CHAMPVA Paper Claims for Providers: Where and How to Mail Them

Where do providers mail CHAMPVA claims?

To this address, listed on VA's CHAMPVA provider page:

VHA Office of Integrated Veteran Care
CHAMPVA Claims
PO Box 30750
Tampa, FL 33630-3750

This is only for provider claims. Beneficiaries filing for reimbursement use a different address in Spring City, PA. Sending a claim to the wrong one delays it.

Should we file on paper or electronically?

Either is accepted. VA recommends electronic claims because they process faster, but paper is a standard option, not an exception.

• Electronic: a HIPAA 837 through the VA clearinghouse, medical payer ID 84146.
• Paper: an itemized claim mailed to Tampa.

For the full electronic setup, see the CHAMPVA Provider Quick-Start.

Which form do we use?

A CMS-1500 or UB-04, whichever fits the claim. The CHAMPVA Guidebook says providers must send an itemized billing statement on one of these forms. Put professional and facility fees on separate forms.

Do not use VA Form 10-7959A. That is the beneficiary reimbursement form.

What has to be on the claim?

Patient

• Legal name
• Address
• Date of birth
• CHAMPVA member number, which is the beneficiary's Social Security number

Patient details on attachments must match the claim.

Provider

• Provider name and degree where it applies
• Physical address where care was given (not a PO Box)
• Billing address
• Phone number
• Full 9-digit EIN/TIN

Services

• Date of service
• Diagnosis codes
• Procedure code for each line
• Quantity for each procedure
• Charge for each procedure

VA recommends one line for each service and each date to avoid errors and underpayment. For a field-by-field review, see the CHAMPVA Claim Data Checklist.

What should we attach?

Other insurance EOBs

If the patient has other insurance that pays first, bill it first and attach its EOB. VA's provider page says to:

• include EOBs from every plan that paid before CHAMPVA;
• make sure every billed service appears on them, even services the other plan did not cover; and
• send processed EOBs that show payment or denial.

See CHAMPVA and Other Health Insurance.

Other records

Only what the service or VA's request calls for. Do not add unrelated records to every claim.

Resubmissions

If VA already processed the claim, include the CHAMPVA EOB with the correction. VA warns against resubmitting with only a claim number. See Correcting or Resubmitting a CHAMPVA Claim.

How should the paper claim be prepared?

VA's provider page gives these instructions so claims scan correctly:

1. Line the form up so data prints in the right fields.
2. Use a clear, dark font.
3. No highlighters.
4. No staples, clips, tape, or tears.
5. Keep any handwriting legible.
6. Match patient details on attachments to the claim.
7. Use the full 9-digit EIN/TIN.
8. Include both the billing and service addresses.
9. Attach other insurance EOBs if they apply.
10. Keep a copy of everything you mail.

Check the address against CHAMPVA Contacts, Addresses, and Forms before mailing.

Do paper claims get paid by check?

No. VA's family member care page says providers must be enrolled in Electronic Funds Transfer to be paid. A payable claim can be held until EFT is set up. See CHAMPVA EFT Enrollment.

Does mailing change the filing deadline?

No. Under 38 CFR 17.276, claims are generally due within 1 year of the date of service, or within 1 year of discharge for inpatient care. There are 180-day windows for certain retroactive approvals, and VA considers written good-cause requests. The rule says delays from a provider's billing process do not count. Allow mailing time. See CHAMPVA Claim Filing Deadlines.

Paper claim workflow

1. Confirm eligibility and payer order.
2. Bill other insurance first and wait for its EOB.
3. Fill out the CMS-1500 or UB-04 with complete data.
4. Attach the EOBs and any requested records.
5. Check the formatting rules above.
6. Check the filing deadline.
7. Mail it to PO Box 30750, Tampa.
8. Confirm EFT enrollment.
9. Check status before sending anything again. See How to Check CHAMPVA Claim Status.