The New York State Workers’ Compensation Board (Board) is pleased to share that we have reached our one millionth prior authorization request (PAR) submission via our new business information system, OnBoard! Even more exciting, with all one million of these submissions:

• Only 5% of these PARs have needed escalation to Level 3 review.
• Less than 1% have required a referral for conciliation or a hearing.

This means that less processing time is needed for the majority of PARs submitted, resulting in more efficient and effective delivery of benefits to injured workers. Now, let’s look at a breakdown of this milestone by PAR type.

Breakdown by PAR type

Request Type	Request Count
Durable Medical Equipment	37,161
MTG Confirmation*	335,123
MTG Special Services	45,250
MTG Variance	242,403
Medication	351,037
Non-MTG Over $1000	1,663
Non-MTG Under or =$1000	9,092
Grand Total	1,021,729

*NOTE: The submission of MTG Confirmation PARs is completely optional for health care providers. Treatment for a given condition that a provider knows to be specifically recommended by the New York Medical Treatment Guidelines (MTGs) is pre-authorized and does not require a Confirmation PAR, except for those relatively few special services for which a Special Services PAR is always required.

OnBoard efficiencies

Since the launch of the first phase of OnBoard in May of 2022, health care providers and payers have been using OnBoard to submit, review, and approve PARs for medical treatment. Since then, 95% of PARs have been resolved without Level 3 review within 30 days or less, depending on the mandatory response time frame of the PAR type. For the other 5%, all medication, durable medical equipment (DME), behavioral health, and “carrier unknown” PARs are being resolved on the same or next business day. Also, all special services PARs are being resolved within three weeks. These enhancements and diligent response times make for a better stakeholder experience and improve the workers’ compensation system as a whole.

New enhancements – coming soon!

Since the beginning of OnBoard, the Board has made more than 45 enhancements to the system and will continue to make improvements based on user feedback. Two additional enhancements are currently underway: Level 1 grant without prejudice and the ability for delegates to submit PARs on behalf of authorized providers. The Board will be announcing the availability of these, and other future enhancements, via WCB Notifications – sign up today if you haven’t already!

Level 1 grant without prejudice

In OnBoard today, payers can only grant a prior authorization request without prejudice at a Level 2 review. Based on stakeholder feedback, the Board is working to implement an enhancement to the system that would allow a Level 1 reviewer to grant without prejudice when a body part/condition has not been accepted or established. This will prevent the need for payers to escalate a PAR to a Level 2 review when the PAR could be granted without prejudice at the Level 1 review and will result in faster payer responses and eliminate unnecessary escalation to Level 2 reviewers.

Delegate submission of PARs

In OnBoard today, all PAR submissions must be done by the provider using their own system credentials and authorized delegates are not permitted to submit a PAR on behalf of the provider. Based on stakeholder feedback, the Board is working to implement an enhancement to the system that would allow provider “delegates” to submit PARs on behalf of authorized providers. The provider will still be responsible for all clinical diagnostic and treatment information contained in the PAR, but the administrative process of submitting the request may be handled by an authorized delegate. This enhancement will result in efficiencies for provider submissions while still protecting the integrity of OnBoard’s security protocols.

Tips to enhance your experience

We previously created a list of 10 tips to help enhance your experience with OnBoard. These tips, along with a recap of the one-year anniversary of OnBoard: Limited Release, are available here.