Va Medical Claims Billing Address

Your name must be listed on the claim form exactly as it is on your CHAMPVA Identification Card.

Va medical claims billing address. Any copayments due should be paid upon checking out of the Dayton VA Medical Center. Electronic Data Interchange EDI. Use CHAMPVA Claim Form VA Form 10-7959a Forma S10-7959a en Espanol. Health Resource Center T.

Make the check or money order payable to VA Include the account number and payment stub. DEPARTMENT OF VETERANS AFFAIRS CLAIMS INTAKE CENTER PO BOX 4444 JANESVILLE WI 53547-4444. Hospital Staff must notify Purchased Care at 707 5628430 of the Veterans arrival and condition. Payer ID for dental claims is 12116.

04Community Care 201 Walnut Ave Mare Island CA 94592. 18 USC 1031 Major fraud against the United States 18 USC 1035 False statements relating to health care matters 18 USC 1342 Fictitious name or address 18 USC 1346 Definition of scheme or artifice to defraud 18 USC 1347 Health care fraud 31 USC3729 False Claims Act 42 USC. Required Documentation for Claims Submitted to CHAMPVA Medical Claims Documentation. To locate all VA facilities click on Find VA Locations.

Veterans who do not make their copayments upon checking out will receive a bill at their address of record within 30 days after their stay or appointment. 844-531-7818 248-524-4260 Utilized for Foreign Claimants. Paper Claims and supporting documentation submitted to the above address will be scanned converted to EDI transactions and submitted electronically to VA. Box 30780 Tampa FL 33630-3780.

VHA Office of Community Care PO. 1-855-va-women 1-855-829-6636 For health care services contact your nearest VA medical facility. Copayments may be made at the Agent Cashier window which is located on the First Floor near our University Blvd. IHSTHP 1601 E Fourth Plan Blvd.

Department of Veterans Affairs Claims Intake Center PO Box 4444 Janesville WI 53547-4444. 1320a-7b Health Care Programs. CALL 911 if Veteran is experiencing a life-threatening medical emergency. Go to the nearest VA medical centers Agent Cashiers Office or mail your payment to the following address.

Download VA Form 21-526EZ PDF Print the form fill it out and send it to this address. Payer ID for medical claims is 12115. Complete ER paperwork and include the following billing address. For dual pension and compensation claims use the mailing address below for compensation claims.

If electronic capability isnt available providers can submit claims by mail. Box 30780 Tampa FL 33630-3780. Local Contract Submit to VA. Department of Veterans Affairs PO.

Copayments may be made at the Agent Cashier Window Building 310 1st Floor. Entrance or contact by calling 205 933-8101 ext. VHA Office of Community Care PO. File your claim by mail using an Application for Disability Compensation and Related Compensation Benefits VA Form 21-526EZ.

Community providers who submit paper claims and supporting documentation should submit those documents to. IHS Claims SubmissionVA Portland Health Care System 10N20NPC ATTN. If you fail to complete VA Form 10-7959a your health care provider will be paid directly.