As of July 1, 2022 the New York State Workers’ Compensation Board (WCB) requires providers to use the CMS-1500 form to submit bills for the treatment of injured workers.

Additionally, providers will be required to submit bills electronically beginning in 2025.

Providers must e-bill through an approved Extensible Markup Language (XML) Submission Partner, one that is approved by the WCB to transmit the CMS-1500 and supporting documents in strictly specified electronic formats.

Below, we break down the technical requirements (which daisyBill is fully equipped to handle on behalf of providers) for compliant e-bill submission.

New York State WCB XML Requirements

To compliantly transmit an e-bill for treating an injured worker, New York State providers must utilize an approved XML Submission Partner such as daisyBill to both:

1. Submit the e-bill and supporting documents to the claims administrator for payment
2. Submit compliant e-bill data and supporting documents (in the mandated XML format) to the WCB

Important Note: the provider must register to submit XML submissions to the WCB. Once registered, the XML Submission Partner can forward the e-bill data and supporting documents to the WCB.

For every e-bill accepted by the claims administrator, the provider’s XML Partner must submit the billing data and supporting documents to the WCB in a ZIP file containing the following:

• The CMS-1500 bill data in XML format, and
• A TIFF file of the supporting documents that must accompany the e-bill

Adhering to WCB e-billing requirements therefore requires billing software (provided by the XML Submission Partner) that does all of the following:

• Renders CMS-1500 information in XML format, and
• Creates TIFFs of the supporting documents, and
• Sends the entire submission to the WCB as a ZIP file

CMS-1500 → XML

Converting e-bill information into the mandated XML format requires expertise and experience. Below is an image furnished by the WCB, mapping the details of how the provider’s billing software must use CMS-1500 data to submit in the XML format (No, this is not a cruel joke; it’s reality).

If it looks intimidating, rest easy!

That’s what your XML Submission Partner is for — to help your office meet the technical requirements.

We welcome all e-billing questions from New York State providers, clients or otherwise. Simply contact daisyBill, and we’ll be happy to share our expertise.

Need a hand making the transition to workers’ comp e-billing? daisyBill makes it easy. Reach out to see how we can help your practice.

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