III. Entering New Bills

  • Bill are filed under existing claims. There are four options for locating the Claim under which you will file your bill.
    • Option 1: Enter Claim Number
    • Option 2: Enter Last Name and Last 4 digits of the patient SSN
    • Option 3: Enter Last Name and Date of Injury (DOI)
    • Option 4: Enter Last Name and Date of Birth(DOB) 
  • Select the Search tab at the bottom of the screen.
  • If the Claim is found you will be shown the Claim Number, the patient name, last 4 of the SSN, and the DOI to verify you are on the correct claim. If the claim is not found, verify the information for this bill and then enter the correct Claim Number, etc.
  • Select Submit a New Bill at the top of the screen.
  • You will be brought to a New Bill screen with data entry fields on the left and a field locator guide on the right.
  • Patient information for the selected claim appears at the top of the data entry form for verification.
  • First, select the type of bill being submitted: CMS 1500, UB-04 or C-4. See Appendix for Screen layouts.
  • Next, specify the provider you would like to associate with this bill. Note: You may need to enroll the provider into eFileNYSClaims before it can be selected. The enrollment process involves the creation of an account in eFileNYSClaims’s database and verification of the provider’s eligibility by the New York State Insurance Fund.
    • If the provider had been previously enrolled and associated with a bill processed by eFileNYSClaims, it may be listed in the “Providers Recently Processed” grid. In this case, click Select next to the record and jump to step 9.
    • If the “Providers Recently Processed” grid is not visible or the provider is not listed, and you are not sure if it has been enrolled, search by one of the 3 search fields -- NPI, WCB Authorization or EIN.
      • If search returns a record with a Select link, the record has been enrolled and may be selected.
      • If search returns a record with an Enroll Provider button, the provider must be enrolled before it can be selected. Click Enroll Provider to complete the enrollment form. Fill out the requested fields.
      • If an NPI number search does not return a record, please make sure you have the correct number.
      • If a WCB Authorization Number does not return a record, please make sure you have the correct number.
      • If an EIN number search does not return a record, the provider is not enrolled in the eFileNYSClaims database. You must have the NPI or WCB Authorization Number to enroll a provider.
  • Enter the remaining fields to complete the bill form.
  • Under Services Rendered, you may add multiple line items as necessary. Remember to click Add after each entry to include the line in the grid. These will be listed in the middle of the screen and can be Edited or Deleted as necessary.
  • Under Attachments, select the Document Type that you will be attaching from the drop down list. At a minimum, NYSIF requires a copy of the bill to be attached. Note: You may select Defer Attachment if you would like to attach your documents at a later time. Bills saved with “Defer Attachment” checked, will be placed in the Pending Attachment queue, which appears under the Bills tab.
  • With a document type selected, click the Select Files button to browse your computer file folders and select a file to attach to this bill. NYSIF requires attachments to be in PDF format.
  • If the Provider had been previously verified by NYSIF, you may Submit the bill. If verification of the provider is pending, you may Save your bill for submission later. An e-mail notification will be sent to the account holder when the provider has been verified. Access the Saved Bills queue and Submit the bill.