Update to Workers’ Compensation Dental Claim Submissions

The NYS Workers’ Compensation Board continues to upgrade its claims submission process. OnBoard is a web-based platform that will enable providers to submit dental and medical claims and prior authorization requests electronically. Providers will have access to real-time claims data and will be able to track claims status.

Phase 3 of the OnBoard Project, which includes the submission of prior authorization requests (PAR), went into effect on May 2, 2022. Workers’ Compensation Law requires that if the cost of the procedure(s) will exceed $1,000 (according to the dental fee schedule); the dental provider is required to request prior authorization. All PARs should now be submitted electronically.

Beginning July 1, 2022, providers will be required to submit claims electronically, using the CMS-1500 form.

In order to submit PARs and electronic claims, providers must first register for access to the Medical Portal. It may take up to five business days for the Board to review your registration. Once your registration is approved, you will receive an email containing an ID number and temporary password to access the Medical Portal.

After logging into the Medical Portal, providers who have not already signed up for XML submission of the CMS-1500 will see a link "Agreement for XML submission of CMS-1500" under the Billing section. Select the link and click the "I Accept" button.

If providers want to find an XML submission partner who can submit CMS-1500 files on their behalf, a list of approved XML submission partners and their contact information is available on the Board’s website.

To receive updates, dentists should register for OnBoard emails. The Board is hosting webinars, which provide training and updates on the OnBoard system, in addition to factsheets, website content, instruction guides and tutorial videos to demonstrate use of the new system.

Additional Information

Learn more about the CMS-1500 Initiative.

Questions about the registration process: Contact Customer Service at the Workers’ Compensation Board, 877-632-4966.

Questions about OnBoard: OnBoard@wcb.ny.gov

Questions about the CMS-1500 initiative: CMS1500@wcb.ny.gov

Additional questions may be directed to Jacquie Donnelly at NYSDA: jdonnelly@nysdental.org.

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