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DEEOIC Forms and References
DEEOIC Forms and References A Message to … Calendar 2025 Provider Authorization Forms Form EE-22 – General Medical Authorization …
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DEEOIC- Initial Home Health Care, Nursing Home or Assisted Living Request forms: EE-17A and EE-17B
… Home Health Care, Nursing Home or Assisted Living Request forms: EE-17A and EE-17B A regulatory … and went into effect April 9, 2019. This change made OMB forms EE-17A and EE-17B required for initiating initial … living, and nursing home care. Upon implementation of the forms on June 3, 2019, medical providers will no longer …
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Updated OWCP-915 and DEEOIC Auth Forms Now Available
Updated OWCP-915 and DEEOIC Auth Forms Now Available Updated OWCP-915 and DEEOIC Auth Forms Now Available
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Claimant Reimbursement Forms
Claimant Reimbursement Forms Attention OWCP Claimants: … Feb 17, 2024, new OWCP-957 Medical Travel Refund Request forms will be available for mileage (957A) and expenses …
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General Forms and References
General Forms and References Note: For program specific forms including claimant reimbursement forms, please click the respective program link. …
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Updated OWCP-915 and DEEOIC Auth Forms Now Available
Updated OWCP-915 and DEEOIC Auth Forms Now Available Updated versions of … claimant reimbursement and DEEOIC authorization request forms are now available and have an expiration date of 07/31/2027. Please begin using the updated forms for any claimant reimbursement or DEEOIC authorization …
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DFEC Special Reports or Forms Utilization Review
DFEC Special Reports or Forms Utilization Review Effective … a new Utilization Review (UR) for special reports or forms billing. Billing Utilization Review for special reports or forms allows: Up to 12 units per year for services …
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DFEC Special Reports or Forms Utilization Review
DFEC Special Reports or Forms Utilization Review Effective … Utilization Review (UR) when billing for special reports or forms. Please select this link to visit the Announcements …
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DFEC Forms and References
DFEC Forms and References A Message to …
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DCMWC Forms and References
DCMWC Forms and References A Message to …