New Pharmacy Benefit Manager

The U.S. Department of Labor (DOL) has contracted with Conduent to provide pharmacy billing 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 a new Medical Benefit Identification Card (MBIC). If you are a DEEOIC or DCMWC claimant and still need a new MBIC, please contact the Acentra Health Customer Service toll-free number at 1-800-638-7072 for DCMWC or at 1-866-272-2682 for DEEOIC.

Pharmacies are required to submit their pharmacy transactions electronically to Conduent for payment. Pharmacies are encouraged to call Conduent at 1-866-664-5581 for prescription benefit and processing assistance.

New Benefit Cards (DEEOIC and DCMWC claimants)

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

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

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

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

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