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Need to refund an overpayment, cancel or correct a claim?
Here's what you need to know.
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Request for Service form updated, easier to use
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Check CHAMPVA beneficiary eligibility in real time
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Effortlessly sync with VA through External Provider Scheduling
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Reminder: For faster service, submit CHAMPVA claims electronically
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If you need to send a refund to VA because you received a duplicate payment, or if you need to cancel or modify a claim, submit a void or correction. Do not send unsolicited funds.
When you submit your correction or void, make sure to use the correct frequency code to ensure your claim is processed correctly. Not only does this avoid discrepancies and delays, it keeps track of adjustments as part of the administrative record.
If you need to refund a payment due to duplicate payment or want to cancel a previously submitted claim, use the claim void option:
- Use frequency code 8.
- Include the original 18-digit transaction control number (TCN) (claim number).
If you need to refund a partial payment because of changes to the services billed or to modify a previously submitted claim, use the corrected claim option:
- Use frequency code 7.
- Include the original 18-digit TCN (claim number).
What to expect after submission
Once a claim with frequency code 7 or 8 is received, VA will notify you of the outcome. VA will inform you of next steps if funds need to be recouped from you.
Remember: Don’t send a refund check unless explicitly instructed to do so.
If you have any questions or need further assistance, please contact our Customer Call Center at 877-881-7618, 8 a.m. to 9 p.m. ET, Monday-Friday.
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If a Veteran patient of yours needs more treatment from you than their referral authorizes, you will need to submit a request for VA to authorize that care. The Request for Service (RFS) form (10-10172) was recently updated and is now only two pages instead of three. One page is for medical services, and the other is for durable medical equipment (DME).
This simplified version of the form means you don’t have to waste time wading through unnecessary fields. Plus, VA can review your submissions more quickly and easily, which helps ensure your Veteran patients get the care they need promptly.
If your facility has a current Community Care Network agreement with TriWest or Optum, or a Veterans Care Agreement with your local VA medical center, you can submit the RFS using HealthShare Referral Manager (HSRM). If you don’t have access to HSRM, visit the VA Storefront for access.
Blank RFS forms are also available online.
Reminder: A separate form is needed for each service requested.
What happens after you submit your RFS?
Once you submit the RFS, it takes up to three business days for VA to review and process your request. You will be notified of the decision through your chosen communication method. Remember – please do not provide care without authorization.
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If you provide care for patients covered by the Civilian Health and Medical Program of Veterans Affairs (CHAMPVA), you can electronically check their eligibility status.
Instead of calling the CHAMPVA customer service center, you can use your electronic data interchange (EDI) system. After connecting with VA’s clearinghouse, Change Healthcare Optum, or another clearinghouse of your choice, use the eligibility and benefit inquiry (270) transaction. VA’s real-time payer ID is VAHAC.
Checking a patient’s eligibility status electronically avoids phone calls, provides additional information such as the patient’s remaining deductible and out-of-pocket maximum, and saves administrative costs.
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If you haven’t heard, VA’s new scheduling process, External Provider Scheduling (EPS), makes booking Veteran patient appointments easier on you and your staff. EPS software integrates with over 150 electronic health records and seamlessly connects with your schedule enabling VA schedulers to book appointments for you. You maintain full control of your schedule, and there is no cost to participate.
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Streamlined Scheduling — VA schedulers book directly into your scheduling grid.
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Integrates with Existing Systems — Seamless integrations. No new programs required.
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Provider Control — You retain full control over your schedule and availability.
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Faster Booking Process — Reduces the need for multiple phone calls and faxes.
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Simplified Care Coordination — Seamless authorizations and bi-directional information sharing.
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Cost-Free Participation — No cost to you!
Over 8,000 provider services are live in EPS.
Email EPSProviderEngagementTeam@va.gov to find out more or join today!
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Filing claims electronically for patients covered by the Civilian Health and Medical Program of Veterans Affairs (CHAMPVA) is faster! Paper claims are still accepted but take an average of 20 days longer. Send paper CHAMPVA claims to Tampa, Florida. (NOT to Spring City, Pennsylvania.)
VHA Office of Integrated Veteran Care
CHAMPVA Claims
PO Box 30750
Tampa, FL 33630-3750
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E D U C A T I O N & T R A I N I N G
Program description: Symptoms of PTSD may change over time, and many older Veterans have never spoken about their traumatic wartime experiences. This course increases awareness of the impact of PTSD in older Veterans and includes unique treatment aspects and intervention related to this population. The web-based training is suitable for mental health professionals, nurses, physicians, and social workers. It is sponsored by VA’s Office of Mental Health and Suicide Prevention, National Center for PTSD.
Location: VHA TRAIN
Credit/hours: One (1)
Accreditations: ACCME, ACCME-NP, ANCC, APA, ASWB, NBCC, NYSED SW
Kratom dependence: Overview and treatment
Program description: Kratom is a readily available substance often perceived to be a natural and safe alternative to opioids. However, kratom carries similar risks for abuse and dependence, as well as development of a use disorder. The on-demand video is suitable for mental health professionals, physicians, nurses, social workers, and pharmacy professionals. 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
Serving Veterans with substance use in VA homeless programs
Program description: This training discusses the legal definitions of homelessness, range of VA homeless programs and housing types, prevalence of substance use disorders among homeless Veterans, services provided in VA homeless programs, and recommendations for collaborating with homeless program staff to improve access to care. The live webinar is suitable for physicians, physician assistants, nurses, psychologists, pharmacists, counselors, occupational therapists, rehabilitation counselors, and social workers. It is sponsored by VA’s Institute for Learning, Education, and Development.
Date: July 22, 2 p.m. ET
Location: VHA TRAIN
Credit/hours: One (1)
Accreditations: AAPA, ACCME, ACCME-NP, ACPE, ANCC, AOTA, APA, ASWB, JA IPCE, NBCC, NYSED-P, NYSED SW
Menopause in the women Veteran population – Intermediate
Program description: This training discusses how military exposures may have affected early onset of menopause in women Veterans. It explores considerations for earlier osteoporosis screening and cardioprotective recommendations for women with potential or known military exposures. The on-demand video is suitable for physicians, nurses, mental health professionals, social workers, and pharmacy professionals. It is sponsored by the War-Related Illness and Injury Study Center (WRIISC) within Health Outcomes Military Exposures (HOME).
Location: VHA TRAIN
Credit/hours: One (1)
Accreditations: AAPA, ACCME, ACCME-NP, ACPE, ANCC, AOTA, APA, ASWB, CDR, JA IPCE, NBCC, NYSED-P, 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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