If you have any feedback on how we can make our new website better please do contact us. We would like to hear from you.
 

How Medical Providers Can File a Claim

Your provider is your doctor or other health care medical team member, such as an MD, DO or PhD. In order for them to get paid, they must be enrolled with the US Department of Labor and get an ACS number. If you have a doctor who is able to treat your condition but is not enrolled, they can still enroll and become a participating provider and you can help them. Direct them to this page for various forms (select  links and forms) and select Federal Employee's Compensation Act (FECA). Don't hesitate to contact the Peace Corps Post Service Unit if you have any questions or need help. 

1. They must register and obtain an ACS number

2. Then they must enroll with to have their bills paid electronically with an ETF (electronic funds transfer) process. Here is the form and here are the instructions.

3. Prior medical authorization must also be obtained for treatment. Forms for that are available here.

4. Next, you see your doctor or have your medical treatment or tests.

5. Make sure that your provider uses the diagnostic codes for treatment that are congruent with what your claims examiner says are in your record and correspond with your claim. Claims can be denied because the doctor makes an error in coding.

6. Your provider then submits bills/claims and this is the link to the form and the instructions for completing the HCFA CMS 1500 form if they are an out-patient provider.

7. Hospitals need to go to this link for information on filing.

8. Once bills are submitted you and your provider can go to this website to see which bills are paid. You will need the dates and ACS number of provider to see what has been paid or why bills are denied.


 

 Copyright © 2014  Health Justice for Peace Corps Volunteers  All Rights Reserved

  Site Map