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Health Administration Center

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CURRENT LOCATION: LESSONS
LESSONS:
Lesson 1: Eligibility/Application Process
    • Sponsor
    • Beneficiary/Dependent
  • Factors Affecting Eligibility
    • Spouse
    • Child
    • Widow
    • Medicare
Lesson 2: Benefit Information
  • Overview
    • Authorized providers
    • Pre-authorizations
    • Generally excluded benefits (Non-covered benefits)
  • General Medical Services
  • Ambulatory Surgery Center (ASC)
  • Dental
  • DME
  • Family Planning and Maternity
  • Hospice
  • Inpatient Services
  • Mental Health Services
    • Inpatient
    • Outpatient
    • PHP
    • RTC
    • SUDRF
    • Other
  • RX
  • Preventive Health
  • SNF
  • Transplants
Lesson 3: Cost and Payment Information
  • Beneficiary Costs
    • Deductible
    • Cost-share
    • Catastrophic Cap
    • Payment in full
  • Cost and Payment Summary (Chart)
    • ASC
    • Dental
    • DME
    • Home Health
    • Hospice
    • Inpatient
      • DRG (Acute, SUDRF)
      • CTC (SNFs and those facilities identified in the policy manual)
      • Per Diem (MH, RTC, PHP)
    • Outpatient
    • RX
    • Travel
Lesson 4:Other Health Insurance (OHI)
  • Terms
  • Double Coverage
    • HMOs
    • Medicare
    • Other primary payers
    • Medicaid
    • State victims of crime
    • Workers comp
    • Other third party (i.e., auto, home, school, etc.)
  • What CHAMPVA Pays After the OHI Paid
  • Supplemental
Lesson 5: Actions on Claims
  • Timely Filing
  • Actions on Claims
    • CHAMPVA EOB
    • Appeals/Reconsideration
  • Fact Sheets
  • Forms

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