General Administrative Forms & 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
- DCMWC: 1-800-638-7072
- DEEOIC: 1-866-272-2682
Select Option 2 (for Provider) and then select 3.
Note: For program specific forms, please click the respective program link above.
Claimant Reimbursement
Claimant Medical Reimbursement (OWCP-915)
Medical Travel Refund Request (OWCP-957)
Miscellaneous Templates
**Opening the following PDFs requires Adobe Reader.**
Adjustment Request
Other References
Provider Enrollment & Updates
Provider Enrollment Application (OWCP-1168)
EDI Enrollment Template (For Billing Agent/Clearinghouse Only)
Supporting Document Cover Sheet
How to view PDFs using Adobe Reader
**Opening the following PDFs requires Adobe Reader.**
Provider Enrollment Cover Sheet