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Re: [owcp] Prescription format

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  • wcaid@aol.com
    Nancy Use the following link to see for yourself. I have also pasted the page to this email. Laurie Click here: Government Guide:
    Message 1 of 14 , Apr 26, 2004
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      Nancy

      Use the following link to see for yourself.  I have also pasted the page to this email.

      Laurie


      Click here: Government Guide: http://www.governmentguide.com/ams/clickThruRedirect.adp?55076483,16920155,http://www.dol.gov


      April 26, 2004    DOL Home > ESA > OWCP > DFEC Home Page > Consolidated Bill Processing and Medical Authorization System  
      Information on FECA's Consolidated Bill Processing and Medical Authorization SystemThe Federal Employees’ Compensation (FEC) division of OWCP consolidated its medical authorization and bill payment processes on September 2, 2003. All Medical Authorizations and Bill processing are now handled by our private contractor, ACS. For medical authorizations and billing and/or reimbursement questions, please call 866-335-8319, Monday – Friday, 8am – 8pm, EST. Providers may fax urgent medical authorization requests to 800-215-4901. All mail and bills for Federal workers’ compensation cases should be sent to:

      U.S. Department of Labor
      DFEC Central Mailroom
      PO Box 8300
      London, KY 40742-8300



      These changes allow us to serve you more efficiently. We thank you for your cooperation.Information for Injured Workers Information for Medical Providers Information for Employers


















    • wcaid@aol.com
      Nancy Why are your medical providers telling you to send everything? That is the cost of doing business!!! However, it does give you the advantage of seeing
      Message 2 of 14 , Apr 26, 2004
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        Nancy

        Why are your medical providers telling you to send everything?  That is the cost of doing business!!!  However, it does give you the advantage of seeing everything that is sent, before it is sent.  Especially if there is an error, you can get your doctor to correct it before it becomes an issue you have to fight.  So I would get a fax to send everything.

        What is "Working Rx" in Salt Lake City?  If it is a pharmacy they should know how to bill for worker's comp.  As for approving prescriptions-each accepted claim has a list of drugs that is approved, or acceptable for the 'injury.'  Use this link:

        http://owcp.dol.acs-inc.com/portal/main.do;PORTAL_JSESSIONID=AH7pVeRjM55NVw0gs7x05SN1iIjDHYcawnJCQZ5L1s0NxcW3lOA5!790982935

        NEW! YOU CAN NOW DETERMINE IF A MEDICAL SERVICE IS COVERED FOR AN INJURED WORKER OR REQUIRES PRIOR AUTHORIZATION WITHOUT LOGGING INTO THE MAIN SITE.Eligibility Inquiry is now available to users without requiring login. You may inquire on a FECA claimant's eligibility for a medical service from any page by selecting the Eligibility Inquiry option from the left navigation menu. Note that eligibility data is still encrypted for the protection of confidential information.
         

        This site, and the one in my previous email should answer your questions.

        Laurie










      • FourDirect@aol.com
        Laurie, Thanks. I m looking into it all. I ve had such a hard time finding a pharmacy that will even work with the USDOL that I am still going through my
        Message 3 of 14 , Apr 27, 2004
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          Laurie,

          Thanks. I'm looking into it all. I've had such a hard time finding a pharmacy that will even work with the USDOL that I am still going through my pharmacy in AZ three years after I moved to NY as I haven't found anyone here willing to deal with them and this place in AZ is willing to work with Working Rx. I have a complicated complex set of illnesses and sequelae of symptoms that nothing of mine has ever fit neatly on a form or a line.

          I've also never had a doctor or provider either in NY or in AZ who has had the knowledge or the willingness to write the materials necessary or to even bill the government. I'd have been dead a long time ago had I depended on them. Since rarely has it taken fewer than 11 or so submissions to get anything paid, I don't blame the health care folks for being unwilling to devote that kind of time but I certainly do pay the price. It's tough with a complex and complicated set of illnesses.

          So, I'm having a flareup again this week but will check out your website information right now.

