N.Y. Comp. Codes R. & Regs. tit. 12, § 328.3
(a) Upon receipt of such notice of objection (form A-1), the physician may request arbitration by notifying the chairman in accordance with the following:
(3) Failure to make timely request for arbitration shall be deemed a waiver of the right to arbitration.
If the physician wishes to arbitrate the bill, he shall complete and sign the request for arbitration and forward it to the medical registration section together with a check to the order of the Chairman, Workers' Compensation Board, in the sum of five dollars as a minimum arbitration fee. Notwithstanding any provision in this section to the contrary, upon application of the physician, the chairman may for good cause shown excuse the physician for the delay in filing the request for arbitration, and schedule the disputed bill for arbitration.