Workers' Compensation Dental Claim Submissions

(Reviewed January 19, 2024)

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

Providers are now required to submit claims electronically, using the CMS-1500 form. All Prior authorization requests (PARs) should be submitted electronically as well. 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.

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.

Additional Information

You can visit the Board's website for CMS-1500 news, FAQs, and more. The Board has also created a special webpage dedicated to sharing timely updates on various Board initiatives with a health care provider focus. Visit What Providers Need to Know.

Questions about OnBoard: OnBoard@wcb.ny.gov

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

For clinical feedback and questions, email provider@wcb.ny.gov.

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