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NYS Society of Orthopaedic Surgeons, Inc.
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PILOT Project: Draft Medical Treatment Guidelines
NYS Workers Comp PILOT Project Regarding Medical Treatment Guidelines
NYSSOS has been asked by the NYS Workers Compensation Board to find Orthopaedic Surgeons interested in participating in a PILOT project regarding the use of new draft Medical Treatment Guidelines. NYSSOS is extremely interested in finding as many offices as possible to participate in this project in an effort to identify those areas of the Guidelines that do not work well so that they can be amended before the draft Medical Treatment Guidelines are proposed for final adoption by the State of New York.
A full description of the draft PILOT project prepared by the NYS WCB can be viewed at: Pilot Project Description. Please note that this is only a draft and may be amended prior to the project commencing. Interested physicians/physician offices will be given a briefing prior to the start of the project and your expression of interest in the project now does not act as your final commitment (once you learn more about the project, you can decide you do not want to participate).
The three carriers that the NYS WCB anticipates will participate include Xerox, State Insurance Fund and Liberty Mutual. If you do a significant amount of work with these carriers, NYSSOS encourages you to give serious consideration to participating in this project. For your further information, the Medical Treatment Guidelines are uploaded and linked below.
If you are interested in participating in this project, please send your name, address, phone number and email address to NYSSOS or call (518) 439-0000. Your reply is requested by July 8, 2009.
Draft Medical Treatment Guidelines
The draft Medical Treatment Guidelines from the NYS Workers Compensation Board include:
C4 Forms: Efective Date April 1, 2009
The following information was posted on the NYS Workers Compensation Board website on March 23, 2009. A link to the full alert in included below.
Mandatory Use of New And Revised Medical Report Forms on April 1, 2009
This is to remind all doctors that they must use the new C-4 family of forms for any and all treatment provided on and after April 1, 2009.
The WCB Board will not enforce payment for any examinations, services and/or treatments provided that are not reported using the correct new C-4 form for services provided on and after April 1, 2009. In addition, the Board will investigate why the doctor is not using the correct new form and, if warranted, issue an administrative warning or commence temporary suspension or revocation proceedings.
PLEASE NOTE: While the new C-4 family of forms must be used to report services and/or treatments provided effective April 1, 2009, the doctor has the option of including a HCFA-1500 or CMS-1500 form for billing purposes only along with the prescribed Board medical report.
Doctors and or facilities contracting with an XML Submission Vendor, (Clearinghouse) for the submission of Form EC-4NARR have the option of submitting to the carrier, the CMS 1500 along with the required narrative and the other required fields contained in the submission.
For more information, please visit:NYS Workers Compensation Board C4 Information
For an online tutorial of how to file the new C4 forms, please visit:C4 Online Tutorial
For detailed information about frequently asked questions, please visit: WCB C4 Q&A
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