From: <Saved by Windows Internet Explorer 7>
Subject: Western Michigan Area Local
Date: Wed, 11 Mar 2009 15:21:31 -0500
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    <TD><B>Logical Answers to Practical Questions -- for Injured Workers =

      <P><FONT face=3D"Times New Roman">Where do I send =
mail?</FONT></P></B>
      <P><FONT face=3D"Times New Roman">All mail and bills for Federal =
workers=92=20
      compensation cases should&nbsp; be sent to:</FONT></P>
      <DIR>
      <DIR><B>
      <P><FONT face=3D"Times New Roman">U.S. Department of Labor<BR>DFEC =
Central=20
      Mailroom<BR>PO Box 8300<BR>London, KY 40742-8300=20
      </FONT></P></DIR></DIR></B>
      <P><FONT face=3D"Times New Roman">Be sure to include the claim =
number on=20
      EVERY page you send.</FONT></P><B>
      <P><FONT face=3D"Times New Roman">I just found out you won=92t =
authorize or=20
      pay for treatment/medication my doctor prescribed. What do I do =
now?=20
      </FONT></P></B>
      <P><FONT face=3D"Times New Roman">We have recently enhanced our =
computer=20
      system to ensure that the care the injured worker is receiving is =
relevant=20
      to the condition(s) for which the case was accepted. These =
enhancements=20
      were made in accordance with the Federal Employees=92 Compensation =
Act which=20
      mandates OWCP to furnish an injured worker with services, =
appliances, and=20
      supplies prescribed by a qualified physician which OWCP deems =
likely =93to=20
      cure, give relief, reduce the degree or the period of disability, =
or aid=20
      in lessening the amount of monthly compensation.=94 While we have =
always had=20
      processes in place to help assure that OWCP authorizes and pays =
only for=20
      services, treatments, medications, and durable medical equipment =
related=20
      to the accepted conditions on a claim, our recent computer =
enhancements=20
      provide more rigor to these processes. </FONT></P>
      <P><FONT face=3D"Times New Roman">As a result of this, some =
injured workers=20
      may find that treatment or medications previously allowed are no =
longer=20
      available to them. If an injured worker=92s physician believes a =
treatment,=20
      procedure, or medication is necessary for the treatment of the =
injured=20
      worker=92s accepted conditions, the provider needs to submit =
medical=20
      documentation for review by the claims examiner. As is the case =
with=20
      anything sent to OWCP, please be sure to include the injured =
worker=92s=20
      claim/case number on every page. Please mail all documentation to =
U.S.=20
      Department of Labor, DFEC Central Mailroom, P.O. Box 8300, London, =
KY=20
      40742-8300. </FONT><B><FONT face=3D"Times New Roman"></FONT></P>
      <P><FONT face=3D"Times New Roman">How do I learn the status of a =
medical=20
      authorization request?</FONT></P></B>
      <P><FONT face=3D"Times New Roman">Injured Workers, Providers, and =
Employing=20
      Agencies can check on the status of medical authorizations at =
<SPAN=20
      style=3D"mso-bidi-font-family: 'Courier New'"><A=20
      href=3D"https://owcp.dol.acs-inc.com/portal/main.do"=20
      =
target=3Dblank>https://owcp.dol.acs-inc.com/portal/main.do</A></SPAN></FO=
NT><SPAN=20
      style=3D"COLOR: black; FONT-FAMILY: Times New Roman">.</SPAN><FONT =

