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Office of Workers' Compensation Programs

Medical Bill Processing Portal

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  3. DFEC

Forms and References

General
DCMWC
DEEOIC
DFEC
DLHWC

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)

ADA Dental Claim Form

 

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

Medical Authorization - Surgical Package

Medical Authorization - Home Health

Visit the following websites for additional information on OWCP programs:

DOL | OWCP | DCMWC | DEEOIC | DFEC | DLHWC

U.S. Department of Labor | 200 Constitution Ave NW, Washington, DC 20210
Telephone: 1-866-4-USA-DOL (1-866-487-2365) | TTY | Contact Us

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