Quick answer
If CHAMPVA sends you an EOB or letter asking for missing information, that is generally a request to complete an existing claim—not a reason to immediately file a decision review.
VA's current CHAMPVA claim instructions say you must respond to a request for more information within 1 year of the date on the EOB or letter.
You can respond in either of these ways:
- Online: submit through the CHAMPVA claim tool again, choose “A resubmission for an existing claim,” and upload the missing documents.
- By mail: send a copy of the EOB or request letter plus the requested information to CHAMPVA Claims at the current claims mailing address.
If VA has already made a decision that it cannot cover the claim and you disagree with that decision, that is different. VA directs you to its decision-review process rather than treating the issue as a missing-document resubmission.
The key is to identify whether VA is asking you to complete the record or whether VA has actually made an adverse decision.
First, identify what VA actually sent you
An EOB or letter can communicate different things. Read the reason carefully before choosing your next step.
| What the notice says | What it usually means | What to do next |
|---|---|---|
| VA needs a document or more information before deciding the claim | The claim is incomplete | Send the requested information as a resubmission for the existing claim |
| VA needs an Other Health Insurance EOB | VA needs the primary payer's adjudication | Submit the matching OHI EOB and any other documents VA requests |
| VA needs proof that you paid the provider | VA cannot finish a beneficiary reimbursement without payment evidence | Submit a receipt or paid statement that matches the claim |
| VA says it cannot cover or pay the claim and gives review rights | VA has made an adverse decision | Read the decision-review notice and use the appropriate review route if you disagree |
VA's family-member-care review guidance reinforces this distinction. It specifically identifies missing documentation, an OHI EOB, and proof of payment as matters that do not require a decision review merely because the information is missing.
What to include when you resubmit missing information
Start with the EOB or letter and send exactly what VA says is missing.
For a mailed response, VA specifically tells beneficiaries to include:
- a copy of the EOB or request letter; and
- the requested information or documents.
For an online resubmission, upload the requested documents to the existing-claim resubmission workflow.
Depending on what VA says is missing, the documents may include the following.
Itemized medical billing information
VA's current claim guidance says an itemized bill should include information such as:
- the beneficiary's full name and date of birth;
- the provider's full name and medical title;
- the provider's tax identification number;
- the office or building address where the service was provided;
- the date of service and charges;
- the quantity of services;
- diagnosis information; and
- CPT or HCPCS procedure information.
A basic balance-due statement may not contain enough detail. If VA says the bill is incomplete, ask the provider for an itemized billing statement or superbill that includes the missing elements.
Other Health Insurance EOB
When another health plan pays before CHAMPVA, VA may need the other insurer's claim-specific EOB.
VA says the EOB should identify the matching service date, provider, services processed, amount paid, and the provider's NPI when it is not already shown on the itemized bill.
Do not send a plan's general summary of benefits in place of the claim-specific EOB.
Proof of payment
If you paid the provider and are asking CHAMPVA to reimburse you, VA may require proof of payment.
Examples VA accepts for an initial reimbursement claim include a receipt or a billing statement marked paid. If your request letter identifies proof of payment as the missing item, send evidence that clearly connects the payment to the provider and claim involved.
Prescription documentation
For an out-of-pocket prescription claim, VA uses pharmacy-specific documentation rather than a standard medical itemized bill. The current claim page lists details such as the pharmacy information, medication name, dosage, strength, quantity, cost, fill date, prescriber, and the 11-digit National Drug Code.
If VA's letter says a prescription claim is incomplete, compare the request against those required pharmacy details before resubmitting.
How to resubmit a CHAMPVA claim online
VA's online workflow can be used to update an existing claim.
A practical sequence is:
- Open VA's current How to file a CHAMPVA claim page and use the online claim option.
- When the tool asks what you are submitting, choose “A resubmission for an existing claim.”
- Use the EOB or request letter to identify exactly what VA needs.
- Upload the missing documents in readable form.
- Review the submission so names, dates of service, provider information, and insurance documents match the existing claim.
- Submit the resubmission and save any confirmation information for your records.
The important point is that this is an update to an existing claim, not a separate unrelated reimbursement request.
For a fuller walkthrough of the electronic filing tool, see How to File a CHAMPVA Claim Online.