          Thanks,
          Nancy
        • FourDirect@aol.com
          Laurie, Hum, I wasn t able to find out how to actually know what I need to send ACS. I got such confused information from them last week on the phone. I think
          Message 4 of 14 , Apr 27, 2004
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            Laurie,

            Hum, I wasn't able to find out how to actually know what I need to send ACS. I got such confused information from them last week on the phone. I think that my situation must be more complicated than yours. Prior to ACS taking over the Working Rx was the management company that the USDOL had hired in Utah to determine what prescriptions would be approved or denied. They took over about 4 years ago and the pharmacies billed them after the OWCP regional office would sign off or not sign off on approving prescriptions. ACS must be using a different system now but I was unable to find out what is coverered and I'm trying to petition for 3 meds to be covered for "non-traditional" uses and need to know if these letters of rationale go to my claims examiner or to ACS.

            I'll keep muddling..... And on it seems to always go.

            ACS is apparently approving different coding numbers for treatments now, too. The physical therapy codes that used to be covered are now rejected and I've had to borrow a lot of money to continue treatment only to find out that they're all denied retroactively. Do others have this problem?

            We just keep resubmitting bills with various codes hoping that something will hit the target!!! Hard way to function.

            Kevin, have you had this problem? Others out there? I had finally gotten it down once London, KY took over prior to ACS and now it seems to be a struggle all over again.

            Laurie, I really do appreciate your ongoing help.
            Nancy
          • wcaid@aol.com
            Nancy Check out www.fedworkerscomp.net It s the most info in one place to help us anywhere. You may also subscribe to the list & ask questions. Laurie
            Message 5 of 14 , Apr 27, 2004
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              Nancy

              Check out   www.fedworkerscomp.net

              It's the most info in one place to help us anywhere.
              You may also subscribe to the list & ask questions.

              Laurie
            • FourDirect@aol.com
              Laurie, Great. Thanks! Nancy
              Message 6 of 14 , Apr 28, 2004
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                Laurie,

                Great. Thanks!
                Nancy
              • Kevin
                Nancy, Different people have had widely differing experiences with ACS. My one contact with them was so frustrating that I don t intend to contact them unless
                Message 7 of 14 , Apr 30, 2004
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                  Nancy,

                  Different people have had widely differing experiences with ACS. My
                  one contact with them was so frustrating that I don't intend to
                  contact them unless I really have to. What I was told by ACS is
                  that they don't have the authority to approve anything. Rather I
                  was informed that they administer only what has been approved by my
                  claims examiner. Apparently in my case, they have been told which
                  diagnosis (ICD-9) and procedure (CPT) codes are acceptable. If my
                  doctor submits something outside of the "acceptable," ACS has no
                  authority to do anything except to reject them. Of course, as a
                  claimant, the only way to find out what's acceptable is by trial and
                  error. No one (i.e., neither ACS nor OWCP) will provide much
                  information to guide you.

                  Some of what's acceptable doesn't even make sense. For example, in
                  my case, the only ICD-9 codes that ACS will accept are 493 or 493.00.
                  My doctor used 493.0 for years, but that will automatically reject
                  from ACS' system even though it's a perfectly legitimate code.

                  Furthermore, ACS isn't consistent. The last 6 bills that I've
                  submitted for reimbursement have been filled out exactly the same
                  way by my doctor. One was paid in full; two were not paid at all;
                  and three were partially paid. Go figure!

                  My caseworker in Congressman Bass' office won't deal with ACS
                  either, preferring to contact OWCP directly.

                  Kevin


                  --- In owcp@yahoogroups.com, FourDirect@a... wrote:

                  > ACS is apparently approving different coding numbers for
                  treatments now, too.
                  > The physical therapy codes that used to be covered are now
                  rejected and I've
                  > had to borrow a lot of money to continue treatment only to find
                  out that
                  > they're all denied retroactively. Do others have this problem?
                  >
                  > We just keep resubmitting bills with various codes hoping that
                  something will
                  > hit the target!!! Hard way to function.
                  >
                  > Kevin, have you had this problem? Others out there? I had finally
                  gotten it
                  > down once London, KY took over prior to ACS and now it seems to be
                  a struggle
                  > all over again... Nancy
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