Providers may submit authorization requests using WCMBP Provider Portal (direct data entry), fax or mail. Providers must be actively enrolled in the program for which they are submitting an authorization. For example, if you are enrolled as a DFEC provider, you cannot submit an authorization for the DEEOIC program until you enroll with the DEEOIC program. Before submitting authorization, confirm that the Claimant is eligible for the services you are rendering.
Process OverviewProviders have multiple submission options:
Direct Data Entry:All providers are encouraged to submit authorization requests using the WCMBP Provider Portal (direct data entry). By using the WCMBP Provider Portal, the provider can instantly confirm if an authorization is required. If an authorization is required, the request review process starts immediately at submission.
Providers may submit authorization requests using fax. Using the fax method may delay the request review process for up to 24 hours as the fax is uploaded to the WCMBP Provider Portal. If there is missing information in the in the authorization request, the fax is returned to the provider using USPS to make necessary corrections.
NOTE: All faxed authorization requests must be on the appropriate template to be ingested into the WCMBP Provider Portal. If the correct template isn’t used, the requester will receive a fax alert that the authorization request must be resubmitted using the correct template.
Providers may submit paper authorization requests using USPS. Using the paper method may delay the request review process for up to 24 hours as the form is uploaded to the WCMBP Provider Portal once received in the mailroom.
NOTE: All paper authorization requests must be on the appropriate template to be ingested into the system. If the correct template isn’t used, the requester will receive a Return to Provider (RTP) letter explaining that the authorization request must be resubmitted using the correct template.
