WHAT PAYERS NEED TO KNOW - ARCHIVED UPDATES
December 20, 2022
OnBoard PAR Status Email Updates
Change in PAR Status emails will include new information beginning January 13, 2023:
- In addition to the current content in the subject line, the PAR status and WCB Case ID will also be included, providing additional at-a-glance details and making it easier for organizations to apply mail rules.
- The text of the email will now include a due date, when applicable, ensuring the time frame for proper response is clear.
Read more in a notification dated December 8, 2022 .
Updated Paid Family Leave Forms
The Board has updated the request forms for Paid Family Leave (PFL). The revised forms are now available on the Paid Family Leave website. PFL insurers should update any of their own PFL forms, accordingly, by January 1, 2023. Read more in a notification dated December 5, 2022 .
The Board has also updated the Notice of Compliance (Form PFL-120) to include PFL for COVID-19 quarantine leave. Read more in a notification dated December 9, 2022, and email certificates@wcb.ny.gov to obtain a copy.
Payers Must Use and Fully Complete Form IME-5
The Board requires the use of the current Claimant's Notice of Independent Medical Examination (Form IME-5) when notifying an injured worker that an independent medical exam is required. This form must be fully completed, including the purpose of the exam and the IME provider's authorization number.
Read more in a notification dated November 29, 2022 .
Adoption of Amendment 12 NYCRR 440.8
The Chair has adopted the addition of subdivision (c) of section 440.8 of Title 12 NYCRR, restoring language requiring self-insured employers and insurance carriers to notify pharmacies when there is a network that the injured worker must use.
Read more in Subject Number 046-1568.
CMS-1500 Medical Narrative Attachment Update
Health care providers are strongly encouraged to include causal relationship, work status and temporary impairment on most medical narrative attachments to the CMS-1500.
There are several instances, however, in which this information is not as critical to the payer, or the Board, and it is not needed to properly adjudicate the medical bill.
Payers should not routinely file a Notice of Objection to a Payment of a Bill for Treatment Provided (Form C-8.1B) to deny payment to health care providers solely based on the absence of one or more of these three elements.
Read more in a notification dated November 18, 2022 .
Reminders
Use of the CMS-1500 is now mandatory. Visit CMS-1500 initiative for more details and send your questions to CMS-1500@wcb.ny.gov.
OnBoard is now live. Visit the Board's website for training guides, webinar recordings, and other resources.
The Board is hosting free COVID-19 & workers' comp webinars. The Board has been hosting a series of webinars to aid workers with long-haul COVID-19 workers' compensation claims. Additional webinar dates are now available.
The latest versions of several Paid Family Leave presentations are now available, including family care, foster care/adoption, military leave, and bonding. Visit the Paid Family Leave website for more information.
Stay Informed!
Check out the Board's Payers Recorded Webinars and Guides web page for past webinars.
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