Extensible Markup Language (XML) is an industry-standard format which provides an infrastructure to allow the electronic submission of data. The Workers' Compensation Board's (Board) CMS-1500 initiative utilizes XML as the vehicle for submission of the CMS-1500 form and its corresponding medical narrative reports and/or attachments. All health care providers and XML submission partners submitting XML CMS-1500 data to the Board must be registered, as described below.
To be eligible for XML submission of CMS-1500 forms to the Board, providers must first register with the Board. Upon successful registration, the Board will mail a Treating Health Care Provider’s Agreement for XML Submission of CMS-1500 Forms and Medical Narrative Reports for the provider to execute, notarize and return to the Board. The Board will notify the provider by email, at the email address provided on the registration, that he/she may inform their Board-approved XML submission partner that CMS-1500 XML submission may commence. Providers who currently submit XML data to the Board (i.e., on an EC-4NARR) do not need to execute a new legal agreement. Listing of Providers Authorized to Submit XML Data (MS Excel)
When CMS-1500 forms are submitted to the Board using the XML submission process, DO NOT mail, fax or email a duplicate paper form to the Board. The workers' compensation law requires providers to submit copies to the claimant, employer, insurance carrier, claimant representative, etc. It is the provider's responsibility to ensure that this reporting requirement is met.
XML Submission Partners
All XML submission partners, including existing ones, must execute a Test Agreement for Business Partners Submitting Medical Reports in XML Format, successfully complete CMS-1500 XML testing and execute a new XML Submission Partner's Agreement for XML Submission of CMS-1500 Forms and Medical Narrative Reports on Behalf of Health Care Provider with the Board. Clearinghouses interested in becoming an XML Submission Partner will need to register first with the Board.
The Board will accept the CMS-1500 form, medical narrative and/or attachments, and acknowledgment receipts from payers, using the Board's specific XML form submission process. When mandatory, XML submission partners may also be required to submit reporting metrics to the Board documenting the efficiency of form submission to the payer.