Providers who continue to elect to submit paper claims and paper documentation to support claims for unauthorized emergency care should be aware of the following:

• VA must be capable of linking submitted supporting documentation to a corresponding claim
• Community providers have three options that allow for that linkage
• Submit the claim electronically via 837 transaction and the supporting documentation via 275 transaction
• Include the claim, or a copy of the claim, on top of the supporting documentation that is mailed to the following address:
  
  VHA Office of Community Care
  PO Box 30780
  Tampa, FL 33630-3780
• Include a completed cover sheet with the supporting documentation that is mailed to the above address.  

Supporting documentation may include:

• Ambulance Run Report
• Emergency Room Notes
• History and Physical
• Progress Notes
• Transfer Notes and Discharge Summaries
• Other Health Insurance (OHI) and Explanation of Benefits (EOBs)
• Any other document type normally sent via paper in support of a Veteran unauthorized emergency claim
• NOTE: Documentation that is not required include flow sheets and medication administration

  While VA always encourages providers to submit claims electronically, on and after May 1, 2020 it is important that all documentation submitted in support of a claim comply with one of the two paper submission processes described above. Any supporting documentation that VA is unable to link to a claim will be returned to sender for additional information.

  NOTE: The processes outlined above are exclusive to supplying documentation for unauthorized emergent care. These do not apply to authorized care.

Authorized and Referred Care

Medical documentation for care referred and authorized by VA or VA’s Third-Party Administrators (TPAs) should be submitted to the referring VA as part of the Veteran’s care coordination process.  VA has several options providers can choose from for submission of these documents.  More information about submitting documentation for authorized care can be found at Request and Coordinate Care.

More Information

For more information on this change, please visit the  VA Community Care website.

Due to COVID-19, all paper community care claims and supporting documentation must now be mailed to the following address, (effective May 1, 2020):

VHA Office of Community Care
PO Box 30780
Tampa, FL 33630-3780

As is always the case, VA strongly encourages community providers to submit claims and required supporting documentation electronically through VA’s clearinghouse, Change Healthcare. Doing this can improve claim accuracy and reduce the amount of time for claims processing determinations.

Community providers interested in information about claims and supporting documentation submission should visit the Community Care File a Claim for Veteran Care web page. 

(Please note: this does not apply to claims for treatment provided under one of VA’s TPAs, e.g. TriWest or Optum.)

VA and the Department of Defense (DOD) have launched a modernized health information exchange (HIE) that improves the ability to securely exchange Veteran health records with community providers.

Benefits of this new joint HIE capability are available to all VA and DoD care providers and all participating community providers.  The joint HIE also provides a platform for future interoperability expansion, including connecting to CommonWell, an organization devoted to ensuring medical data is transferable between software systems and medical technology with a network of more than 15,000 community providers, expected later this year.

Read more about VA and DoD's joint HIE capabiliy.