OWCP Virtual Help Session OWCP will host Virtual Help Session on Friday July 7, 2023, from 5:00 - 6:00 pm ET. Providers will have an opportunity to ask general questions regarding the medical bill processing system including enrollment, authorizations, billing, and web portal features. Providers will be able to gain insight on helpful information, available tools and to request further assistance. During this open forum, attendees are not obligated to stay for the full hour. If you are interested in joining, please click this link to register. Attendee name and email are required to register for the event. Once entered, you will receive an invitation with a link to join the event. Tips for the Virtual Help Session call: We welcome the opportunity to connect with you! If you need any technical assistance prior to or during the call, please contact WCMBP_TRAINING@cns-inc.com for help.
OWCP Bill Processing Improvement - 06-21-2023 Effective June 24, 2023, the DFEC and DEEOIC Programs for the Office of Workers’ Compensation Programs (OWCP) will enhance bill processing to prevent denials related to accepted conditions if an approved authorization is on file for the billed service. No changes are necessary for submitting authorization requests or bills. All approved authorizations will need to match the billing OWCP Provider, OWCP Claimant, date(s) of service, and procedure code. In addition, the DEEOIC program will require the billed diagnosis code to match the authorized diagnosis code. The following are updates specifically for the DEEOIC program: For additional information, please contact our Call Center at the number listed below, where a Call Center representative will be happy to assist you.
OWCP-CNSI Virtual Help Session OWCP-CNSI will host Virtual Help Session on Friday June 2nd from 3:00-4:00 pm ET. Providers will have an opportunity to ask general questions regarding the medical bill processing system including enrollment, authorizations, billing, and web portal features. Providers will be able to gain insight on helpful information, available tools and to request further assistance. During this open forum, attendees are not obligated to stay for the full hour If you are interested in joining, please click this link to register. Attendee name and email are required to register for the event. Once entered, you will receive an invitation with a link to join the event. Tips for the Virtual Help Session call: We welcome the opportunity to connect with you! If you need any technical assistance prior to or during the call, please contact WCMBP_TRAINING@cns-inc.com for help.
Authorization Match Improvement - 05-18-2023 Effective May 13, 2023, the OWCP Workers’ Compensation Medical Bill Processing (WCMBP) System will allow authorization match by OWCP ID or Billing NPI for DEEOIC and DFEC bills. This enhancement will result in decreased denials due to authorization mismatch for providers with multiple locations associated with one billing NPI. There are no changes to the steps for submitting authorization requests or bills. Providers should ensure the billing NPI on file is up to date. If the billing NPI associated with your OWCP Provider ID needs to be updated, please use the Maintain Provider Information option on the Medical Bill Processing Portal. Please refer to this link for the Updating Provider Information Resource Guide. For additional information, please contact our Call Center at the number listed below, where a Call Center representative will be happy to assist you.
1-800-638-7072
1-866-272-2682
1-844-493-1966
OWCP Remittance Voucher (RV) Re-design - 05-17-2023 Effective May 13, 2023, the Office of Workers’ Compensation Programs (OWCP) Remittance Voucher will be redesigned for providers and claimants to increase understanding of the payments and associated bill statuses. Enhancements include, but are not limited to: Remittance Vouchers will continue to be mailed to the mailing address on file and available in PDF format on the Workers’ Compensation Medical Bill Processing (WCMBP) Portal. An updated Remittance Voucher (RV) user guide will be available after May 13, 2023 on the WCMBP Portal for providers at Provider Payments | OFFICE OF WORKERS' COMPENSATION PROGRAMS (dol.gov) and for claimants at Claimant's Corner | OFFICE OF WORKERS' COMPENSATION PROGRAMS (dol.gov) For additional information, please contact us at the number listed below, where a Call Center representative will be happy to assist you.
1-800-638-7072
1-866-272-2682
1-844-493-1966
OWCP-CNSI Virtual Help Session OWCP-CNSI will host Virtual Help Session on Friday May 5th from 2:30-3:30 pm ET. During this open forum, attendees are not obligated to stay for the full hour. If you are interested in joining, please click this link to register. Attendee name and email are required to register for the event. Once entered, you will receive an invitation with a link to join the event. Tips for the Virtual Help Session call: We welcome the opportunity to connect with you! If you need any technical assistance prior to or during the call, please contact WCMBP_TRAINING@cns-inc.com for help.
Providers will have an opportunity to ask general questions regarding the medical bill processing system including enrollment, authorizations, billing, and web portal features. Providers will be able to gain insight on helpful information, available tools and to request further assistance.
OWCP-CNSI Virtual Help Session OWCP-CNSI will host Virtual Help Session on Friday April 14th from 11 am to 1 pm ET. If you are interested in joining, please click this link to register. Attendee name and email are required to register for the event. Once entered, you will receive an invitation with a link to join the event. Tips for the Virtual Help Session call: We welcome the opportunity to connect with you! If you need any technical assistance prior to or during the call, please contact WCMBP_TRAINING@cns-inc.com for help.
Providers will have an opportunity to join the call to ask general questions regarding the medical bill processing system including enrollment, authorization submission, billing, and web portal features. Providers will be able to gain insight on helpful information, available tools and to request further assistance.
