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
If you disagree with the payment decision for your supplemental claim, have new and relevant evidence to submit, or want to request a review of your claim based on a change in law, a supplemental claim may be an option for you.
Unless your supplemental claim is based on a change in law, you’ll need to submit supporting evidence that’s new and relevant for your application to be completed. Supplemental claims must be submitted within 1 year of the decision.
Claims Intake Center
Attn: 104P Appeals
P.O. Box 4444
Janesville, WI 53547-4444
844-678-8979
If you disagree with a VA payment decision, you can request a new review of your claim by a higher-level reviewer. The reviewer will determine whether an error or a difference of opinion changes the claims processing decision. You can’t submit new evidence with a Higher-Level Review. Requests for a Higher-Level Review must be submitted within 1 year of the decision.
NOTE: You can’t request a Higher-Level Review after a previous Higher-Level Review or Board Appeal on the same claim.
Claims Intake Center
Attn: 104P Appeals
P.O. Box 4444
Janesville, WI 53547-4444
844-678-8979
For information on filing an appeal with the Board of Veterans’ Appeals, please visit the VA Board Appeals webpage.
Request assistance
As a community provider, you may contact VA Customer Support with questions about claims processing or available review options.
VA Customer Support: 877-881-7618
Monday–Friday, 8 a.m.–9 p.m. ET
Related pages
Provider claims
- Decision reviews and appeals–Veteran care