Champva Amount Allowed ?

[Harley-1]

I have noticed on a recent explanation of benefits that most charges were adjusted with amounts allowed but when the item had unclassified and observation/recovery no deduction on amount allowed was done and I am talking about miscellaneous $4287.50 billed $4287.50 allowed and observation/reco $8253.30 billed and $8253.30 allowed- spoke to Chad at Champva and was basically told that they were allowed the full amount for both because they picked the right billing codes that seem to be above reproach? Is there any recourse for this type of billing ?

[Buck52]

Harley1

Click on the Archive podcast Radio show for the date 1-21-15 Wed & Listen in here on Hadit

Glen Johnson explains how ChampVA works & how and who they pay & EOB ( Eligibility of Benefits) ...guidelines ect,,,ect,, even mention overseas for veterans/spouses living there or on vacation there maybe some infor there for ya.

Broken Arm Billing amount 10.0000$$

Champ VA Allowable amount 750.00 your 25% Amount 250.00 provider gets 1000.00

Bill concider paid in full

After all Glen Mention makes me proud to have ChampVA.

Edited January 23, 2015 by Buck52

[Pete53]

I think that if ChampVA is secondary than what they give is all the provider can get. You can appeal anything that the VA or ChampVA does.