EEOICPA CIRCULAR NO. 14-01              October 16, 2013

 

SUBJECT: Carrier Reimbursement Letter

 

The purpose of this Circular is to provide guidance for all Division of Energy Employees Occupational Illness Compensation (DEEOIC) staff in responding to inquiries from insurance carriers who have provided written correspondence to the DEEOIC regarding the collection of primary payer information to identify and recover medical benefit payments as a part of their coordination of benefits.

 

Upon receiving correspondence from an insurance carrier attempting to coordinate benefits for a condition which has previously been accepted under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA), the Claims Examiner (CE) is to respond using the accompanying Coordination of Benefits Response Letter, which instructs the carrier to submit all reimbursable charges, including a copy of the original bill and proof of payment, to the bill processing contractor. The Coordination of Benefits Response Letter can be seen as Exhibit 1 below.

 

Prior to mailing the Coordination of Benefits Response Letter, the CE is required to complete the applicable fields; which include the name and address of the insurance carrier, claimant name and claim number, appropriate ICD-9 code(s) and their status effective date(s).

 

 

 

 

RACHEL P. LEITON

Director, Division of Energy Employees

Occupational Illness Compensation

 

Distribution List No. 1: Claims Examiners, Supervisory Claims Examiners, Technical Assistants, Customer Service Representatives, Fiscal Officers, FAB District Managers, Operation Chiefs, Hearing Representatives, District Office Mail & File Section