The Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) provides a comprehensive healthcare portal designed to streamline interactions between healthcare providers and the VA’s medical support system. This portal offers critical services for providers serving spouses, widows, and children of eligible veterans.
Official Links
- CHAMPVA Provider Information: https://www.va.gov/COMMUNITYCARE/providers/info-champva.asp
- VA Customer Call Center: 800-733-8387
What Providers Can Do
Healthcare providers using the CHAMPVA portal can:
- Submit electronic claims
- Check claim status
- Verify patient eligibility
- Process medical reimbursements
- Access essential billing information
Eligibility for Portal Access
Providers must:
- Be properly licensed in their state
- Not be on the Medicare exclusion list
- Have valid credentials for medical service provision
Access and Authentication
Electronic Claims Submission
Providers can submit claims electronically through:
- VA clearinghouse
- Payer ID: 84146 (medical claims)
- Payer ID: 84147 (dental claims)
Important Login Requirements
Starting January 1, 2025, providers must:
- Enroll for Electronic Funds Transfer (EFT)
- Receive payments directly into a bank account
Key Features
Claim Processing
- Electronic 837 claim transactions accepted
- Includes Institutional, Professional, and Dental claims
- Medicare crossover claims supported
Preauthorization Requirements
Certain services require advance approval, including:
- Adjunctive dental procedures
- Mental health services
- Substance abuse treatments
- Organ and bone marrow transplants
Billing Guidelines
Providers must:
- Accept CHAMPVA allowable rates
- Cannot balance bill beneficiaries
- Exceptions only with prior beneficiary notification
Privacy and Security
- HIPAA-compliant transactions
- Secure electronic claim submissions
- Protected patient information handling
Customer Support
VA Customer Call Center
- Phone: 800-733-8387
- Hours: 8:05 a.m. to 7:30 p.m. ET, Monday-Friday
Claim Submission Methods
-
Electronic Submission (Preferred)
- Fastest processing
- Through VA clearinghouse
- HIPAA-compliant transactions
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Paper Claims
- Mailing Address:
VHA Office of Integrated Veteran Care
CHAMPVA Claims
PO Box 30750, Tampa FL 33630-3750 - Longer processing time (approximately 20 days additional)
- Mailing Address:
Unspecified Details
Some specific portal functionalities were not detailed in the provided sources. Providers are encouraged to contact CHAMPVA directly for comprehensive, up-to-date information.
The CHAMPVA Provider Portal represents a critical tool for healthcare providers serving veterans’ families, offering streamlined, secure, and efficient claims processing and medical support services.
Disclaimer: Information current as of June 17, 2025. Always verify most recent guidelines directly with CHAMPVA.
FAQ
Are Champus and TRICARE the same?TRICARE (formerly called CHAMPUS) is for active-duty and retired service members, their families, and their survivors.Mar 19, 2025
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.
What is TRICARE, formerly Champus?TRICARE is the Department of Defense’s triple-option health-care program which replaced the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS).
Does TRICARE have a provider portal?Availity Essentials is TriWest’s secure portal for submitting transactions for TRICARE West Region beneficiaries. Register now with Availity to access important applications, resources and training information.
https://infocenter.humana-military.com/provider/service/account/login
Log in to review current details and make any changes by clicking on the view/update link next to your location address in the group information section.
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.