What Payers Need to Know - Archived Updates
March 30, 2022
OnBoard: Limited Release Phase 1 Now Live!
Phase One of OnBoard: Limited Release (OBLR) is now live, with thousands of decisions on unpaid medical bills and medication prior authorization requests now flowing through the system on a daily basis. Read more about the key processes now available to payers online.
The Board held an OBLR Q&A webinar for payers on March 16. You can access the recorded webinar or slides via the resources section of the Payers OnBoard webpage.
Just a reminder that all prior authorization requests (PARs), including new PARs created in OBLR, and PARs that were processed and completed in the former Drug Formulary application, can be found within the case folder in eCase. You can search eCase using the claimant's Case ID to see PARs related to the claimant as well as the history of a particular PAR. Documents generated in OBLR are immediately placed in the claimant's case folder in eCase.
Phase Two of OnBoard: Limited Release, in which the prior authorization request process for durable medical equipment (DME) will run through the new system and the Board's new DME fee schedule takes effect, is scheduled to launch on April 4. The Board held a training session for OBLR Phase Two on March 22. If you missed the live session, you can view the recording on resources section of the Payers OnBoard webpage.
The Chair has announced that Request for Further Action by Insurer/Employer (Form RFA-2) will be changing to align with the implementation of the third phase of OnBoard: Limited Release. You can read more in Subject Number 046-1503.
Be sure you are up to date with all the latest regarding OnBoard. Visit the OnBoard section of our website for FAQs, details about OnBoard: Limited Release, and sign up to receive notifications.
New Resources on COVID-19 and Workers' Compensation
In February, the Board began hosting a new 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 COVID-19 web page for additional resources, including information on our upcoming COVID-19 webinar.
Additional webinar dates will be added soon!
CMS-1500 Reminders
Beginning July 1, 2022, payers are required to use the new Form C-8.1B and Form C-8.4 with applicable CARCs to object to medical bills. Payers must also provide the EOBs electronically to health care providers identifying the same CARCs as specified on the Form C-8.1B or Form C-8.4. However, there will be a 45-day grace period for payers to accept the older versions of Form C-8.1B and Form C-8.4.
Read more about the CMS-1500 initiative and send your questions to CMS1500@wcb.ny.gov.
Telehealth Update
The Chair proposed the Revised addition of subdivision (g) to section 324.2 of Title 12 NYCRR to provide the option for telehealth visits in some circumstances. A Notice of Emergency Adoption was published in the January 26, 2022, edition of the State Register, and includes billable codes for telemedicine, which is important for payers to be aware of.
You can read more in Subject Number 046-1504.
Stay Informed!
The Board recently hosted its first What Payers Need to Know webinar and will be offering these sessions periodically moving forward. You can access the recorded webinar or slides via the What Payers Need to Know section of the Payers Recorded Webinars and Guides webpage.
That page also features past webinars on a variety of other topics for payers including OnBoard and CMS-1500.
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