NYS How-To: Register for XML Submissions

NYS How-To: Register for XML Submissions

New York State’s much-needed transition to electronic billing marches on, but not without its growing pains.

Namely, the NYS Workers’ Compensation Board (WCB) requires providers to submit a copy of every bill to the WCB. But to do so electronically  even when the provider bills through an approved partner like daisyBill  requires the provider to navigate an arduous XML registration process.

Read on for step by step instructions on how to register to electronically submit bills to the WCB. Whether you’re a daisyBill client or not, following the steps below is worth the effort for faster, easier, less frictious workers’ comp billing.

Why NYS e-Billing Providers Should Register for XML Submission

NYS providers who choose to bill electronically can submit bills in Extensible Markup Language (XML) format, through an Extensible Markup Language Submission Partner (XML Submission Partner), like daisyBill. The provider is responsible for choosing an XML Submission Partner from the list of WCB-approved entities.

Billing electronically via the XML process in NYS works as follows:

Step

Entity

Responsibility

Timeframe

1

Provider

Submits the bill and narrative report to the XML Submission Partner (in any format agreed upon between the provider and Submission Partner)

Within 48 hours of rendering treatment

2

XML Submission Partner

Submits e-bill and the narrative report (in XML, .tif, or .tiff format) to the employer’s claims administrator

Within 7 business days of receipt of the bill and report from the provider

3

Claims Administrator (or claims administrator’s clearinghouse)

Acknowledges receipt of provider’s e-bill

Within 7 days of receiving provider e-bill

4

XML

Submission Partner

Submits electronic copies of the CMS-1500, narrative report, and payer acknowledgment of receipt to the WCB

Within seven business days of receipt from the treating provider

5

Claims Administrator (or claims administrator’s clearinghouse)

Returns electronic Explanation of Review (EOR) or objects to the bill

Within 45 days of receiving the provider’s e-bill

However, the complexity lies in Step 4. If the provider fails to obtain XML submission approval from the WCB, the WCB does not allow the provider’s XML Submission Partner to submit the required electronic copies of the bill and report to the WCB.

In order for a provider to take the fullest advantage of e-billing and enable the XML Submission Partner to send bill submissions to the WCB, the provider MUST register with the WCB. The WCB accepts XML submissions only for registered providers.

For example, the screenshot below from daisyBill software demonstrates that for an XML-approved provider, the Bill History indicates that daisyBill submitted the e-bill and report copy to the WCB.

Conversely, for unregistered providers, the WCB rejects XML submissions sent by the XML Submission Partner. For example, the screenshots below from daisyBill software demonstrate that the WCB rejected the XML submission daisyBill sent on behalf of the unregistered provider.

Unregistered providers must submit a copy of the bill and report to the WCB via mail, fax, or email. Additionally, when the WCB rejects an XML submission for a provider, daisyBill adds an alert to the bill along with a link for the provider to register to be an approved XML provider.

Treating injured workers is challenging enough! Follow the steps below, and let the XML Submission Partner send copies of all e-bills to the WCB.

How to Register for XML Submission for NYS Workers’ Comp

To have your XML Submission Partner automatically copy your workers’ comp e-bill submissions to the WCB on your behalf, take the following steps:

Step 1. Register for the Medical Portal

First, providers must register for the WCB Medical Portal from the WCB website’s registration page (if already registered for the portal, simply log in and skip to Step 2). Click ‘Continue’ to begin.

Step 1a. Select Specialty

Next, choose your medical specialty from the dropdown menu.

Step 1b. Determine Authorization Status

Indicate your Authorization Status. If you’re unsure of your status, you can check the “Listing of Providers Authorized to Submit XML Data” here.

Once the Provider’s Authorization status has been selected, click ‘Next’.

Step 1c. Enter Requisite Information

Fill out the required information fields, then click ‘Submit.’

It may take 3 to 5 days for registration for the Medical Portal to process, and to receive the necessary credentials to log in to the Medical Portal.

Step 2. Access the Medical Portal

Once you have received credentials to access the Medical Portal, use them to log in.

Step 3. Locate the ‘Billing’ Section of the Medical Portal

Step 4. Accept the terms for ‘Agreement for XML submission of CMS-1500’

Click the link titled ‘Agreement for XML submission of CMS-1500’ to accept the terms of the agreement. Once accepted, the link will no longer appear on subsequent logins.

Step 5. Ensure you are listed on "Listing of Providers Authorized to Submit XML Data"

Once the provider is added to the WCB’s list of approved XML submitters, your XML Submission Partner will be able to automatically copy all future XML bill submissions to the WCB.  

By putting the time in to register for XML Submission, your practice will save countless hours in the long run, while also ensuring that no bill submission copies are lost in the mail or otherwise not documented for future reference.

If you have any questions about e-billing in New York State, just reach out to daisyBill. We are here to help.


Protect your practice. Harness the power of daisyBill software, data, and expertise for faster, better workers’ comp billing. Reach out to learn how we can help.

CONTACT US

How did you like the article ?

DaisyBill provides content as an insightful service to its readers and clients. It does not offer legal advice and cannot guarantee the accuracy or suitability of its content for a particular purpose.