The VA CHAMPVA Provider Portal offers healthcare providers a streamlined electronic claims management system for processing medical claims related to the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA). This platform enables efficient claim submission, tracking, and management for providers serving veteran families and eligible beneficiaries.
Official Links
- CHAMPVA Provider Information: https://www.va.gov/COMMUNITYCARE/providers/info-champva.asp
- eCAMS Provider Portal: https://www.occepp.fsc.va.gov/
What Providers Can Do
Healthcare providers using the CHAMPVA Provider Portal can:
- Submit electronic medical claims
- Check claim status
- Verify patient eligibility
- Process claims for various services including:
- Medical treatments
- Mental health services
- Substance abuse treatments
- Organ and bone marrow transplants
Eligibility for Portal Access
Providers must meet specific requirements to use the portal:
- Hold an active state medical license
- Not be on the Medicare exclusion list
- Have an active System for Award Management (SAM.gov) account
- Possess an AccessVA – ID.Me account
Login and Access Process
Login Requirements
- Create an AccessVA – ID.Me account
- Maintain an active SAM.gov registration
- Use the electronic claims submission system
Claim Submission Methods
- Electronic submission (preferred method)
- Payer ID: 84146 for medical claims
- Payer ID: 84147 for dental claims
- Paper claims (20 days longer processing time)
Key Portal Features
- Electronic claim transactions
- Medicare crossover claim processing
- Claim status verification
- Eligibility checking
Privacy and Security
The VA emphasizes strict security protocols:
- All system access is monitored
- Users consent to potential system review
- Unauthorized access attempts are prohibited
- Potential criminal or administrative penalties for misuse
Customer Support
Contact Information
- VA Customer Call Center: 800-733-8387
- Hours: 8:05 a.m. to 7:30 p.m. ET, Monday-Friday
- eCAMS Provider Portal Support: 1-855-299-0231
- Email: [email protected]
Special Considerations
Claim Acceptance
- Providers must accept CHAMPVA allowable rates
- Cannot balance bill beneficiaries
- Exceptions require prior beneficiary notification
System Maintenance
- Regular maintenance: Thursday evenings
- Time: 7:00 pm to 11:00 PM Central Standard Time
Upcoming Changes
Starting January 1, 2025:
- Specific medication prescriptions (Ozempic, Mounjaro) will require Type 2 diabetes diagnosis code
- Weight loss prescriptions not covered under current policy
Important Notes
- Electronic claim submission is strongly recommended
- Preauthorization required for certain services
- No specific provider contract required
Additional Resources
- Filing CHAMPVA Claims guide
- Rejected Claims explanation
- Fact sheets for outpatient providers
Disclaimer
Providers should always verify the most current information directly with VA CHAMPVA services and maintain updated credentials and system access.
FAQ
How to verify champva benefits for providers?
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1. Confirm Patient’s CHAMPVA Eligibility:
- Check the CHAMPVA card: The card will indicate the patient’s coverage and eligibility information.
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airSlatehttps://www.airslate.comHow do I verify VA insurance? | airSlateEligibility for CHAMPVA ends if the widower remarries prior to age 55. CHAMPVA eligibility terminates at midnight on the date of the remarriage. Widower Remarri…
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- Verify with the VA: Use the CHAMPVA website or contact the CHAMPVA claims office to verify the patient’s eligibility.
- Confirm Other Health Insurance (OHI): If the patient has other health insurance, verify the information and how it interacts with CHAMPVA.
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VA.govhttps://www.va.govCHAMPVA Benefits | Veterans AffairsAug 6, 2025 — Mail your completed form and supporting documents to this address: VHA Office of Integrated Veteran Care. CHAMPVA Claims. PO Box 500. Spring City, PA…
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VA.gov Home | Veterans Affairshttps://www.va.govFile a Claim for Family Member Care–Information for Providers – Community CareClaim Filing Requirements CHAMPVA is always the secondary payer except to Medicaid, Indian Health Services, State Victims of Crime Compensation, and supplementa…
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- Check the CHAMPVA card: The card will indicate the patient’s coverage and eligibility information.
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2. Check Covered Services:
- Consult the CHAMPVA policy manual: This manual outlines the specific services and procedures covered under the program.
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Freeman Recovery Centerhttps://www.freemanrecoverycenter.comDo Drug and Alcohol Rehab Centers in Nashville, TN Take CHAMPVA Insurance for Veterans and Military PersonnelHowever, CHAMPVA doesn’t cover services provided outside the scope of the provider’s license or certification. Moreover, it’s crucial to consult the CHAMPVA Pol…
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- Use the CHAMPVA Pay mobile app: This app helps providers identify if a medical code is covered by CHAMPVA, according to CHAMPVA.US.
- Refer to the VA National Formulary: For pharmacy-related services, the VA National Formulary can be consulted, says vacommunitycare.com.
- Consult the CHAMPVA policy manual: This manual outlines the specific services and procedures covered under the program.
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3. Claim Filing Procedures:
- Electronic Claims: Utilize the VA’s clearinghouse and HIPAA transactions (276/270) for electronic claims submission.
- Paper Claims: If electronic submission is not possible, refer to VA.gov for instructions on mailing or faxing claims.
- EDI Payer IDs: Use the appropriate Payer IDs for medical and dental claims when submitting electronically (VA CCN for medical and dental, or 12115 for medical and 12116 for dental if not using the VA CCN).
- Contact the appropriate claims office: If you need to follow up on a claim, contact the relevant claims processing office, such as Optum United HealthCare or TriWest Healthcare Alliance, depending on where you filed.
- Electronic Claims: Utilize the VA’s clearinghouse and HIPAA transactions (276/270) for electronic claims submission.
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4. Additional Resources:
- eCAMS Provider Portal: This portal allows providers to access claim status and remittance information.
- CHAMPVA website: The website provides resources such as claim forms, policy manuals, and contact information.
- Community Care contact information: If you need to coordinate care or have specific questions about a Veteran’s case, contact the appropriate VA medical facility community care office.
- eCAMS Provider Portal: This portal allows providers to access claim status and remittance information.
Does Champva have a patient portal?
Does Champva have a provider network?CHAMPVA is a health care program which shares the cost of certain medically necessary procedures and supplies with eligible beneficiaries. We do not have a network of health care providers, so you can visit most authorized providers.
Is Champva and TRICARE the same insurance?CHAMPVA is for the spouses, dependents, and survivors of Veterans and service members who meet certain service-connected disability requirements. TRICARE is a Defense Department (DOD) program. TRICARE (formerly called CHAMPUS) is for active-duty and retired service members, their families, and their survivors.
https://www.va.gov/COMMUNITYCARE/providers/info-champva.asp
The VHA Office of Integrated Veteran Care (IVC) processes CHAMPVA applications, determines eligibility, authorizes benefits, and processes medical claims.
https://www.occepp.fsc.va.gov/
Check the status of their VA claim through this eCAMS Provider Portal (ePP). Please login to access the eCAMS Provider Portal.