Ambulatory Surgical Center Services - 11-14-2022 Ambulatory Surgical Centers should bill for facility charges on the OWCP-1500 using the appropriate AMA CPT® code(s) for the primary, secondary, tertiary, etc. procedures and should use the "SG" modifier with each CPT® code.
OWCP Pricing Updated for RCC to CPT Crosswalk - 10-03-2022 Effective October 1, 2022, Outpatient UB-04 billed lines submitted with both the Revenue Center Code (RCC) and a CPT/HCPCS/OWCP procedure code will be priced based on the procedure code fee schedule. This pricing update will apply to bills submitted for DFEC, DEEOIC, and DCMWC. Please note that there will be no changes for RCC pricing for lines billed without a procedure code. In addition, this pricing update will not affect the RCC Codes requiring CPT/HCPCS/OWCP Codes for Outpatient Hospital Services, per the OWCP Fee Schedule. It also will not affect Outpatient Bills (13x or 14x) that are priced via OPPS for DFEC and DEEOIC Programs, or implant lines billed with RCC 0274 – 0279 that require a manufacturer’s invoice for reimbursem*nt (DFEC program only). Please click this link to visit the OWCP Fee Schedule page for more information. For additional information, you may contact our Call Center at the number listed below, where a Call Center representative will be happy to assist you.
Important Notice Concerning Coverage of Lung Transplants by the Federal Black Lung Program - 09-14-2022 The Division of Coal Mine Workers' Compensation, or Federal Black Lung Program, requires prior approval of the pre-transplant evaluation for lung transplants and the lung transplant itself for Black Lung beneficiaries (20 C.F.R. § 725.705). Information about an individual's general eligibility for medical benefits may be obtained by calling the District Office where the patient's claim file is located, or by calling the Black Lung toll-free number at (800) 638-7072. Eligibility for medical benefits does not automatically include approval for a pre-transplant evaluation or a lung transplant. Before seeking approval for a pre-transplant evaluation or a lung transplant, a medical center must be approved as a lung transplant center by the Center for Medicare and Medicaid Services (CMS), or the request will automatically be denied. The list of approved transplant centers is available at: https://qcor.cms.gov/default.jsp?referer=http://qcor.cms.gov/main.jsp After reaching the homepage, select the “Resources” link on the upper right hand of the page. A pop-up window will open. Select link for “List of CMS-Approved Organ Transplant Programs”. This will open an excel spreadsheet which contains certification information for all Medicare-certified transplant programs, organized by State. Please refer to the approved lung transplant programs. Approved lung transplant centers must determine if the patient's medical benefits are the responsibility of a coal mine operator or insurer or the Black Lung Disability Trust Fund. The patient should have this information. For a pre-transplant evaluation or transplant to be considered, it must be necessitated by the coal miner's black lung condition and directly related conditions. If the patient is covered by an insurer or coal mine operator, the company's approval must be obtained prior to a pre-transplant evaluation or transplant. Pre-transplant evaluation and transplant coverage is decided on a case-by-case basis. The Federal Black Lung Program expects coal mine operators or insurers to provide the same coverage that it does. The documentation that coal mine operators or insurers require to determine whether or not they will approve coverage may vary. If the patient is covered by the Black Lung Disability Trust Fund, the approval process must be initiated by emailing the request to https://owcpmed.dol.gov or by calling the toll-free number (800) 638-7072. Requests for pre-transplant evaluations and lung transplants should include basic information including the patient's name and date of birth, as well as the name of the facility performing the evaluation or transplant. Additionally, a request for a pre-transplant evaluation must include a physician's letter of justification. A physician's letter of medical justification is a well-rationalized narrative statement, prepared by a qualified physician who has been actively treating the patient for their pulmonary condition. The letter of medical justification represents the physician's independent assessment and opinion and must include a brief review of the claimant's pertinent medical history, a brief statement regarding the claimant's current medical condition, and explanation of the claimant's medical need for a lung transplant evaluation. Requests for lung transplants must include the medical facility's lung transplant protocols and all medical records produced for the pre-transplant evaluation, including the results of all tests, consultations, and narrative reports. After the Federal Black Lung Program evaluates the information submitted, it will notify the requestor of a determination regarding coverage. Any pre-transplant evaluation or transplant performed prior to receiving prior approval by the Federal Black Lung Program will be denied. Any questions about pre-transplant evaluations or transplants should be directed to the Division of Coal Mine Workers' Compensation at efax-maos-transplant@dol.gov or by calling the toll-free number (800) 347-2502.
DCMWC Announcement: Final Rulemaking on Medical Benefit Payments - 04-05-2020 On June 14, 2018, the Office of Workers' Compensation Programs Division of Coal Mine Workers' Compensation issued a final rule governing the Black Lung Disability Trust Fund's payment of medical benefits under the Black Lung Benefits Act. The revised regulations became effective on August 31, 2018. Most of them, including those governing payments for medical equipment, prescription drugs, and inpatient medical services, applied immediately. However, the regulations governing payment of professional medical services and outpatient medical services had a later applicability date of November 30, 2019, so that a new computer system could be developed to process these bills. OWCP is delaying the applicability date of the regulations governing payments for professional medical services and hospital outpatient services from November 30, 2019, to April 26, 2020, due to unforeseen delays in developing the computer system. More information is available at: https://www.dol.gov/owcp/dcmwc/
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