New Benefit Cards (DEEOIC and DCMWC claimants) - 02-14-2024

If you are a DEEOIC or DCMWC claimant, you will be receiving a new benefits card in the mail in March 2024 with associated documents from Acentra Health on behalf of OWCP. Your current card will remain active until March 15, 2024. If you do not receive your card by March 15, 2024, please call Acentra Health Customer Service toll-free number for DCMWC at 1-800-638-7072 or DEEOIC at 1-866-272-2682.

OWCP Provider Enrollment Electronic Signature - 01-22-2024

Effective January 27, 2024, providers can submit provider enrollment applications and enrollment maintenance updates using an electronic signature.

An electronic signature will be applied to the application based on the account information of the user who is completing the application online. A “wet” or physical signature will no longer be required to submit an enrollment application or update.

Electronic signatures are also applicable in these scenarios:

  • Online provider enrollment application with the status of “In Progress” (started but not submitted).
  • Online provider enrollment application with status of “Returned to Provider” (RTP’d).

Please refer to the Enrollment Resource Guides for further information by visiting https://owcpmed.dol.gov/portal/Provider/Enrollments.

For additional information, contact our Call Center at the number listed below, where a Call Center representative will be happy to assist you.

Division of Coal Mine Workers' Compensation (DCMWC):1-800-638-7072

Division of Energy Employees Occupational Illness Compensation (DEEOIC):1-866-272-2682

Division of Federal Employees' Compensation (DFEC):1-844-493-1966

OWCP New Option for Requesting Authorization Cancellation - 12-07-2023

Effective December 9, 2023, the DEEOIC and DFEC Programs for the Office of Workers’ Compensation Programs (OWCP) are implementing an enhancement to allow providers to cancel an authorization request. Specifically, this cancel option will be available for initial and correction authorization requests with an “In Review” or “Processed Awaiting Decision” status.

For additional information, please contact our Call Center at the number listed below. A Call Center representative will be happy to assist you.

  • Division of Energy Employees Occupational Illness Compensation (DEEOIC):
    1-866-272-2682
  • Division of Federal Employees' Compensation (DFEC):
    1-844-493-1966
OWCP DFEC Bill Processing Improvement for Newly Accepted Cases - 12-06-2023

Effective December 9, 2023, the DFEC Program for Office of Workers’ Compensation Programs (OWCP) will enhance bill processing to automatically reprocess previously submitted bills that denied when the injured or ill worker’s case was under development, after the case is later accepted as payable by OWCP.

On December 9, 2023, a one-time courtesy bill reprocessing will occur for claimant cases that were adjudicated by DFEC, and accepted conditions assigned in the previous four weeks.

Afterwards, bills denied after December 9, 2023, will be automatically reprocessed if the case is accepted as payable.

Please note that additional denial EOBs may post during reprocessing. For example, if denials post for authorization of services related to accepted conditions, then providers are encouraged to request authorization for the billed service(s).

For additional information, please contact our Call Center at the number listed below, where a Call Center representative will be happy to assist you.

  • Division of Federal Employees' Compensation (DFEC):
    1-844-493-1966
OWCP Bill Submission NPI and Taxonomy Update - 10-25-2023

In an ongoing effort to better align with industry standards of practice, the Office of Workers’ Compensation Programs (OWCP) is enhancing its medical bill processing system to capture the provider NPI and taxonomy number for billing and servicing providers. Providers are encouraged to include NPI and taxonomy number when billing for services provided to injured or ill workers for the Office of Workers’ Compensation Programs.

Online Bill Entry (web portal direct data entry):

Refer to the Direct Data Entry Billing Tutorial for instructions and examples.

  • Web portal fields will be added for providers to include billing and rendering (servicing) NPI and taxonomy.
  • Be sure to note that for all claim types, the billing NPI will be added to your bill based on your OWCP provider record. You may update the billing NPI on your bill prior to submitting.
    Note: If the wrong billing NPI populates on your bill, please be sure to submit a provider enrollment update with the correct NPI information. For step-by-step instructions, refer to the quick reference guide Updating Provider Information in the Provider Portal
  • Messaging may appear on the portal to ensure NPI and taxonomy are both entered

Mail (paper form):

Refer to the billing instructions for each claim form by visiting the OWCP Forms and References page and selecting the OWCP Program (DCWMC, DEEOIC, or DFEC).

