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