How to resubmit missing information by mail
VA's current missing-information instructions tell beneficiaries to mail a copy of the EOB or letter together with the requested information to:
VHA Office of Integrated Veteran Care
CHAMPVA Claims
PO Box 500
Spring City, PA 19475
For this type of response, VA's public instructions focus on the request letter/EOB plus the missing documents. They do not tell you to start over with an unrelated new paper claim merely because the existing claim needs more information.
Keep a complete copy of what you send. If you use a mail service that provides tracking or delivery confirmation, save that record with your claim documents.
The 1-year response deadline is separate from the original claim deadline
There are two different clocks that can matter:
- the deadline for filing the original CHAMPVA claim; and
- the deadline for responding after VA asks for missing information.
VA's current claim page says that when it sends an EOB or letter asking for additional information, you must respond within 1 year of the date on that EOB or letter.
Do not confuse that post-filing response period with the ordinary deadline for the original claim.
For the initial-filing rules and special retroactive situations, see CHAMPVA Claim Filing Deadlines: 1-Year and 180-Day Rules.
Resubmission versus decision review
The distinction is based on what VA has done with the claim.
Use a resubmission when VA still needs information
A resubmission is appropriate when VA is asking for information needed to finish deciding the existing claim, such as:
- missing itemized billing information;
- an OHI EOB;
- proof of payment;
- provider records; or
- another specific document identified in the request.
In that situation, solve the documentation problem first.
Consider decision review when VA made an adverse decision
VA's beneficiary claim page says that if VA decides it cannot cover the claim under CHAMPVA and you disagree, you can request a decision review.
That is different from an EOB or letter that says VA cannot yet decide the claim because information is missing.
VA also maintains a current decision reviews and appeals page for family member care. That page explains available review routes and, importantly, separates actual review requests from ordinary submission of missing documents.
If your notice includes formal review rights, use the instructions in the notice and current VA review guidance rather than repeatedly resubmitting the same unchanged claim.
If the missing document is held by your provider
VA says you can submit the missing documents yourself or ask VA for help getting them from your provider.
If you ask VA to obtain the records, VA warns that the process can take additional time.
A practical approach is to contact the provider yourself when possible, ask for the exact record named in the VA request, and compare it with the EOB or letter before submitting it. If the provider cannot supply it promptly, use VA's help option rather than ignoring the request.
Common resubmission mistakes
Starting a brand-new unrelated claim
If VA is asking for documents on a claim that already exists, use the existing-claim resubmission path so the new records can be associated with that claim.
Appealing before supplying the requested document
A request for missing information is not automatically a denial. If VA cannot decide the claim because the record is incomplete, provide the missing evidence first.
Sending an incomplete OHI record
If CHAMPVA is waiting for another insurer's adjudication, send the actual claim-specific EOB, not a general insurance-card summary or plan brochure.
For the broader payer-order rules, see How CHAMPVA Works With Other Health Insurance.
Resending the same incomplete bill
If VA says the itemized bill lacks codes, provider identifiers, dates, or other required details, obtain a corrected itemized statement rather than sending the same document again.
For the billing elements used on beneficiary claims, see VA Form 10-7959A: Line-by-Line CHAMPVA Claim Guide.
Missing the response deadline
Keep the date of the VA request visible in your claim file and respond well before the one-year deadline.
Resubmission checklist
Before you send the response, confirm that:
- you identified the existing claim and the exact reason VA needs more information;
- you gathered every document listed in the EOB or request letter;
- any itemized bill contains the missing provider, service, diagnosis, procedure, or charge information;
- any required OHI EOB matches the same service and provider;
- proof of payment is included when VA requests it;
- you chose the existing-claim resubmission option if filing online;
- you included a copy of the EOB or request letter if mailing the response;
- you kept copies of everything submitted; and
- you are responding within 1 year of the date on VA's request.
Bottom line
When CHAMPVA asks for missing information, complete the existing claim first. Use the online resubmission option or mail the EOB/request letter with the missing documents.
A decision review is for an actual decision you disagree with—not simply for a claim that VA says is incomplete.
Read the notice, fix the specific documentation problem, keep proof of what you submitted, and watch the one-year response deadline.