Get Owcp 915

The Owcp 915 is a critical form used to claim reimbursement for out-of-pocket medical expenses related to accepted conditions under the Office of Workers' Compensation Programs. This guide provides a step-by-step approach to filling out the form online to ensure a smooth submission process.

Follow the steps to complete the Owcp 915 effectively.

1. Press the ‘Get Form’ button to access the Owcp 915 form and open it for completion.
2. Begin by entering your personal information in the specified fields. Include your full name, OWCP file number, address, and telephone number.
3. In the provider information section, specify the name of the doctor's office, hospital, pharmacy, or medical supply company where expenses were incurred.
4. Detail the description of the charge. This includes explaining the nature of the expense, such as whether it pertains to a medical appointment, medication, or medical supplies.
5. Enter the date of service in the format MM/DD/YYYY. Provide the range of dates for treatment against which you are claiming reimbursement.
6. Indicate the total amount you paid as the claimant for each service or item reported.
7. Ensure that you have included proof of payment for each item as instructed. Indicate 'Yes' or 'No' for the confirmation of proof of payment for all claimed items.
8. Calculate and total the reimbursement amount you are requesting.
9. In the certification section, confirm that all provided information is accurate. Your signature and date are required to validate the claim.
10. Finally, after completing all necessary fields and ensuring accuracy, save your changes, and you may choose to download, print, or share the completed form.

Complete your Owcp 915 form online today for seamless reimbursement.