Health Insurance Claim Form (OWCP-1500):

  • Billing provider NPI is to be entered in Box 33a and billing taxonomy is to be entered in Box 33b
    Note: If you have been submitting your 9-digit billing OWCP provider ID using Box 33b, please begin entering your OWCP provider ID in Box 33 per the form instructions.
  • Rendering (servicing) taxonomy and rendering (servicing) NPI are to be entered in Box 24J

For Uniform Health Insurance Claim Form (OWCP-04):

  • Billing provider NPI is to be entered in Box 56 and billing taxonomy is to be entered in Box 81CCa
  • Attending (servicing) NPI is to be entered in Box 76 and attending taxonomy is to be entered in Box 81CCb

For ADA Dental Claim Forms:

  • Billing provider NPI is to be entered in Box 49 and billing taxonomy is to be entered in Box 52a
  • Treating (servicing) NPI is to be entered in Box 54 and servicing taxonomy is to be entered in Box 56a

EDI (HIPAA 837s): Refer to the updated 837 Companion Guide.

  • 837 file segment details for billing provider NPI and taxonomy
    NPI or Taxonomy 837 File Segment
    NPI Loop – 2010AA
    Segment – NM1
    NM108: Identification Code Qualifier = XX
    NM109: NPI
    Taxonomy Loop – 2000A Segment – PRV
    PRV01: BI (Billing)
    PRV02: PXC (Qualifier for taxonomy code)
    PRV03: Provider taxonomy code
    Example: PRV?BI?PXC?207Q00000X~
  • 837 file segment details for servicing provider NPI and taxonomy PRV03: Provider taxonomy code
    Claim Type Location NPI or Taxonomy 837 File Segment
    Professional/Dental Header NPI Loop: 2310B — RENDERING PROVIDER NAME
    Segment: NM1?82
    NM108: Identification Code Qualifier = XX
    NM109: NPI
    Example : NM1?82?1?DOE?JANE?C???XX?1234567804~
    Taxonomy Loop: 2310B
    Segment: PRV
    PRV01: PE (Performing)
    PRV02: PXC (Qualifier for taxonomy code)
    PRV03: Provider taxonomy code
    Example: PRV?PE?PXC?1223G0001X~
    Line NPI Loop: 2420A — RENDERING PROVIDER NAME
    Segment: NM1?82
    NM108: Identification Code Qualifier = XX
    NM109: NPI
    Example: NM1?82?1?DOE?JANE?C????XX?1234567804~
    Taxonomy Loop: 2420A
    Segment: PRV
    PRV01: PE (Performing)
    PRV02: PXC (Qualifier for taxonomy code)
    PRV03: Provider taxonomy code
    Example: PRV?PE?PXC?208D00000X~
    Institutional Header NPI Loop: 2310A - ATTENDING PROVIDER NAME
    Segment: NM1?71
    NM108: Identification Code Qualifier = XX
    NM109: NPI
    Example: NM1?71?1?JONES?JOHN????XX?1234567891~
    Taxonomy Loop: 2310A
    Segment: PR
    PRV01: AT (Attending)
    PRV02: PXC (Qualifier for taxonomy code)
    Example: PRVAT?PXC?208D00000X~

New messaging will appear on your remittance voucher to alert you if any of the required NPI or taxonomy information is missing or does not match your provider record. Be sure to view the Explanation of Benefits (EOB) Quick Reference Guide for further details.

For additional information, contact our Call Center at the number listed below, where a Call Center representative will be happy to assist you.

Division of Coal Mine Workers' Compensation (DCMWC):
1-800-638-7072

Division of Energy Employees Occupational Illness Compensation (DEEOIC):
1-866-272-2682

Division of Federal Employees' Compensation (DFEC):
1-844-493-1966

Attention - New OWCP provider Manual - 10-16-2023

We are excited to announce a “NEW” Provider Manual located on the Workers’ Compensation Medical Bill Processing (WCMBP) portal.

Based on the feedback that we have received from the provider community, we developed a manual that offers important information on billing, authorizations, enrollment, policies, and eLearnings. This new Provider Manual will serve as an all-inclusive resource to ease gaining access to answers about the WCMBP system and services, such as how to maintain provider license, where to submit authorizations, or how to understand bill adjustments and appeals.

Please visit the Featured Content section of the portal website at https://owcpmed.dol.gov/portal/ for more information.

For additional information, please contact our Call Center at the number listed below, where a Call Center representative will be happy to assist you.

