WebForm OWCP-1168. OMB Number 1215-0137. Expires: 13b. NPI: 13c. Taxonomy Code(s): 11a. Provider Type Code 14a. Name. Provider Type (Individual or Facility) (Please see … WebDOL
Previous editions unusable OWCP-1168 (Revised 0 0) Page 1
WebForms; Form Number. OWCP's Gestalt Title / Description. CA-1* Federations Notice von Traumatic Injury and Claim for Continuation of Pay/Compensation. CA-2* Note of Occupational Disease and Claim for Compensation. ... OWCP-1168. Provider Enrollment select. OWCP-1500* Health General Claim Form. WebForm OWCP-915 replaces CA-915 . OWCP-957* Medical Travel Reimbursement Request. OWCP-1168. Provider Enrollment form. OWCP-1500* Heal Guarantee Claim Form. SF1199A. can my deep cavity be refilled
eCFR :: 20 CFR 10.800 -- How do providers enroll with OWCP for ...
WebWrite or type the required information on the hardcopy and authorize the form, if applicable, with a hand-written signature. Then mail the completed form to our central mailroom at the following address: U.S. Department of Labor OWCP/DCMWC P.O. … WebFeb 14, 2024 · Frederick Licari by telephone at 202-693-8073, TTY 202-693-8064, (these are not toll-free numbers) or sending an email to [email protected]. SUPPLEMENTARY INFORMATION: This ICR seeks approval under the PRA for revisions to the Provider Enrollment Start Printed Page 8610 Form (Form OWCP-1168). WebForms and References Providers will experience much faster processing times when submitting medical bills/attachments, authorizations, and non-bill documents electronically. Forms are available in PDF format for providers to complete and mail of fax for authorization requests. Latest News Take the Call Center Customer Satisfaction Survey can my dead boyfriend see me