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View Instructions on how to Submit an Authorization Correction Learn if a Claimant is Eligible for Services

Authorizations Introduction

Providers may submit authorization requests using WCMBP Provider Portal (direct data entry), fax or mail. Providers must be actively enrolled in the program for which they are submitting an authorization. For example, if you are enrolled as a DFEC provider, you cannot submit an authorization for the DEEOIC program until you enroll with the DEEOIC program. Before submitting authorization, confirm that the Claimant is eligible for the services you are rendering.

Process Overview

Providers have multiple submission options:

Direct Data Entry:

All providers are encouraged to submit authorization requests using the WCMBP Provider Portal (direct data entry). By using the WCMBP Provider Portal, the provider can instantly confirm if an authorization is required. If an authorization is required, the request review process starts immediately at submission.

Fax:

Providers may submit authorization requests using fax. Using the fax method may delay the request review process for up to 24 hours as the fax is uploaded to the WCMBP Provider Portal. If there is missing information in the in the authorization request, the fax is returned to the provider using USPS to make necessary corrections.
NOTE: All faxed authorization requests must be on the appropriate template to be ingested into the WCMBP Provider Portal. If the correct template isn’t used, the requester will receive a fax alert that the authorization request must be resubmitted using the correct template.

Paper:

Providers may submit paper authorization requests using USPS. Using the paper method may delay the request review process for up to 24 hours as the form is uploaded to the WCMBP Provider Portal once received in the mailroom.
NOTE: All paper authorization requests must be on the appropriate template to be ingested into the system. If the correct template isn’t used, the requester will receive a Return to Provider (RTP) letter explaining that the authorization request must be resubmitted using the correct template.

Tutorials
Resource Guides
Forms and References
DEEOIC

Form EE-22 - General Medical Authorization Request

Form EE-24 - Durable Medical Equipment Authorization Request

Form EE-26 – Rehabilitative Therapies Authorization Request

Form EE-28 – Transportation Authorization Request

Form EE-30 – Transplant Authorization Request

Form EE-32 – Home Health Care Authorization Request

DFEC

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

DCMWC

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Certificate of Medical Necessity (CM-893)

FAQs
I am a DFEC provider. Do I need to submit an authorization request for telehealth services?

Authorization requirements for DFEC telehealth bills are dependent on Provider Type and the Procedure Codes. If authorization is required, your bills must be submitted with the necessary modifiers. Please utilize the WCMBP Provider Portal for eligibility and authorization requirements. See the DFEC bulletin https://www.dol.gov/agencies/owcp/dfec/regs/compliance/DFECfolio/FECABulletins/FY2020-2024 for more information. Go to this page on the portal for the DFEC Forms and References and select Medical Authorization - General Medical from the Authorization Templates list.

How do I submit an authorization request?

Authorization requests may be submitted via Direct Data Entry using the WCMBP Provider Portal, or by Fax at: 1-800-215-4901 (DFEC) or 1-800-882-6147 (DEEOIC). Direct Data Entry is the recommended method as it provides real time editing and speeds the overall authorization process.

Where do I find the new authorization templates/forms?

The new authorization templates/forms can be found at https://owcpmed.dol.gov/portal/resources/forms-and-references/general. Select the respective program in the dark gray bar on that page, and click the link of the authorization type that you want to submit.

Do I have to be registered to acces the forms on the portal?

There is no registration needed to access the authorization templates. The new authorization templates are available at: https://owcpmed.dol.gov/portal/resources/forms-and-references/general.