Effective May 13, 2023, the Division of Coal Miner Workers’ Compensation Program (DCMWC) will require medical providers and facilities to submit supporting medical documentation for services they provide to claimants for their covered black lung conditions. You must attach supporting medical documentation when you submit a Health Care Finance Administration form (HCFA-1500) for professional services rendered in a physician’s office, or a Uniform Medical Billing form (UB-04) for all hospital services except non-emergency services of 24 hours or less (for which you may use either form).

The provider submitting the reimbursement form is responsible for attaching sufficient supporting documentation to substantiate the medical services or supplies billed. The supporting documentation must be attached to the bill submission and must support the billing codes submitted on the reimbursement form. All medical services provided to DCMWC claimants must be documented in the submitted supporting documentation, including the date of service, the miner’s name and date of birth, and a signature of the rendering provider that is both legible and time/date stamped.

More information on how to upload and submit bills and attachments through the Workers Compensation Medical Bill Portal’s Direct Data Entry function is available at https://owcpmed.dol.gov/. This link also has training tutorials to help you get familiar with the entire process.

Please review examples of required supporting documentation that should be attached to bills. For additional details please refer to our letter to enrolled providers.

If you have any questions, regarding the contents of this letter, please contact DCMWC’s medical bill processing vendor at 1-800-638-7072.