Overview

The process for filing a claim for services rendered to a Veteran in the community varies depending upon whether VA issued a referral for the care and whether the rendering provider has a contract or agreement with VA or one of VA’s Third Party Administrators. The following information will explain who to submit claims to and the requirements you must follow when submitting claims.

Authorized care

All non-urgent and non-emergent care requires authorization from VA in advance. Authorized care refers to medical or dental care that was approved and arranged by VA to be completed in the community. Your referral (VA Form 10-7080) will state where to submit your claim.

Emergency care can also be authorized by VA in certain circumstances when the VA is notified within 72 hours of the start of treatment. Refer to your notification decision to determine where to submit your claim.

Unauthorized emergency care

When emergency care has not been authorized, claims and supporting documentation must be submitted to VA.

VA and CCN claims

If your care was authorized, how you submit your claim depends on your status in the VA network and how the care was authorized.

• Community Care Network (CCN) claims must be filed with the correct CCN Third Party Administrator (TPA)
  • Urgent care claims should always be submitted to the Community Care Network. For more information, visit the Urgent care page.

• VA claims are filed according to the VA authorization/referral
  • Bowel and bladder care claims, refer to the Bowel and bladder care claims section
  • Foreign Medical Program claims, refer to the FMP claims section

CCN claims

If you are part of the CCN with Optum or TriWest, you must file the claim with the correct CCN Third Party Administrator (TPA) as per the authorization/referral. Contact the appropriate organization based on where the claim was submitted with questions.

• For CCN Regions 1-3, file with Optum
  • Region 1: 888-901-7407 (M-F, 8:00 a.m. – 6:00 p.m. ET)
  • Region 2: 844-839-6108 (M-F, 8:00 a.m. – 6:00 p.m. ET)
  • Region 3: 888-901-6613 (M-F, 8:00 a.m. – 6:00 p.m. ET)
    
    
• For CCN Regions 4-5, file with TriWest
  • 877-226-8749 (8:00 a.m. – 4:30 p.m. CT)

VA claims

• Veterans Care Agreement (VCA)/Local contract: If you have a Veterans Care Agreement (VCA) established with VA or are not part of one of VA’s formal networks, file claims with VA according to the authorization/referral.
  • If you’ve treated a Veteran emergently and the care has not been authorized by VA, file those claims with VA.
• Dental claims: Dental claims must be filed via 837 EDI transaction or using the most current American Dental Association (ADA) form and comply with ADA and specific, VA requirements listed below. In addition to the information contained on this page, please refer to the instructions provided on the ADA website.
  

Before filing your claim:

• Make sure you have received an official referral/authorization to provide care OR that the care is of an emergent nature
• Submit the claim to the correct payer
• Include the authorization number on the claim form for all non-emergent care
• Make sure the services provided are within the scope of the authorization
• Check the accuracy of billing codes
  • Include the 17 alpha-numeric (10 digits + “V” + 6 digits) VA-assigned internal control number (ICN) in the insured’s I.D. field. The Veteran’s ICN can be found on the VA issued HSRM referral.
  • The Veteran’s full 9-digit social security number (SSN) may be used if the ICN is not available.
    
    

VA claim submissions

• Electronic submissions to VA
  Electronic 837 claim and 275 supporting documentation submissions can be completed through the VA clearinghouse or through another clearinghouse of your choice.
  • Medical Claim Payer ID: 12115
  • Dental Claim Payer ID: 12116
  • EDI Referral/Authorization Annotation Information includes:
    • Prior Authorization Number is Loop = 2300, Segment = REF*G1, Position = REF02
    • Home Health Agencies billing with an OASIS Treatment number use the Prior Authorization segment for the TAC and the Referral Number segment on the 837I submission
      
      
• Paper submissions to VA
  Paper claims and documents are converted to EDI formats (837 for claims, 275 for attachments). If the claim doesn’t meet minimum 837 requirements, it will be rejected for correction. Mail paper claims and documents to:

VA claim corrections and voids

To submit a correction or void for a VA claim, view the Claims corrections and voids page

VA claims support

Supporting documentation

Supporting documentation for claims processing applies only to unauthorized emergency care claims. It is not required for authorized care claims.

Providers may also need to submit medical documentation to VA for care coordination. Claims documentation and care coordination documentation are separate processes.

Any supporting documentation that VA cannot match to a claim will be returned to the sender for additional information.

Electronic submissions for supporting documentation

If you submitted the claim electronically, submit supporting documentation electronically using the 837/275 transaction. This is the preferred method.

Paper submissions for supporting documentation

The process for paper submission of supporting documents depends on how the claim was originally submitted.

• If you originally submitted the claim by paper: Resubmit the paper claim with the supporting documentation to the address below.

• If you originally submitted the claim electronically using an 837 transaction: Mail the supporting documentation with VA Form 10-10143f, P2E Documentation Cover Sheet

Care coordination documentation

Submit medical documentation to the authorizing VA medical facility for care coordination purposes as soon as possible after care is provided. Any supporting documentation needed for claims processing must be submitted through the process described in the VA and CCN claims section.

Submitting documentation for care coordination does not satisfy claims documentation requirements. For care coordination requirements, visit the Care coordination webpage.

