National Provider Identifier: Submit all that are applicable, including, but not limited to billing, rendering/servicing, and referring.Complete and accurate standard Center for Medicare & Medicaid Services (CMS) or electronic transaction containing false claims notice (such as CMS 1450, CMS 1500 or 837 EDI transaction).If you are submitting a paper claim, please review the Filing Paper Claims section below for paper claim requirements. Please review the Where To Send Claims and the Where To Send Documentation sections below for mailing addresses and Electronic Data Interchange (EDI) details. 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.For CCN Regions 4-5, file with TriWest.Community Care Network (CCN)–If you are part of the CCN with TriWest Healthcare Alliance (TriWest) or Optum United Health Care (Optum), you must file the claim with the correct CCN Third Party Administrator (TPA) as per the authorization/referral.There are three routes for filing claims for authorized care which depend on your status in VA’s network and how the care was authorized: To file a claim for services authorized by VA, follow instructions included in the “Submitting Claims” section of the referral. Emergency care can also be authorized by VA in certain circumstances when the VA is notified within 72 hours. Most commonly, authorized care refers to medical or dental care that was approved and arranged by VA to be completed in the community. VA Software Documentation Library (VDL).Clinical Trainees (Academic Affiliations).War Related Illness & Injury Study Center.Average Administrative Cost for Prescriptions.Durable Medical Equipment/ Pharmacy Requirements.– Veterans Health Information Exchange Program.Spina Bifida Health Care Benefits Program.– Indian Health Service/Tribal Health/Urban Indian.CHAMPVA In-house Treatment Initiative (CITI).Indian Health Service/Tribal Health Program.
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