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OnBoard A Better System for a Better Board

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The next chapter in the modernization of the New York State Workers’ Compensation Board, the OnBoard Project, is well underway. The Board, with our integration partner CapTech Consulting, is building a new claims system that will replace our multiple legacy, paper-based claims systems, such as CIS and eCase, with a single, web-based platform.

The new system will offer exciting elements, including improved and expanded access to real-time claim data, new electronic self-service features for interacting with the Board, and a reduction in the amount of overall paper forms to improve system responsiveness to stakeholder needs.

Timeline

The multi-year project officially kicked off in Summer 2019, with CapTech Consulting on site and actively working with Board staff to design the new and improved system.

The Board is committed to identifying opportunities to release system functionality early, to better assist stakeholders. Therefore, elements of the OnBoard system will be released in multiple waves:

  1. OnBoard: Limited Release – Spring 2021
  2. eClaims EDI R3.1 Upgrade – Mid-2021
  3. OnBoard system – 2023

OnBoard: General FAQs

  • When will the new system be available?

    The OnBoard system is targeted for 2023. A limited release of the OnBoard system is planned for early 2021. OnBoard: Limited Release includes prior authorization request (PAR) processing and Provider’s Request for Decision on Unpaid Medical Bill(s) (Form HP-1) submission.

  • What are the biggest changes to the forms process?

    Most Board-required forms will be available as eForms, which:

    • Are interactive, browser-based screens that pre-populate with any known data.
    • Guide the user to fill in any remaining required information.
    • Allow the user to save a draft of a partially completed eForm for later completion and submission.
    • Validate information instantly to flag inaccuracies or incomplete items, for significantly faster corrections and processing time.
    • Allow for the attachment of necessary documentation.
    • Are processed and placed in the electronic case file immediately.
  • Will I be required to submit eForms to the Board, or will paper forms still be accepted?

    • Claimants are encouraged, but not required, to submit information electronically. The new system will be easier to use, confirm all required information, and allow for real-time status tracking.
    • Non-claimant parties will be required to submit most forms electronically via the new system.
  • When I submit an eForm, when will I have confirmation that it has been received and is being processed?

    When you submit an eForm, you will receive immediate feedback regarding potential missing information, and processing confirmation. You will also be able to download a PDF of your eForm submission.

  • We currently use our own claim management computer software to generate Board paper forms. Will the new system allow our computer software to communicate with the Board to automatically send eForm data?

    Yes. An Application Programming Interface (API) will be available as part of the full release of OnBoard in 2023 for stakeholders to communicate directly between your computer system and the Board to automate the submittal of eForms. If you are interested in becoming a testing partner, please contact us at OnBoard@wcb.ny.gov.

  • Can we submit forms in another language?

    Claimant-based eForms within the system will be available for the most common non-English languages spoken in New York State (based on the most recent United States census data), as designated in New York State’s Language Access Policy (LAP).

  • Is eCase being replaced?

    Yes. The final, full system will improve upon and replace eCase.

  • If I am already registered for eCase, will my registration transfer to the new system?

    The Board will use existing user profile information for those already registered to use our online services. This will help support a smooth user transition to the new system. Existing users will receive details before the new system is available.

  • Can we track claim status?

    Yes. Users will have access to view claim information based on secure, role-based permissions. Access will be available 24/7.

  • Are there opportunities to test prior to the system going live?

    This project will involve significant testing, and we’re looking for volunteers! If you are interested in participating, please contact us at OnBoard@wcb.ny.gov.

  • Will there be training regarding how to use the new system?

    Yes. Training videos, reference guides and other supporting materials will be provided for you to learn the new system.

  • Where can I go for more information? Who can I contact?

    The project website is updated regularly with the latest information. You can also subscribe to receive email alerts when updates are made. If you have specific questions or feedback, please email the Board at OnBoard@wcb.ny.gov.

For limited release FAQs, see OnBoard: Limited Release.

OnBoard: Limited Release

  • What benefits will be introduced with OnBoard: Limited Release?

    Stakeholders will experience several major benefits with the new OnBoard system. However, building a new, integrated system from the ground up takes time. That’s why we’re starting with some high-priority processes that will benefit from moving online.

    The Expanded Provider Law that took effect on January 1, 2020, is significantly increasing the number of providers that can be authorized to treat injured workers. More providers also means an increase in prior authorization requests (PARs). To support Board-authorized providers, the Board is focusing on the early release of digital PARs and the Request for Decision on Unpaid Bills (Form HP-1), as well as on building out the end-to-end processing of PARs for early release to providers and insurers.

    OnBoard will offer exciting upgrades to data collection and availability, streamline processes, and, via straight-through processing, increase the speed with which injured workers can get the treatment they need. For example, PARs and Form HP-1 in paper form will be replaced with intuitive, web-based wizards that will prepopulate known data and walk users through the unique data required for the request. Rather than needing to know form names and numbers, where to find them, and who to send them to, users will be guided by the system to enter required data. Built-in logic will automatically create electronic forms (eForms) for reference and route the request appropriately.

    Using wizards and other methods for collecting and validating data, versus scanned images of paper forms, will result in vastly improved system responsiveness to stakeholder needs.

    Additional benefits debuting in the limited release of OnBoard will be the ability for insurers and providers to communicate directly concerning a PAR, as well as to access the status of a PAR on demand.

