Submitting Claims

Providers can submit U.S. Department of Veterans Affairs (VA) Veterans Choice Program (VCP) and Patient-Centered Community Care (PCCC) claims electronically by using electronic data interchange (EDI) or manually by mailing in a paper claim. To facilitate faster claims processing, we suggest submitting claims electronically. Electronic claims submissions provide you with an electronic acknowledgement of claim receipt and allow for faster payments.

Claim Submission Tips

Visit our Claims Tips page to learn tips on how to expedite the submission, review and processing of your claim.

Note: Health Net Federal Services, LLC (HNFS) requires the submittal of a Request for Taxpayer Identification Number and Certification (W-9) form in order to issue claims payment for VCP and PCCC claims.

Timely Filing

Visit our Timely Filing page for details on submission deadlines for new and resubmitted claims.

Submitting Electronic Claims

Why choose an EDI claims submission process over paper?

  • EDI provides you with an electronic acknowledgement of claim receipt.
  • EDI claims enter into the claims processing system faster.
  • EDI allows for faster claims payments.

Get started now – Register with Change Healthcare to start submitting claims electronically.

If already registered, you may submit your claims using the following information:

Payer Name: Health Net – VA Patient-Centered Community Care Program
Payer ID: 68021

Note: This payer name and ID also applies to Veterans Choice Program electronic claims.

Submitting Paper Claims

Providers can submit paper claims by mailing completed CMS-1450 (UB04) or CMS-1500 (version 02/12) claim forms to the applicable claims address. (For information on how to order forms, visit www.palmettogba.com.)

Veterans Choice Program Patient-Centered Community Care
Veterans Choice Program – VACAA
PO Box 2748
Virginia Beach, VA 23450
Patient-Centered Community Care
PO Box 9110
Virginia Beach, VA 23452

HNFS recommends electronic claims submission. However, If you choose to submit paper claims, please keep the following tips in mind: 

  • Complete the “From” and “To” dates in box 24A – “DATE(S) OF SERVICE.”
  • Do not photocopy the CMS 1500 (version 02/12). Only original red and white, or red and white computer-generated claim forms, are acceptable.
  • Accurately complete each field in the claim form and type clearly within the field space provided. If required text does not appear within a field, or crosses over an adjacent field, the claim will reject upon submission.
  • Type content using Times New Roman font, either 10 or 12 point, without highlights, italics, or bold texts.*
  • Do not use staples, tape or correction fluid (such as Wite-Out®), as these will cause the claim to reject upon submission.
  • Do not fax the CMS 1500 (version 02/12) to HNFS as we cannot accept faxed claims for processing.

*Other types of fonts and handwritten claims are accepted, but could result in a rejection if the data cannot be validated. The recommendations identified above will result in the best performance and outcome of the optical character recognition (OCR) process.  

For detailed instructions on how to complete a paper claim form, please view the Medicare Claims Processing Manual located on Medicare’s website.

 

 

Veterans Crisis Support

Support for your patients who are U.S. Veterans:

  • 1-800-273-8255 Press 1
  • Confidential chat at VeteransCrisisLine.net or text to 838255

Because one small act can make a difference.