How to Bill Pharmacy Claims to VA & Medicare Part D
Things You'll Need
- Claim Form
- Itemized Statement
Instructions
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Veterans Affairs Claims
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1
Obtain itemized statement from the pharmacy. The statement should include social security number, pharmacy name and contact information, name of prescribing the physician, price and date. Drug information should include the drug name, the 11-digit National Drug Code, the prescription strength and the quantity.
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2
Fill out claim form VA Form 10-7959a. This form can be found online on the VA website or can be requested via telephone.
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3
Mail to CHAMPVA claims address: VA Health Administration Center, CHAMPVA, PO Box 469064
Denver, CO 80246-9064.
Medicare Part D Claims
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4
Print out claim form CMS 1490S, "Patient's Request for Payment" from the official Medicare site.
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5
Obtain itemized statement from pharmacy. This statement should include your social security number, date of prescription, name of prescribing physician, description of medicine (code, name, strength and quantity) and the contact information for pharmacy.
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6
Send claim form and statement to appropriate address. Medicare receives claims at regional locations. The instructions for filing a claim have a chart for locating the address nearest you.
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