      face=3D"Times New Roman"> Having this information on the web is =
beneficial=20
      since authorization information is available 24 hours/day, 7 =
days/week=20
      without calling for an authorization number or waiting for the =
receipt of=20
      an authorization letter in the mail.&nbsp; Claimant eligibility, =
bill=20
      status, and medical authorization inquiry functionality is also =
available=20
      24 hours a day via our Interactive Voice Response (IVR) system. To =
access=20
      the IVR, call 866-335-8319. To speak with a Customer Service=20
      Representative regarding an authorization, you may call =
850-558-1818 which=20
      will be a toll call. This number is available Monday =96 Friday, =
8am =96 8pm,=20
      EST.</FONT><B><FONT face=3D"Times New Roman"> </FONT></P>
      <P><FONT face=3D"Times New Roman">How do I learn the status of a =
bill or=20
      claim for reimbursement?&nbsp; </FONT></P></B>
      <P><FONT face=3D"Times New Roman">Injured Workers, Providers, and =
Employing=20
      Agencies can check on the status of bills and reimbursements at =
<SPAN=20
      style=3D"mso-bidi-font-family: 'Courier New'"><A=20
      href=3D"https://owcp.dol.acs-inc.com/portal/main.do"=20
      =
target=3Dblank>https://owcp.dol.acs-inc.com/portal/main.do</A></SPAN></FO=
NT><SPAN=20
      style=3D"COLOR: black; FONT-FAMILY: Times New Roman">.</SPAN><FONT =

      face=3D"Times New Roman"> Claimant eligibility, bill status, and =
medical=20
      authorization inquiry functionality is also available 24 hours a =
day via=20
      our Interactive Voice Response (IVR) system. To access the IVR, =
please=20
      dial 866-335-8319. To speak with a Customer Service Representative =

      regarding a bill or reimbursement, you may call 850-558-1818 which =
will be=20
      a toll call. This number is available Monday =96 Friday, 8am =96 =
8pm, EST.=20
      </FONT></P><B>
      <P><FONT face=3D"Times New Roman">How do I do find out my accepted =

      conditions?</FONT></P></B>
      <P><FONT face=3D"Times New Roman">While your initial acceptance =
letter=20
      includes this information, claims are often updated to include =
other=20
      conditions. This information is now available online at <SPAN=20
      style=3D"mso-bidi-font-family: 'Courier New'"><A=20
      href=3D"https://owcp.dol.acs-inc.com/portal/main.do"=20
      =
target=3Dblank>https://owcp.dol.acs-inc.com/portal/main.do</A></SPAN></FO=
NT>=20
      <FONT face=3D"Times New Roman">click on the "Eligibility and =
Accepted=20
      Conditions" link. You can help your Provider by giving her/him the =
list of=20
      accepted conditions for your claim and by telling her/him how to =
access=20
      this information online.</P></FONT><B>
      <P><FONT face=3D"Times New Roman">I think that other diagnoses =
need to be=20
      added as accepted conditions on my claim.&nbsp; What should I=20
      do?</FONT></P></B>
      <P><FONT face=3D"Times New Roman">If you believe that additional =
or=20
      different conditions warrant acceptance on your claim, please =
provide OWCP=20
      with medical documentation supporting the claim's expansion for =
review by=20
      the claims examiner.&nbsp; As is the case with anything sent to =
OWCP, this=20
      medical documentation must include the claim/case number on every =
page and=20
      should be mailed to U.S. Department of Labor, DFEC Central =
Mailroom, P.O.=20
      Box 8300, London, KY 20742-8300. </FONT></P><B>
      <P><FONT face=3D"Times New Roman">What form do I submit to get =
reimbursed=20
      for traveling to and from my medical appointments?</FONT></P></B>
      <P><FONT face=3D"Times New Roman">Complete the OWCP-957 =93Medical =
Travel=20
      Refund Request=94 form to request reimbursement for your=20
      transportation/mileage expenses.&nbsp;This form is available =
online at=20
      <SPAN style=3D"mso-bidi-font-family: 'Courier New'"><A=20
      href=3D"https://owcp.dol.acs-inc.com/portal/main.do"=20
      target=3Dblank>https://owcp.dol.acs-inc.com/portal/main.do</A> =
</SPAN>=96=20
      click on the =93Forms and Links=94 link.&nbsp; Write your OWCP =
claim number on=20
      the top right side of the form.&nbsp; You may record 3 trips on =
each=20
      form.&nbsp; The section requiring a Doctor=92s signature for each =
trip does=20
      not apply to OWCP claimants.&nbsp;</FONT></P>
      <P><FONT face=3D"Times New Roman">Mail the completed OWCP-957 =
to:</FONT></P>
      <DIR>
      <DIR><B>
      <P><FONT face=3D"Times New Roman">U.S. Department of Labor<BR>DFEC =
Central=20
      Mailroom<BR>PO Box 8300<BR>London, KY 40742-8300=20
      </FONT></P></DIR></DIR></B><B>
      <P><FONT face=3D"Times New Roman">How do I get reimbursed for out =
of pocket=20
      expenses I=92ve paid for authorized treatments, pharmacy=20
      expenses/medications, medical appliances, or medical supplies for =
a=20
      work-related injury?&nbsp;</FONT></P></B>
      <P><FONT face=3D"Times New Roman">Reimbursement for pharmacy=20
      expenses/medications, medical appliances and supplies, and =
medical,=20
      surgical, and dental services can be claimed using Form OWCP-915 =
=93Claimant=20
      Medical Reimbursement Form=94. This form is available online at <A =

