DFEC Forms and References
A Message to Medical Providers: Hardcopy bills and documents require a team of individuals to physically report to our mailroom facility to open, scan, and transmit these documents to our bill processor for payment. These steps, under the current conditions of the pandemic, may cause delays in processing. To avoid any delay, OWCP is asking that medical providers submit medical bills/attachments, authorizations, and non-bill documents electronically. Providers will experience much faster processing times with electronic submissions and our online notification of any bill errors further reduce processing time.
If you need assistance with submitting electronically, please call:
- DFEC: 1-844-493-1966
Select Option 2 (for Provider) and then select 3.
Provider Bills
Health Insurance Claim Form (OWCP-1500)
Uniform Health Insurance Claim Form (OWCP-04)
Authorization Templates
Medical Authorization - Durable Medical Equipment
Medical Authorization - General Medical
Medical Authorization - Physical Therapy/Occupational Therapy
Medical Authorization - Transportation and Travel
Medical Authorization - HCPCS J-Code Unspecified/Unclassified