Forms

• CMS-1500 (OMB NO. 0938-0999) Health Insurance Claim Form
• CMS-1450 (OMB NO. 0938-0997)Health Insurance Claim Form
• HCFA-1450 UB-92 (OMB NO. 0938-0279)Health Insurance Claim Form
• VA Form 10-583 - Claim for Payment of Cost of Unauthorized Medical Services

How to File a Claim

• Instructions for Providers
• Instructions for Veterans

Emergency Care in Non VA Facilities

• Non-VA Emergency Care Handout
• Non-VA Emergency Care Brochure

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