      href=3D"https://owcp.dol.acs-inc.com/portal/main.do"=20
      target=3Dblank>https://owcp.dol.acs-inc.com/portal/main.do</A> =96 =
click on=20
      the =93Forms and Links=94 link. Put each date of service on a =
separate line.=20
      If you are requesting reimbursement for a co-pay, write =
=93Co-Pay=94 in the=20
      =93Description of Charge=94 field. Use a separate form for each =
provider you=20
      paid. Don=92t mix prescriptions and office visits on the same =
form.=20
      </FONT></P>
      <P><FONT face=3D"Times New Roman">A reimbursement claim for =
medical=20
      services, surgical services, medical appliances, or medical =
supplies must=20
      be accompanied by a copy of the OWCP-1500/HCFA-1500 =93Health =
Insurance=20
      Claim Form=94 showing individual charges and signed by the medical =
Provider.=20
      A reimbursement claim for dental services may be accompanied by a =
dental=20
      version of the HCFA-1500 called the ADA 515 instead. While both of =
these=20
      forms are available online (<A=20
      href=3D"https://owcp.dol.acs-inc.com/portal/main.do"=20
      target=3Dblank>https://owcp.dol.acs-inc.com/portal/main.do</A> =96 =
click on=20
      the =93Forms and Links=94 link), your medical Provider is very =
familiar with=20
      them and maintains a supply. Your medical Provider must complete =
and sign=20
      these forms. </FONT></P>
      <P><FONT face=3D"Times New Roman">A reimbursement claim for =
pharmacy=20
      expenses/medications must be accompanied by a copy of the =
Universal Claim=20
      Form or other pharmacy statement showing the name of the drug, NDC =
code,=20
      quantity provided, cost, prescribing physician, and date the =
prescription=20
      was filled. </FONT></P>
      <P><FONT face=3D"Times New Roman">All reimbursement requests must =
be=20
      accompanied by proof of payment =96 a cash receipt, canceled =
check, or=20
      credit card receipt.</FONT></P>
      <P><FONT face=3D"Times New Roman">Mail the completed OWCP-915 and =
related=20
      documentation to: </FONT></P>
      <DIR>
      <DIR><B>
      <P><FONT face=3D"Times New Roman">U.S. Department of Labor<BR>DFEC =
Central=20
      Mailroom<BR>PO Box 8300<BR>London, KY 40742-8300&nbsp;=20
      </FONT></P></DIR></DIR></B>
      <P><FONT face=3D"Times New Roman">Be sure to include your claim =
number on=20
      EVERY page you send.</FONT></P><B>
      <P><FONT face=3D"Times New Roman">I think I might need some help =
in using=20
      the web portal at <SPAN style=3D"mso-bidi-font-family: 'Courier =
New'"><A=20
      =
href=3D"https://owcp.dol.acs-inc.com/portal/main.do">https://owcp.dol.acs=
-inc.com/portal/main.do</A></SPAN></FONT><SPAN=20
      style=3D"COLOR: black; FONT-FAMILY: Times New Roman">. =
</SPAN><FONT=20
      face=3D"Times New Roman">Do you have some instructions or a user=20
      manual?</FONT></P></B>
      <P><FONT face=3D"Times New Roman">Yes. Go to<SPAN=20
      style=3D"mso-bidi-font-family: 'Courier New'"> <A=20
      href=3D"https://owcp.dol.acs-inc.com/portal/main.do"=20
      =
target=3Dblank>https://owcp.dol.acs-inc.com/portal/main.do</A></SPAN></FO=
NT><FONT=20
      face=3D"Times New Roman"><B> </B>and click on the Help link (upper =
right=20
      corner). This will open a User Guide.</FONT></P><B>
      <P><FONT face=3D"Times New Roman">What are the benefits of =
centralizing=20
      medical authorizations and billing?</FONT></P></B>
      <P><FONT face=3D"Times New Roman">The new system is designed to =
allow our=20
      contractor, ACS, to approve services and payments based on =
established=20
      treatment guidelines and OWCP staff decisions regarding covered=20
      conditions. In turn, this allows OWCP staff to dedicate more time =
to=20
      entitlement issues and return to work efforts. We have made =
eligibility,=20
      medical authorization, and billing information accessible 24 hours =
a day/7=20
      days a week to Injured Workers, Employing Agencies, and Providers =
via the=20
      Interactive Voice Response (IVR) system and the web. Providers can =
now=20
      request, and for routine services receive, authorization on-line =
which is=20
      easier for providers and speeds up the authorization process.=20
      </FONT></P><B>
      <P><FONT face=3D"Times New Roman">Why did you change to a toll =
number to=20
      talk with a Customer Service Representative?</FONT></P></B>
      <P><FONT face=3D"Times New Roman">We offer an automated toll-free=20
      Interactive Voice Response (IVR) system at 866-335-8319 which =
provides=20
      access to information regarding eligibility, authorization, and =
bill=20
      payment status. This information is also available online at <SPAN =