  • What are the key differences between OnBoard: Limited Release and OnBoard?

    OnBoard: Limited Release OnBoard
    Timing: Spring 2021 Timing: 2023

    Purpose:

    This first phase of the OnBoard project will allow providers to easily submit Prior Authorization Requests (PAR) for care, as well as a Provider’s Request for Decision on Unpaid Medical Bill(s) (Form HP-1). OnBoard: Limited Release will also simplify and improve processing time while streamlining the prior authorization process.

    Purpose:

    The full launch of OnBoard will serve as the Board’s new web-based claim’s platform. The new system will streamline and replace the Board’s legacy, paper-based systems.

    External Stakeholders:

    • Health Care Providers
    • Medical Suppliers
    • Insurers
    • Third-Party Administrators

    External Stakeholders:

    • Attorneys
    • Injured Workers
    • Employers

    Details:

    • Digitize and streamline the PAR process
    • Digitize the intake process for the Form HP-1
    • Add Durable Medical Equipment (DME) and Non-MTGs* < $1,000 prior authorization
    • Replace the Drug Formulary** currently available in the Medical Portal with Medication prior authorization via OnBoard
    • Auto-transfer completed forms to the CIS case folder and user work queues, as needed (e.g., Claims, Disputed Medical Bills)

    Details:

    • Expanded access to claims data
    • Real-time status information and alerts
    • Self-service interaction with the Board
    • Replaces eCase
    • 24/7 access
    • Integration with other Board systems
    • Greatly reduced reliance on paper forms
    • Increased data accuracy, reduced duplication and time delays, and more logical workflows
    • More organized and linked data

    *New York Workers’ Compensation Board’s Mid and Low Back Injury Medical Treatment Guidelines

    ** New York Workers’ Compensation Drug Formulary

  • What is a Prior Authorization Request (PAR)?

    A PAR is a requirement for an injured worker’s health care provider to obtain prior approval from the payer before the costs associated with a specific treatment are covered under workers’ compensation. There are several categories of treatment that require prior authorization. The Board requires prior authorization information related to workers’ compensation treatment to be shared with, and sometimes adjudicated by the Board’s MDO.

  • What is a Request for Decision on Unpaid Bills (Form HP-1)?

    A Form HP-1 is a form by which a health care provider requests that the Board determine whether an insurer should pay a medical bill which they previously declined to pay in full, or in part. The Form HP-1 is submitted when the health provider has been unsuccessful in obtaining payment from an insurer for services rendered to a patient who has a workers' compensation case. See more detailed information on the Form HP-1 process.

  • Who benefits from having the PAR processes centralized within the OnBoard system?

    Because the new system will automate data validation, reduce duplication, streamline processes, and trigger action automatically, everyone benefits. Providers will have a clearer path to authorization, insurers will get needed information quickly, injured workers will have faster access to appropriate treatments, and employers will benefit by their healthy employees returning to work faster.

  • What are the different types of PARs? Are any new?

    In New York State, there are currently five types of PARs. Concurrent with the release of OnBoard, there will be a total of seven PAR types:

    1. MTG Confirmation (Attending Doctor's Request for Optional Prior Approval and Carrier's/Employer's Response [Form MG-1])
    2. Durable Medical Equipment (new)
    3. Medication (currently known as Drug Formulary and Provider’s Request For Formulary Prior Authorization and Insurer’s Response [Form DF-L1])
    4. Non-MTG Over $1,000 (Attending Doctor's Request for Authorization and Carrier's Response [Form C-4 AUTH])
    5. Non-MTG Under $1,000 (new)
    6. MTG Special Services (included on Form C-4Auth)
    7. MTG Variance (Attending Doctor's Request for Approval of Variance and Carrier's Response [Form MG-2])
  • How will I know the status of my PAR or Form HP-1?

    The status of any requests will be easily visible in the limited release of OnBoard. Providers and insurers can log in 24/7 to view and act on their queue of active requests. Email and text notifications are also available to alert users when a status change has occurred.

For general project FAQs, see OnBoard: General FAQs.

Get Involved & Stay Informed

The Board is committed to partnering with our external stakeholders throughout the project to gain critical input to ensure the new system addresses their needs. Keep an eye on our upcoming webinars page for upcoming OnBoard Project webinar announcements. Your thoughts, concerns, and ideas are always welcome and appreciated. You can reach the OnBoard Project Team at OnBoard@wcb.ny.gov.

The Board will also be sharing regular updates as we make progress on this important project. To stay informed on the OnBoard Project, please watch this page and subscribe for email updates.

A Business Process Re-Engineering Project

The OnBoard Project is one of several key initiatives borne out of the Board’s Business Process Re-Engineering (BPR) Program - a multi-year effort designed to redefine the Board’s role in the workers' compensation system, improve access to quality medical care and improve the underlying technology systems that support the organization. Many BPR initiatives have already been implemented, including virtual hearings, release of an updated medical fee schedule for Board-authorized providers, implementing performance standards to improve payer compliance, and improving the Board’s dispute resolution processes.

Resources

  • Intro to OnBoard: VideoLink to External Website
  • Business Information System (BIS) Project Webinar - January 14, 2020: VideoLink to External Website / Slides adobe pdf
  • Business Information System (BIS) Project Q&A Webinar - January 21, 2020: VideoLink to External Website / Slides adobe pdf