Division of Coal Mine Workers' Compensation (DCMWC): 1-800-638-7072

Division of Energy Employees Occupational Illness Compensation (DEEOIC): 1-866-272-2682

Division of Federal Employees' Compensation (DFEC): 1-844-493-1966

OWCP Servicing Provider License Maintenance - 09-25-2023

Effective October 28, 2023, the Office of Workers’ Compensation Programs (OWCP) will begin a review process to ensure servicing provider license or certification information is active and up to date.

Providers enrolled as a group practice are required to identify servicing (medical) providers during the enrollment process. This new process will send correspondence to the group if any servicing provider license information expires in 60 or 30- days. Groups will be required to update servicing provider license information if the license expiration is forthcoming. If that action is not completed, then the servicing provider record will be terminated from the group. Please note this will not terminate the group’s OWCP provider ID.

Providers can review and update servicing provider information via the Workers’ Compensation Medical Bill Processing (WCMBP) portal at https://owcpmed.dol.gov/ or via paper on the OWCP-1168 located on the Forms and References page.

Online: We encourage providers to use the WCMBP Portal to review and update servicing provider license information, including license expiration date. Please upload a current copy of the professional license or certification for the servicing provider. Servicing provider (medical provider) information, such as SSN, NPI, name, taxonomy and license information are found on "Step 10 – Add Servicing Provider Information." of the online enrollment process.

In addition, providers will be able to review and confirm existing provider record information, such as group NPI, provider contact information, and payment details.

Log in to your account via our website: OWCP Medical Bill Processing Portal (https://owcpmed.dol.gov). We have provided detailed instructions on how to review and verify your OWCP record in the Updating Provider Information Resource Guide. Registration is required for online access. Please refer to the Legacy and New Providers Initial Access and Online Billing (dol.gov) Quick Reference Guide for more information.

Mail: Mail the updated OWCP-1168 Provider Enrollment application along with the Provider Enrollment Cover Sheet and your OWCP Provider ID to the following address:

Provider Enrollment
Department of Labor - OWCP
P. O. Box 8312
London, KY 40742-8312

Fax: Send the updated OWCP-1168 via fax with the Provider Enrollment Cover Sheet and your OWCP Provider ID to 888-444-5335.

The Provider Enrollment Cover Sheet is located on the Forms and References page.

For additional information, please contact our Call Center, where a representative will be happy to assist you.

Division of Coal Mine Workers' Compensation (DCMWC):1-800-638-7072

Division of Energy Employees Occupational Illness Compensation (DEEOIC): 1-866-272-2682

Division of Federal Employees' Compensation (DFEC): 1-844-493-1966

OWCP Virtual Help Session - 08-17-2023

OWCP will host Virtual Help Session on Friday September 8, 2023, from 3:00 - 4:00 pm ET. Providers will have an opportunity to ask general questions regarding the medical bill processing system including enrollment, authorizations, billing, and web portal features. Providers will be able to gain insight on helpful information, available tools and to request further assistance.

During this open forum, attendees are not obligated to stay for the full hour.

If you are interested in joining, please click this link to register. Attendee name and email are required to register for the event. Once entered, you will receive an invitation with a link to join the event.

Tips for the Virtual Help Session call:

  • Please refrain from referencing specific claimant information or disclosing other protected health information (PHI) during the call
  • Participants can participate via voice or chat during the session
  • The help session will be memorialized via recording and/or transcription to ensure all questions and issues are captured
  • Providers are not required to attend for the duration of the call

We welcome the opportunity to connect with you!

If you need any technical assistance prior to or during the call, please contact WCMBP_TRAINING@cns-inc.com for help.

DEEOIC Authorization Updates - 08-03-2023

Effective August 5, 2023, the Division of Energy Employees Occupational Illness Compensation (DEEOIC) will update the guidelines for submitting the same services within an authorization request.

Providers will not be able to submit an authorization request under the following conditions:

  • The same procedure code on multiple lines, even if the dates of service are not overlapping
  • The same procedure code on multiple lines, even if submitted with a modifier
  • The same revenue center code (RCC) on multiple lines without a different procedure code or with no procedure code

Providers will be able to submit an authorization request under the following conditions:

  • The same procedure code using a date range
  • Separate dates of service under different authorization requests.

For additional information, please contact our Call Center at the number listed below, where a Call Center representative will be happy to assist you.