      style=3D"mso-bidi-font-family: 'Courier New'"><A=20
      href=3D"https://owcp.dol.acs-inc.com/portal/main.do"=20
      =
target=3Dblank>https://owcp.dol.acs-inc.com/portal/main.do</A></SPAN>. A =

      great deal of information is available through the automated =
toll-free IVR=20
      and web based processes which are available 24/7. All of these =
allow for a=20
      greater savings to DFEC so that future enhancements can be =
implemented.=20
      </FONT></P><BR>
      <P><BR></P></TD></TR></TBODY></TABLE></CENTER>
<CENTER>
<TABLE borderColorDark=3Dred cellPadding=3D20 width=3D"60%" =
borderColorLight=3Dblue=20
border=3D5>
  <TBODY>
  <TR>
    <TD>If you still have pressing questions, review <A=20
      =
href=3D"http://www.dol.gov/esa/owcp/dfec/regs/compliance/DFECFolio/q-and-=
a.pdf"=20
      target=3Dblank>Publication CA-550</A><BR>"Questions and Answers =
About the=20
      Federal Employees' Compensation Act" </TD></TR>
  <TR>
    <TD>If you would like to review the governing laws, <A=20
      =
href=3D"http://www.access.gpo.gov/nara/cfr/waisidx_07/20cfr10_07.html"=20
      target=3Dblank>click here</A> for questions &amp; answers from =
Title 20, US=20
      Code. </TD></TR></TBODY></TABLE></CENTER>
<CENTER><FONT face=3D"lucida sans, Arial, Helvetica, sans-serif" =
size=3D1><B><BR>
<P>
<CENTER><IMG src=3D"http://www.wmal.org/div2.gif"></CENTER>
<P>
<P>
<P><FONT face=3D"lucida sans, Arial, Helvetica, sans-serif"=20
size=3D1></FONT></P></B></FONT></CENTER></FONT></BODY></HTML>

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