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Claims go to VA or Medicare, not both Expect recovery of duplicate payments
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You may see more patients due to the Dole Act
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External Provider Scheduling: It’s kind’ve a big deal
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Not enrolled in EFT for CHAMPVA claims?
Here’s how (and why).
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VA recovering overpaid
claims from some
CHAMPVA providers
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Expect recovery of duplicate payments
Some Veterans are eligible for health care through both VA and Centers for Medicare & Medicaid Services (CMS). However, you can only submit a claim to VA or CMS for reimbursement, not to both. If claims are submitted to both VA and CMS for the same services at the same time, it can lead to double payment and create the appearance of abusive billing practices.
VA and CMS will recover duplicate payments
Attempts to recover a duplicate payment may come from VA or CMS, depending on which agency has the predetermined right to recover.
You do not need to take any action unless VA or CMS sends you a bill of collection, which will include instructions on how to pay the bill and ask questions.
Recovery efforts will begin as early as this month and may include duplicate payments made for services dating back to June 6, 2019. This effort will be ongoing, not a one-time data match.
Although the purpose of the match is recovery of duplicate payments, additional actions could occur in accordance with existing laws and policies, to include administrative fees, penalties and fines, and potential suspension of a community provider from providing care to Veterans through VA or Medicare.
For more information on how to bill VA community care medical claims, please reference:
*Emergency medical care claims billed under Title 38 U.S.C. §1725 must be billed to Medicare first and VA shall be the secondary payer.
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As a result, VA will no longer conduct a secondary clinical review for Veterans determined to be eligible for community care based on the Best Medical Interest (BMI) eligibility criterion. This means that for Veterans eligible for community care under BMI, the determination is now only made between the Veteran and their referring clinician—no other approvals are required.
Because there’s no longer a secondary review, you may see increased referrals for community care. Thank you for partnering with us to ensure Veterans receive timely access to care.
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VA is making community care appointments easier to schedule with a new process called External Provider Scheduling (EPS). With EPS, you can go from a referral to scheduling the first appointment in just minutes, instead of days. It makes the process much easier for Veterans, community providers, and VA staff.
In particular, the system streamlines scheduling, referral, and authorization processes while allowing you to stay in full control of your schedule – leaving more time to care for patients instead of administrative support.
EPS is already in use at 38 VA health care systems and supports over 7,000 provider services. Although it’s not available everywhere yet, it’s expanding quickly.
Join your colleagues today at no additional cost!
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*Data as of May 14, 2025
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Are you a health care provider who accepts Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) claims? Enroll now in electronic funds transfer (EFT) to get paid by direct deposit.
EFT payments are not only secure and efficient, but they also safeguard Veterans’ family members access to benefits. Enrolling in EFT also ensures you get paid.
Your payments will be automatically deposited into a bank account.
If you’re not enrolled in EFT, your claims payments will be paused. Make the move today – it’s a federal requirement.
For assistance with the webform, call 877-353-9791.
About CHAMPVA
CHAMPVA is a health care program for qualified spouses, widows(ers), and children of eligible Veterans. Through CHAMPVA, VA shares the cost of certain health care services and supplies with eligible beneficiaries.
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VA incorrectly processed claims when beneficiaries had more than one other health insurance.
VA is recovering more than $41 million from overpaid claims to providers who accept payment under the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA).
What happened
The overpayments were caused by an error in the claims adjudication system. From October 2021 to December 2024, the adjudication system incorrectly processed claims when CHAMPVA beneficiaries had more than one other health insurance. This resulted in overpayment to many providers.
What this means for you
If you were affected, VA will send you a letter showing the overpaid amount and bill of collection number 741-K5T. Providers can only make payments through the Pay.gov Claim Overpayment portal.
What’s next for affected claims
After recovering overpayments, providers can still send the claims to the secondary payer. If the secondary payer doesn’t pay the claim in full, providers can resubmit the claim to VA with both explanations of benefits for tertiary payment.
Reach out to VA’s Debit Collection Contact Center at 833-930-0816 and follow the prompts if you have questions or need help.