  • Division of Energy Employees Occupational Illness Compensation (DEEOIC): 1-866-272-2682
OWCP Virtual Help Session - 07-20-2023

OWCP will host Virtual Help Session on Friday August 4, 2023, from 11:00 am - 12:00 pm ET. Providers will have an opportunity to ask general questions regarding the medical bill processing system including enrollment, authorizations, billing, and web portal features. Providers will be able to gain insight on helpful information, available tools and to request further assistance.

During this open forum, attendees are not obligated to stay for the full hour.

If you are interested in joining, please click this link to register. Attendee name and email are required to register for the event. Once entered, you will receive an invitation with a link to join the event.

Tips for the Virtual Help Session call:

  • Please refrain from referencing specific claimant information or disclosing other protected health information (PHI) during the call
  • Participants can participate via voice or chat during the session
  • The help session will be memorialized via recording and/or transcription to ensure all questions and issues are captured
  • Providers are not required to attend for the duration of the call

We welcome the opportunity to connect with you!

If you need any technical assistance prior to or during the call, please contact WCMBP_TRAINING@cns-inc.com for help.

DFEC Hearing Aid Supplies and Services Utilization Review - 07-17-2023

Effective July 15, 2023, the Office of Workers’ Compensation (OWCP) Division of Federal Employees’ Compensation (DFEC) Program is implementing a new utilization review (UR) for hearing aid services and supplies.

Please refer to the FECA Circular NO. 23-08 for more information. FECA Circulars | U.S. Department of Labor (dol.gov)

New limits have been defined for DFEC hearing aid supplies and services.

EOB Number EOB Description Applicable Procedure Codes
81021 BATTERY FOR HEARING DEVICE LIMITED TO 30 UNITS PER 180 DAYS V5266
80151 HEARING AID SERVICES ARE LIMITED TO 1 PER 730 DAYS V5264, V5265, V5275
80152 HEARING AID SERVICES ARE LIMITED TO 1 PER 1825 DAYS V5010, V5020, V5030, V5040, V5050, V5060, V5070, V5080, V5090, V5100, V5110, V5120, V5130, V5140, V5150, V5160, V5170, V5171, V5172, V5180, V5181, V5190, V5200, V5210, V5211, V5212, V5213, V5214, V5215, V5220, V5221, V5230, V5240, V5241, V5242, V5243, V5244, V5245, V5246, V5247, V5248, V5249, V5250, V5251, V5252, V5253, V5254, V5255, V5256, V5257, V5258, V5259, V5260, V5261, V5262, V5263, V5267, V5268, V5269, V5270, V5271, V5272, V5273, V5281, V5282, V5283, V5284, V5285, V5286, V5287, V5288, V5289, V5290, V5298
81019 HEARING AID REPAIR/SUPPLY LIMITED TO 3 UNITS PER 1825 DAYS V5014
81061 HEARING AID FITTING/CHECKING LIMITED TO 4 PER 1825 DAYS V5011

For additional information, please contact our Call Center at the number listed below, where a Call Center representative will be happy to assist you.

Division of Federal Employees' Compensation (DFEC):
1-844-493-1966

 

Announcement of DEEOIC and DCMWC Pharmacy Benefit Program - 07-05-2023

The U.S. Department of Labor (DOL) has contracted with myMatrixx®, an Express Scripts Company, to provide Pharmacy Benefit Management (PBM) services to the Office of Workers’ Compensation Programs (OWCP) Division of Energy Employees Occupational Illness Compensation (DEEOIC) and Division of Coal Mine Workers’ Compensation (DCMWC).

All DEEOIC and DCMWC claimants should now have new Medical Benefit Identification Cards (MBIC) and access to myMatrixx®’s nationwide network of participating pharmacies and durable medical equipment. If you are a DEEOIC or DCMWC claimant and still need a new MBIC, please contact the CNSI customer service toll-free number at 1-800-638-7072 for DCMWC or at 1-866-272-2682 for DEEOIC.

Claimants can search for participating pharmacies on the web or by calling myMatrixx®:

As of June 5, 2023, pharmacies have been required to submit their pharmacy transactions to myMatrixx® for payment. Pharmacy providers are encouraged to join the myMatrixx® network and can enroll at www.esiprovider.com.

