Example: dental hygienist

CHAMPVA Dept. of Veterans Affa irs Health …

Payer Name: CHAMPVA . dept . of Veterans Affairs irs Health Administration Center (HAC). Line(s) of Business 84146 (Medical and Hospital). 84147 (Dental). Payer Note: A patient cannot be eligible for Tricare and CHAMPVA as Tricare is for active military. Please also note that CHAMPVA process transactions for the spouses and dependents of a veteran. Physicians providing services for Veterans eterans that require medical service from a non-VAVA medical center should review the payer fact act sheet &. submit transactions to the Department of Veterans Affairs National Fee Program.

Payer Name: CHAMPVA Dept. of Veterans Affa irs Health Administration Center (HAC) Line(s) of Business 84146 (Medical and Hospital) 84147 (Dental)

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  Health, Champva, Veterans, Dept, Aaff, Champva dept, Of veterans affa irs health

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Transcription of CHAMPVA Dept. of Veterans Affa irs Health …

1 Payer Name: CHAMPVA . dept . of Veterans Affairs irs Health Administration Center (HAC). Line(s) of Business 84146 (Medical and Hospital). 84147 (Dental). Payer Note: A patient cannot be eligible for Tricare and CHAMPVA as Tricare is for active military. Please also note that CHAMPVA process transactions for the spouses and dependents of a veteran. Physicians providing services for Veterans eterans that require medical service from a non-VAVA medical center should review the payer fact act sheet &. submit transactions to the Department of Veterans Affairs National Fee Program.

2 Payer ID 84146 & 84147. Products Member ID Number Required The Patient's/Subscriber's 9 digit numeric member ID. ((Example : 123456789). Each Patient/Subscriber has a unique member ID and should be identified as SELF . The Patient is always the Subscriber. Do not send veteran or parent information. If the patient is a newborn than the ID will be 9 numeric +. P'. Group Number Not Applicable NPI / Provider Number NPI is accepted Federal Tax ID Required - A 9 digit numeric Tax Identification Number (TIN), Employee Identification Number (EIN) or Social Security Sec Number (SSN.))

3 (SSN) of the facility or individual provider/group. Authorization Number Authorizations are required for some services. Authorization number on the claim when submitted electronically is optional, but is recommended for faster claims adjudication. Attachments Claims should be submitted electronically. If supporting documentation is required for claims CHAMPVA will request additional information. You can indicate that additional supporting documentation is available using the ASCX12 PWK segment. Attachments cannot be submitted electronically at this time. ti eCOB Secondary claims are accepted electronically.

4 CHAMPVA is a secondary payer to Medicare and most other Health plans. Please note that Medicare automatically crosses over claims to CHAMPVA and providers should NOT submit these directly to the pay payer. Exclusions None Encounters Not applicable Customer Service, Payer For questions or concerns regarding claim routing, clearinghouse rejections or transactions responses contact: Your vendor. If you use software maintained by a company other than Emdeon to submit your claims electronically, call your vendor. Your vendor should contact Emdeon if further assistance needed.

5 ON 24/7 - If you use an Emdeon product, you may have access to Emdeon's online support tool, ON 24/7, enabling you to obtain customer support online 24 hours a day, 7 days a week. Emdeon Client Solutions: option 3. If you use an Emdeon product to submit your claims or you are a contracted client, contact us directly at this phone number. Emdeon Customer and Sales Support: Electronic Claims Resource Center: Payer contact: Mail: CBO Purchased Care Attn: CHAMPVA claims PO. Box 469063 Denver CO 80246-9063. Phone: 1-800-733-8387. E-mail: Please go to and follow the directions for submitting e-mail via IRIS.

6 Web site: Emdeon Real-Time Eligibility, Claim Status, Health Care Service Review Inquiry and Transactions Request are available using Real-Time Payer ID VAHAC. Claim status is only available for electronic claims submitted through Emdeon. Timely Filing Limits One year from date of service. Claims submitted over one year will be denied. CHAMPVA will not accept Emdeon reports as proof of timely filing. ERA/EFT An Electronic Remittance Advice (835) is provided for all electronic claims submitted to Emdeon that are accepted for processing at payer. 835s are not returned on paper claims.

7 To receive an Electronic Remittance Advice (835), contact your vendor directly. Providers/Vendors must complete and submit the Emdeon ERA Provider Setup from to receive 835s. Contact Emdeon at option 1 for enrollment assistance. EFT payments are received separately from US dept of the Treasury. To enroll for EFT, providers will need to fill out and submit to the Treasury Department an SF 3881 which can be found on the following link: or Providers may contact the Treasury for EFT enrollment at the following number:1-877-353-9791.