Supporting documentation for care coordination may include:

• Ambulance run report
• Emergency room notes
• History and physical
• Progress notes
• Transfer notes and discharge summaries
• Other health insurance (OHI) information and explanation of benefits (EOBs)
• Other documents normally submitted in support of a Veteran’s unauthorized emergency care claim

Bowel and bladder care claims

There are two ways to file a claim for bowel and bladder care: as an individual provider, such as a family member, friend, or caregiver, or as an agency provider furnishing care in an agency setting.

• Agency providers: Refer to the general VA claims submission process
• Individual providers: VA will only accept VA Form 10-314, Request for Payment of Bowel and Bladder Services, to request reimbursement of authorized Veteran bowel and bladder care costs
  • The Veteran Integrated Control Number (ICN) and the referral number can be found on the Approved Referral for Medical Care, VA Form 10-7080, issued by the referring VA medical center.

To avoid delays, completed forms must be correct and legible. Claims are only eligible for reimbursement if they are submitted within 180 days of the date of service.

Submit completed forms monthly to:

Foreign Medical Program claims

VA’s Foreign Medical Program (FMP) provides health care benefits for Veterans with VA-rated, service-connected disabilities who receive care while living or traveling abroad.

VA administers FMP, including Veteran registration, eligibility verification, benefit authorization, and claims processing and payment. Through FMP, VA may pay for certain health care services, medications, and durable medical equipment needed to treat:

• a service-connected disability, or
• a condition associated with and aggravating a service-connected disability

Before providing care, you can verify a Veteran’s FMP eligibility by reviewing their FMP benefits authorization letter, which outlines the Veteran’s covered service-connected disabilities.

Direct deposit requirements

VA is changing how we process FMP reimbursement claims to improve security and efficiency. In July 2026, FMP will move to a new claims processing system that supports direct deposit payments.

To get ready for this change, you will have to apply for a foreign tax identification number (FTIN) if you don’t already have one. Once you have an assigned FTIN, submit it to our team using the submission form below.

How to file an FMP claim

Include the following information with every claim:

• Patient’s full name, mailing address, and Social Security number
• Billed charges and date of each service
• Provider’s full name, medical title, office address, and contact information
• Narrative description of the service provided
• Diagnosis treated
• VA claim number
• FMP Claim Cover Sheet (VA Form 10-7959f-2)

Supporting documentation for FMP claims

Additional documentation may be required depending on the type of claim.

To help VA process claims faster, submit documents in English when possible. VA will translate documents submitted in other languages, but translation may add processing time.

Claim submission

Send all documentation via mail, fax or email to:

For more information on submitting a claim, please contact the FMP office.

FMP contacts

How to check claims status

If you filed a claim with Optum, please refer to the Optum VA Community Care Provider Portal. If you filed a claim with TriWest, please refer to TriWest Provider Claims Information.

If you filed a claim with VA, check claims status through the VA Electronic Claims Administration and Management System (eCAMS) Provider Portal (ePP). ePP provides secure, web-based access to real-time claim details and payment information. ePP gives registered users access to:

• Real-time claim status updates
• Line-level adjudication details
• Electronic remittance reports
• Check or direct deposit information
• Explanation of Payment (EOP) documents
• Bill of collection and offset actions

VA Electronic Claims Administration and Management System (eCAMS) uses paperless explanation of payment (EOP) documents. This applies to all claims submitted to VA by paper or electronically to payer IDs 12115, 12116 and VA Financial Services Center.

You may request to continue receiving paper EOPs by emailing the eCAMS Help Desk. The email must include the provider’s National Provider Identifier (NPI), a VA claim number (TCN) associated with the provider, and provider’s phone number and email address.

How VA classifies claims status

• Accepted: VA accepts claims for care that was preauthorized by VA. Providers will receive prompt payment for accepted claims.
• Denied: VA denies claims when care was not preauthorized and the Veteran does not meet eligibility requirements for emergency care.
• Rejected: VA rejects claims when more information is needed before the claim can be paid or denied. Rejected claims may be resubmitted once the required information is available.

Decision reviews and appeals for Veteran care

If you are a community care provider and don’t agree with a VA claims decision related to the services you provided, you may request further review. Your options for decision review and appeals depend on if your claim was for VCA, contract, or unauthorized emergency care. This page explains the three appeal pathways and how to submit a request.

Veterans Care Agreement (VCA) dispute

A VCA dispute applies only to claims processed under a Veterans Care Agreement and associated with a VA Form 10-7080, Approved Referral for Medical Care, marked with a “VCA” affiliation. If this describes your claim, refer to the dispute terms within your signed VCA. The dispute terms dictate your options.

Contract dispute

If you provided care under a VA contract, disputes must be submitted in accordance with the terms of your contract. Follow the dispute procedures and submission instructions outlined in your contract documentation.

Unauthorized emergency care

If you provided treatment to a Veteran in an emergency without authorization from VA, you have three options available to seek further review of your claims decision. You may choose from one or more of the following:

• Supplemental claim
• Higher-Level Review
• Appeal to the Board of Veterans’ Appeals

Request assistance

As a community provider, you may contact VA Customer Support with questions about claims processing or available review options.