New York workers’ comp case management billing —
CMS-1500s, OnBoard, and XML.
New York mandated the CMS-1500 in 2022, then required medical bills to arrive as XML from 1 August 2025 through OnBoard. There is no carrier-funded retraining entitlement — vocational referrals go to ACCES-VR — so NYSIF, the carriers and the TPAs are paying case managers, not counselors.
The facts, before the pitch.
How billing works in New York
- Who you bill
- The carrier or TPA.
- What you send
- CMS-1500 (mandated since 2022).
- The channel
- XML e-submission mandatory since 1 August 2025; OnBoard.
- Fee basis
- No published rate we have verified. Ask the New York State Workers' Compensation Board before anyone quotes you one — including us.
- The clock
- Not a deadline we have verified for New York. Ask the New York State Workers' Compensation Board, and read the payer’s own contract, before you rely on a date.
The system. No carrier retraining entitlement — vocational referrals go to ACCES-VR. Medical billing runs on the CMS-1500 with mandatory XML e-submission.
Electronic billing. Providers must e-bill (XML, since 8/2025). Direct electronic submission is on our roadmap and is not something we ship today: Med Claims Pro builds the bill, the report packet and the receivable, and files your proof of what left — you send it through the channel the New York State Workers' Compensation Board gives you.
Nurse case managers in New York are supported today. Invoice-based case-management billing needs no state-specific setup — it works here now. Private vocational rehabilitation in New York is a different story, told plainly further down, and there is a New York voc-rehab list you can join.
Your week, in New York’s documents.
The most electronically demanding jurisdiction in the country, and a caseload that still generates paper documentation nobody automates.
- 7:45 a.m.Three telephonic case calls before the first field visit.Logged as they end, each with the claim number, the adjuster and the referral source.
- 10:50 a.m.Appointment attended in the outer boroughs. Travel, wait time, forty minutes in the room.Three separate lines, priced as you type, because they are three separate questions later.
- 2:20 p.m.Monthly progress report to the TPA.Built on entries already dated and written up — the software generates the weekly log, and the month is four of those.
- 4:35 p.m.Billing assembled: CMS-1500 where the payer wants one, invoice where they do not.A receivable either way, aged by payer from the day it left.
Every one of those rows is typed once, as it happens. The daily log writes itself as you go, the weekly narrative log builds in your own Word template, a CMS-1500 fills with the right units and the right payer block where a payer wants one — and where your state bills on its own form or an invoice, the dated, timed, priced lines that go on it come off the grid, and the receivable is tracked from the moment the bill leaves. The whole chain →
XML submission is a roadmap item, and we are not going to blur that.
New York requires medical bills to be submitted electronically as XML through OnBoard, and has done since 1 August 2025. Med Claims Pro does not do that today. It builds the CMS-1500 or the invoice, the documentation behind it and the receivable in front of it, and it files proof of what you sent — then you submit through the channel the Board or your clearinghouse gives you.
Direct electronic billing for mandate states is on our roadmap. If that is the deciding feature for you, say so on the call and we will tell you honestly where it is rather than selling you a date.
The other New York fact worth knowing: there is no carrier-funded retraining entitlement. Vocational referrals go to ACCES-VR, which is a state agency, not a billing market.
Who pays you in New York.
NYSIF is the eighth largest workers’ comp carrier in the country and the biggest single name here, with the national carriers and TPAs behind it. The CMS-1500 has been mandatory since 2022.
New York payers
- NYSIF (8th largest carrier nationally)
- Private carriers
- TPAs
National carriers you will meet
- Travelers
- The Hartford
- AmTrust
- Zurich
- Chubb
- Berkshire Hathaway
- Liberty Mutual
- AF Group / Accident Fund
- Old Republic
- Great American
TPAs that send the referrals
- Sedgwick
- Gallagher Bassett
- ESIS
- Helmsman
- Broadspire
- CorVel
- TRISTAR
- CCMSI
- Athens Administrators
One check, many claimants. Whichever of these names is on the envelope, the check covers a dozen files at once. You record it once, tick the bills it pays, and anything short is flagged with the exact gap and the original form attached, ready to rebill. How that screen works.
Portal routes and billing addresses go stale faster than any page can keep up, so we publish them only where we keep them current — today that is Ohio’s nine MCOs. Your New York payers and their submission preferences get set up during onboarding, from your own files.
Case files, adjusters, mileage, receivables.
Invoice and CMS-1500 case-management billing both work in New York today. What is on the roadmap is the electronic submission channel, not the paperwork that has to exist before it.
The activity grid
Field visit, telephonic call, wait time at the appointment, the miles there and back — logged once, with the claim number, the adjuster and the referral source attached as you type.
The log behind the bill
A weekly narrative log per case file, dated and grouped, reproducing your own Word template — and where a payer wants a CMS-1500 the software fills one. It does not write an invoice document today: the dated, timed, priced lines that go on yours come off the grid.
Aging by payer
NYSIF (8th largest carrier nationally), the carriers and the TPAs, each with billed, paid and still-owed, and an aging list that names who is sitting on your money.
It is the same week an Ohio vocational rehabilitation case manager works, in different nouns: case files instead of claimants, adjusters instead of MCO coordinators, billable hours and mileage instead of W-codes. Thirty-odd billable touches a day either way, and the same four documents behind every one of them. The nurse case manager page has the whole workflow.
Where the rules actually live.
Ask the New York State Workers' Compensation Board for
- the rules that govern rehabilitation billing in New York
We have not published a verified link set for New York yet, and we would rather send you nowhere than somewhere out of date. If you have the current documents, send them over — admin@onservice.us.
How we keep this page honest
Every fact above is transcribed from the New York State Workers' Compensation Board or the statute named, dated July 2026, and reviewed when the agency republishes. Where we have not verified something we say so rather than filling the gap.
Found something out of date? Tell us and we will fix it the same week: (302) 202-3172 or admin@onservice.us.
See a New York case-management caseload run itself.
Fifteen minutes, a case-management caseload on screen, and an honest answer about what New York voc rehab would need. Or join the New York voc-rehab list and we will write to you when there is something real to show.
There is a phone number and a person answers it: (302) 202-3172.
States that work like New York
Questions, answered.
Does Med Claims Pro submit XML bills through OnBoard?
No. That requirement has been in force since 1 August 2025 and we do not meet it today. We build the CMS-1500 or invoice, the documentation and the receivable and file proof of what was sent; direct electronic submission is on our roadmap. We would rather lose the sale than misrepresent that.
Can I bill vocational rehabilitation to a New York carrier?
There is no carrier-funded retraining entitlement in New York; vocational referrals go to ACCES-VR. Nurse case management is the live billing market, which is what this page sells.
Does it produce a CMS-1500 to New York’s expectations?
It produces the form with the payer block, units and claim details filled from your entries, with automatic overflow past six service lines. Payer-specific details are configured during onboarding from your own filed copies.
Do you handle NYSIF differently from the private carriers?
Only in the way onboarding configures every payer: format, submission preference, address. In reporting they are payer rows with their own billed, paid, owed and aging.
Is my data on your servers?
No. Local database, your own folders, exportable forever, read-only rather than deleted if you cancel.
See your own week run itself.
We load your state’s codes before the call, so you are looking at a caseload like yours inside the first two minutes — not a slide deck.