Electronic billing (e-billing) is helping New York providers get paid faster than ever for treating injured workers.

As workers’ comp providers prepare for New York’s 2025 transition to mandatory electronic billing, it’s important to remember that payers are also subject to e-billing requirements. Namely, payers must respond to providers’ e-bills with electronic Explanations of Review (e-EORs).

With that, daisyNews offers sincere kudos to the New York State Insurance Fund (NYSIF) and its new clearinghouse vendor, Jopari. For the first time, the non-profit insurer sends compliant e-EORs to providers.

• Effective January 7, 2025, NYSIF switched clearinghouses from Carisk to Jopari.
• On January 8, 2025, a daisyBill provider submitted an e-bill to NYSIF.
• On January 15, 2025, NYSIF responded with payment and a compliant e-EOR.

That’s right—NYSIF paid this provider five working days after the e-bill submission. Providers can expect reimbursement in record time with e-billing available (and with payers in compliance).

NY Provider Paid in 5 Days Flat

For those unfamiliar with e-billing, an e-EOR is the electronic version of the paper Explanation of Review (EOR), sometimes called an Explanation of Benefits (EOB). In many states, including New York, payers must respond to e-bills with e-EORs.

The New York Workers’ Compensation Board (WCB) affirms the e-EOR requirement on the FAQ page (pictured below) for its “CMS-1500 Initiative,” a.k.a. the statewide project to make all workers’ comp billing and payment electronic.

However, almost every payer lacks the technology to accept and compliantly respond to providers’ e-bills (the exceptions being CorVel and the federal Department of Labor). To comply with state requirements, payers hire clearinghouses to accept and respond to e-bills on their behalf.

Until recently, NYSIF was out of compliance with the WCB requirement to send e-EORs.

However, as we covered in this article, NYSIF changed its clearinghouse vendor from Carisk to Jopari, effective January 7, 2025. The next day, January 8, a daisyBill provider submitted an e-bill to NYSIF. As the screenshot from daisyBill below shows, NYSIF responded with payment and a complete e-EOR just five working days later.

Quick payment is not the only benefit, however.

Most importantly, this complete, compliant e-EOR automatically posts all the payment details into daisyBill. Every data point, including the amount received, any reductions applied, payment speed, and more, is logged into the analytics, making revenue management infinitely easier.

The software tracks every detail and metric as e-bills go out and e-EORs roll in. The provider’s staff will know when to take action (such as appealing improper payment denials and reductions), and revenue won’t languish in Accounts Receivable for months on end.

Treating injured workers does not have to be the administrative hassle that providers may (understandably) fear. If you have any questions regarding the August 1, 2025 switch to mandatory e-billing, contact our experts using the pink chat icon at the bottom right of this screen or email us at info@daisybill.com.

Don’t sweat the transition to mandatory e-billing. As a NY WCB-approved submission partner, daisyBill can show your practice the ropes.

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