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E D U C A T I O N & T R A I N I N G
Program description: Accurate and comprehensive assessment of PTSD and suicide risk is important for developing effective treatment plans for Veterans. This course introduces participants to military culture and helps them develop skills in assessing PTSD and suicide risk. This two-day virtual workshop is suitable for licensed behavioral health providers who treat Veterans in the community. It is sponsored by Uniformed Services University | Center for Deployment Psychology.
Location: Uniformed Services University | Center for Deployment Psychology
Credit/hours: Up to fourteen (14)
Accreditations: Consult your accrediting organization or licensing board for acceptance.
Psychosocial interventions for substance use disorder
Program description: This course presents behavioral treatments for substance use disorder that are recommended in the VA/DOD Substance Use Disorder Clinical Practice Guidelines. It also discusses how the Center of Excellence in Substance Abuse Treatment and Education can be a resource to provide these evidence-based interventions to Veterans. The on-demand video is suitable for physicians, physician assistants, nurses, psychologists, pharmacists, counselors, and social workers. It is sponsored by VA’s Institute for Learning, Education, and Development.
Location: VHA TRAIN
Credit/hours: One (1)
Accreditations: AAPA, ACCME, ACCME-NP, ACPE, ANCC, APA, ASWB, JA IPCE, NBCC, NYSED-P, NYSED-SW
Using a trauma-informed approach to care with Veterans experiencing homelessness
Program description: This course provides participants with a foundational understanding of trauma-informed care, specifically focusing on its effects on homeless individuals. Participants will learn ways to integrate the trauma-informed care approach into their work with Veterans who are experiencing housing instability or homelessness. The virtual webinar is suitable for physicians, physician assistants, nurses, psychologists, social workers, counselors, and pharmacists. It is sponsored by VA’s Institute for Learning, Education, and Development.
Date: July 16, 1 p.m. ET
Location: VHA TRAIN
Credit/hours: One (1)
Accreditations: ACCME, ACCME-NP, ADA, ANCC, AOTA, ASWB, JA IPCE, NBCC, NYSED-P, NYSED-SW
Partnering with firearm retailers to promote temporary out-of-home firearm storage
Program description: This course describes preliminary findings from The Armory Project, a VA-community partnership with three firearm retailers to promote lethal means safety messaging and temporary storage options for suicide prevention. The on-demand video is suitable for social workers, counselors, psychologists, physicians, and nurses. It is sponsored by VA’s Institute for Learning, Education, and Development.
Location: VHA TRAIN
Credit/hours: One (1)
Accreditations: APA, ACCME, ACCME-NP, ANCC, APA, NBCC, ASWB, NYSED SW
Opioid safety for Veterans with chronic pain
Program description: This course promotes evidence-based techniques to improve patient outcomes for Veterans with chronic pain and decrease complications associated with opioid prescribing. The web-based training is suitable for pharmacy professionals, physicians, and other clinicians. It is sponsored by the VHA Office of Integrated Veteran Care.
Location: VHA TRAIN
Credit/hours: One (1)
Training available through Optum and TriWest
Numerous live and on-demand webinars and trainings are offered by Optum and TriWest to fit your schedule. Check them out!
Interested in more Optum and TriWest news and information? Click here for access to Optum newsletters. TriWest’s Provider Pulse newsletter can be found here.
Preventing suicide through lethal means safety and safety planning
Program description: This course provides lethal means safety training and resources for mental health and suicide prevention clinicians and other mental health and suicide prevention clinicians. The web-based training is suitable for mental health professionals, physicians, and nurses. It is sponsored by VA’s Office of Suicide Prevention.
Location: VHA TRAIN
Credit/hours: One (1)
Accreditations: APA, ACCME, ACCME-NP, ANCC, APA, NBCC, ASWB, NYSED SW
Questions? If you require assistance, please contact the VHA TRAIN Help Desk by email at vhatrain@va.gov.
How to obtain your credit completion certificate:
Once you complete a credited training, you can obtain your credential certificate(s) in four easy steps:
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Log in to VHA Train - https://vha.train.org/vha/login
- Go to “Your Learning”
- Go to “Your Certificates”
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Download your certificate
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COMMUNITY PROVIDERS: Thank you for all you do to support Veterans.
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