Champva Claims Submission Address (2024)

FAQs

How to submit claims to Champva? ›

To submit a CHAMPVA, CLFMP, CWVV or SBHCP claim, you must use a standard billing form to provide the required information–UB-04 Uniform Bill (CMS 1450) or Centers for Medicare and Medicaid Services-Health Insurance Claim Form (CMS 1500). Electronic pharmacy claims should be submitted through OptumRx.

Changes in status should be reported immediately to CHAMPVA, ATTN: Eligibility Unit, PO Box 469028, Denver, CO 80246-9028 or call 1-800-733-8387. PRIVACY ACT INFORMATION: The authority for collection of the requested information on this form is 38 U.S.C.

Our Payer ID number is 84146 for medical claims and 84147 for dental claims. You can also check medical claim status and eligibility status electronically through the VA clearinghouse using the 276 and 270 HIPAA transactions. CHAMPVA receives Medicare Crossover Parts A & B and DMERC claims for our beneficiaries.

Timely filing requirement: Claims must be received no later than one year after the date of service or, in the case of inpatient care, within one year of the discharge date.

Go to www.va.gov/PACT to file. supplemental claim, contact your primary care team to schedule your toxic exposure screening if not already completed. – and apply – anytime by visiting VA.gov/PACT or calling 1-800- MY-VA-411.

Call 800-733-8387.

CHAMPVA is NOT considered primary health coverage. Find resources and information about Medicare disability benefits.

Although similar, CHAMPVA is a completely separate program with a totally different beneficiary population than TRICARE — a Department of Defense health care program formerly called CHAMPUS.

How do I find my Champva provider? ›

Locate CHAMPVA Provider

If you are having difficulty finding a provider, we recommend you visit the Medicare website and use the “Search Tools” at the bottom of that page to locate a Medicare provider.

If you filed a claim with VA directly for Veteran care, you can check the status of your VA claim through the eCAMS Provider Portal (ePP).

The cons of CHAMPVA are that beneficiaries must pay 25% of the allowable amount, leading to significant out-of-pocket costs for unexpected medical bills. CHAMPVA does not cover dental, chiropractic, routine eye exams, or corrective lenses, and beneficiaries may have limited choice in how their care is provided.

The VA 5-year rule protects your disability claim by not allowing the VA to reduce your disability rating unless your condition has significantly improved over time. This rule pertains to a rating that has been in effect for five years or longer. After a five-year period, the rating is considered a stabilized rating.

Enrolled beneficiaries may review their program and claims at the CHAMPVA website.

A signed written request for reimbursem*nt and receipt of payment must be submitted to your local VA medical facility community care Veterans Experience Officer in a timely manner. You may use VA Form 10-583, Claim for Payment of Cost of Unauthorized Medical Services, to fulfill this requirement.

You can also file your claim by mail or in person at the VA facility where you received care. To do this, you'll need to fill out a Veteran/Beneficiary Claim for Reimbursem*nt of Travel Expenses (VA Form 10-3542). Read the statements and certifications carefully. Then sign and date your form.