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Current National Threat Level is elevated

The threat level in the airline sector is High or Orange.

Forms

The following forms are provided by the Managed Care Services Unit.

MedPAR Account [MS Word] NEW FORM

MedPAR Account [PDF] NEW FORM

MedPAR Form [PDF]   (When MedPAR is unavailable)

CMS-1500 Form

CMS-1500 Instructions

CMS-1450 Form

CMS-1450 Instructions

ADA Form

ADA Instructions

ACH Enrollment Form


Claims, Billing and Payment:

ICE Health Service Corps
VA Financial Services center
PO Box 149345
Austin, Tx 78714-9345
800-479-0523