Please rate Champva Claim Va Form 10 7959A Mar 2025
Claims must be received no later than one year after the date of service or, in the case of inpatient care, within one year of the discharge date.
Provider claims: This claim form is NOT to be used for provider submitted claims.
Other insurance: By law, other coverage must be reported. Except for CHAMPVA supplemental policies, CHAMPVA is always the secondary payer.
EOB: If OHI exists, attach an Explanation of Benefits (EOB) from the other health insurance to the provider's itemized billing statement(s).
Pharmacy claims: Pharmacy claims must include name, quantity, strength, and National Drug Code (NDC) of each drug.
Eligibility: if your marriage to the qualifying sponsor ends by divorce or annulment, your CHAMPVA eligibility ends as of midnight on the effective date of dissolution.
| Question | Answer |
|---|---|
| Form Name | VA Form 10-7959a |
| Form Length | 2 pages |
| Fillable? | Yes |
| Fillable fields | 44 |
| Avg. time to fill out | 8 min |
| Edition | MAR 2025 |
| Where to send | VHA Office of Integrated Veteran Care CHAMPVA Claims, PO Box 500, Spring City, PA 19475 |
| Filing deadline | No later than one year after the date of service or, in the case of inpatient care, within one year of the discharge date |
| Who signs | The patient, sponsor or guardian |
| Matches the agency's file | Yes, checked October 2, 2026 |
| Other names | VA Form 10-7959a, VA 10-7959a, 10-7959a, 10-7959A, CHAMPVA claim form, CHAMPVA Claim Form |
| Official source | VA Form 10-7959a (Rev MAR 2025), Department of Veterans Affairs |
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Please rate Champva Claim Va Form 10 7959A Mar 2025
