explained, Wizard Subscription Billing and Invoices Explained, added to the WCBs list of approved XML submitters. There is no separate/additional registration needed to use the OnBoard: Limited Release system. It is the responsibility of the insurer to make sure that they indicate the contact information of the DME supplier and that it is within a pre-prescribed distance to the injured worker. For more information regarding registration and accessing the new system, visit theMedical Portal OverviewandAccess and Administrationpages. Workers Compensation Resources for Claims Administrators, Medical Review Organization Medical Portal registration, Requests, which only include the 12-MTG related requests on the, Requests for treatment costing over $1000 for Non-MTG body parts previously done on. Like a Level 1 review, the insurers Physician shall approve, deny, or partially approve within four calendar days. IMPORTANT! Next, indicate your Providers Authorization Status. New York State Workers' Compensation Board Review Level 1 Medication PARs (as designated and assigned). In lieu of holding Summer District Dialogue sessions, the BPR team is going on the road to update interested stakeholders on the status of the BPR project. The medical portal will allow the prescriber, insurer, self-insured employer, and Pharmacy Benefit Manager (PBM) to request and respond to prior authorization submissions electronically and access the drug formulary and medical treatment guidelines. Healthcare providers at this time can request action on unpaid medical bills by submitting Form HP-1.0 on OnBoard. The individual(s) responsible for reviewing Level 2 PARs for a specific PAR type must be the insurers physician or a designated MRO. You may select a user from this list and choose the add button to make the user a Level 2 Reviewer. How Do I Choose the Correct Fee Schedule? The Board is building a new claims system that will replace our multiple legacy, paper-based claims systems with a single, web-based platform. Workers' Compensation | Office of Employee Relations Copyright 2019 NYSCA. Sign up to use the NYS Workers' Compensation Board Medical Portal and/or login with the credentials that have been assigned to you; Complete the required training specific to your profession; Your individual National Provider Identifier (NPI), Currently active certification in the medical specialty for which the physician has applied, by a member board of the American Board of Medical Specialties or the American Osteopathic Association, and for those physicians subject to periodic recertification or maintenance of certification requirements, demonstration that the physician is participating in maintenance of certification, or, Completion of a residency or fellowship accredited by the Accreditation Council on Graduate Medical Education or American Osteopathic Association, in the medical specialty for which the physician has applied, or. daisyBill will automatically transmit XML copies to the WCB if the provider has been approved for XML submission by the WCB. daisyBill will also list an alert at the top of the bill page indicating the XML submission was unsuccessful. Navigate to the NY WCB website to registerfor the Medical Portal. Submitting Medical Documentation: See our Provider Tips for Services for Accepted Conditions.pdf (dol.gov) for links to submit supporting documentation directly to a claimant's case file. Our success in fulfilling this mission relies on our approximately 1,000 employees statewide, who bring their talents to . Screaming this for 15 years here..little has changed. Questions regarding registration and access support should be sent to WCBCustomerSupport@wcb.ny.gov. Similar to a Level 1 review, any denial must be accompanied by the specific reasoning of the insurers physician. Medical Director's Office. Under current law, electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt. The SGR methodology required a 21% decrease in all MPFS payments beginning April 1, 2015. NY State Department of Health Cooling Tower Registration: 518-402-7650 or Cooling.Tower@health.ny.gov - Monday - Friday 8:30am - 4:45pm NY State Department of Health Medical Marijuana Program (Registrations) HelpDesk: 1-844-863-9312 or mmp@health.ny.gov - Monday - Friday 8:45am - 4:45pm, excluding State holidays Click the link titled Agreement for XML submission of CMS-1500 to accept the terms of the agreement.