New York workers’ comp case management billing —
CMS-1500s, OnBoard, and XML.

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.Written once from the entries, in your own template, and filed to the case folder.
• 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.

One check, four claimants, one short-pay caught at $16.14, $674.07 still owed. Invented names, real workflow — and the same screen whether you invoice a TPA in New York or an MCO in Ohio.

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, the invoice fills with the right units and the right payer block, and the receivable exists the moment the bill leaves. The whole chain →

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.

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.

Payer fax numbers 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, their submission addresses and their quirks get set up during onboarding, from your own files.

Case files, adjusters, mileage, invoices.

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.

It is the same week Dana works in Ohio with different nouns: case files instead of claimants, adjusters instead of MCO coordinators, billable hours and mileage instead of W-codes. The nurse case manager page has the whole workflow.

Questions, answered.