New York's Workers’ Compensation Board is asking providers to be proactive and get ahead of a major impending change: Electronic billing will be mandatory by this time next year.

Catherine Montgomery

In a recent message, WCB Chair Clarissa M. Rodriguez reminds providers that the WCB will not require claims administrators to pay bills that were submitted in paper form on or after Aug. 1, 2025 (but will continue to enforce payment of paper bills sent prior to Aug. 1).

As any provider, biller or practice administrator knows, it’s best not to wait until you’re up against a deadline to make a major administrative change. New York doctors who aren’t currently e-billing should take action now to identify a state-approved e-billing partner and start the transition.

WCB: Switch to e-billing STAT

The WCB is in the midst of transitioning New York workers’ comp to more standardized, efficient e-billing in a multi-stage process, as follows:

• Starting in 2019, providers were granted the option of switching from New York-specific billing forms to the universal CMS-1500 billing form.
• In 2022, use of CMS-1500 became mandatory for workers’ comp billing. Providers were “strongly encouraged,” but not required, to submit the CMS-1500 electronically.
• Beginning Aug. 1, 2025, medical bills for workers’ comp treatment must be submitted electronically using the CMS-1500.

Starting Aug. 1, 2025, claims administrators are free to deny payment of any bill not submitted electronically through a state-approved XML submission partner (like daisyBill). Providers are free to determine the approved XML submission partner of their choice; claims administrators may not dictate any particular vendor.

Providers are also “strongly encouraged” to submit the required medical narrative report, which must accompany each CMS-1500 submission, using the report template provided by the WCB.

To borrow a phrase from the WCB, we strongly encourage New York providers who are not yet e-billing to make the transition sooner rather than later (regardless of their ultimate choice of submission partner).

This is more than compliance with the state’s mandate; e-billing makes the administrative side of treating injured workers easier, more efficient and ultimately less costly. E-bills are automatically tracked and monitored, with time stamps documenting and proving when e-bills were received and when payment is due — and payment comes drastically faster.

Give your practice the benefit of e-billing and avoid any lost bills or delayed payments as a result of waiting too long to make the switch. 

Catherine Montgomery is the co-founder and CEO of daisyBill, a provider of workers' comp end-to-end revenue cycle management software. This post appears with permission.