OWCP Virtual Help Session

OWCP will host Virtual Help Session on Friday July 7, 2023, from 5:00 - 6:00 pm ET. Providers will have an opportunity to ask general questions regarding the medical bill processing system including enrollment, authorizations, billing, and web portal features. Providers will be able to gain insight on helpful information, available tools and to request further assistance.

During this open forum, attendees are not obligated to stay for the full hour.

If you are interested in joining, please click this link to register. Attendee name and email are required to register for the event. Once entered, you will receive an invitation with a link to join the event.

Tips for the Virtual Help Session call:

  • Please refrain from referencing specific claimant information or disclosing other protected health information (PHI) during the call
  • Participants can participate via voice or chat during the session
  • The help session will be memorialized via recording and/or transcription to ensure all questions and issues are captured
  • Providers are not required to attend for the duration of the call

We welcome the opportunity to connect with you!

If you need any technical assistance prior to or during the call, please contact WCMBP_TRAINING@cns-inc.com for help.

DEEOIC DME Supplies and Accessories Updates - 06-23-2023

Effective June 24, 2023, the Division of Energy Employees Occupational Illness Compensation (DEEOIC) will enhance the bill processing of durable medical equipment (DME) supplies and accessories.

A separate DEEOIC Durable Medical Equipment (DME) supplies and accessories authorization is not required for the following conditions:

  • A rental authorization is approved and on file for the related DME, and service dates are within the rental period.
  • A purchase authorization is approved and on file for the related DME, and service dates are within three (3) years of the purchase period.

Providers will not need to submit a correction to an existing DME authorization for the associated supplies or accessories if an approved authorization is on file.

HCPCS Code Description Associated DME Codes
A4615 A4615 Cannula, nasal E1390, E1391, E1392
A4616 Tubing (oxygen), per foot E1390, E1391, E1392
A4620 Variable concentration mask E1390, E1391, E1392
E0441 Stationary oxygen contents, gaseous, one month’s supply = 1 unit E0424, E0425
E0442 Stationary oxygen contents, liquid, one month’s supply = 1 unit E0440
E0443 Portable oxygen contents, gaseous, one month’s supply = 1 unit E0430, E0431
E0444 Portable oxygen contents, liquid, one month’s supply = 1 unit E0434, E0435
E0555 Humidifier, durable, glass or autoclavable plastic bottle type, for use with regulator or flowmeter E1390, E1391, E1392
E1353 Regulator E1390, E1391, E1392

In addition, new utilization limits are added to restrict certain DME codes for DEEOIC.

EOB Number - Message Procedure Codes Modifier
80907 - DME supply of nasal cannula is limited to 500 units per 180 days A4615 N/A
80908 - DME supply of oxygen tubing is limited to 1000 units per 180 days A4616 N/A
80909 - DME supply of concentration mask is limited to 40 units per 180 days A4620 N/A
80910 - DME supply of humidifier is limited to 20 units per 180 days E0555 N/A
80911 - DME supply of regulator is limited to 10 units per 180 days E1353 N/A
80912 - DME oxygen system rental is limited to 12 units per 366 days E0424, E0431, E0433, E0434, E0439 RR

For additional information, please contact our Call Center at the number listed below, where a Call Center representative will be happy to assist you.

  • Division of Energy Employees Occupational Illness Compensation (DEEOIC): 1-866-272-2682
OWCP Bill Processing Improvement - 06-21-2023

Effective June 24, 2023, the DFEC and DEEOIC Programs for the Office of Workers’ Compensation Programs (OWCP) will enhance bill processing to prevent denials related to accepted conditions if an approved authorization is on file for the billed service.

No changes are necessary for submitting authorization requests or bills. All approved authorizations will need to match the billing OWCP Provider, OWCP Claimant, date(s) of service, and procedure code. In addition, the DEEOIC program will require the billed diagnosis code to match the authorized diagnosis code.

The following are updates specifically for the DEEOIC program:

  • New EOB denial reason 90972 will post if a billed diagnosis code does not match the diagnosis code on the approved authorization.
    • The following new EOB denial reason will appear on the Remittance Voucher (RV): “Matching authorization is available, but dx on bill is different from the approved authorization”
  • New authorization Edit 61342 will post if an authorization is submitted with a non-payable diagnosis code.

For additional information, please contact our Call Center at the number listed below, where a Call Center representative will be happy to assist you.

  • Division of Energy Employees Occupational Illness Compensation (DEEOIC): 1-866-272-2682
  • Division of Federal Employees' Compensation (DFEC):1-844-493-1966