Billing Pharmacy Claims with VA & Medicare Part D: A Step-by-Step Guide

Though most pharmacies will bill Medicare Part D and/or Veteran's insurance claims, it may still be necessary to send in a paper claim. In these situations, you will pay up front for the medication and receive reimbursement from either Medicare or CHAMPVA, veterans' Insurance. Reimbursement is sent via check by mail.

Things You'll Need

• Claim Form
• Itemized Statement

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Instructions

Veterans Affairs Claims

• 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.

• 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.

• 3

  Mail to CHAMPVA claims address: VA Health Administration Center, CHAMPVA, PO Box 469064

  Denver, CO 80246-9064.

Medicare Part D Claims

• 4

  Print out claim form CMS 1490S, "Patient's Request for Payment" from the official Medicare site.

• 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.

• 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.