CHAMPVA
CHAMPVA is a payer organization. For an ASC, what matters isn't the logo. It's how CHAMPVA pays: where it runs rich, where it runs thin, and how its reimbursement compares with peer plans for the same procedures.
Pilot Analysis
Get the complete CHAMPVA analysis
Tell us where to send it. Our team will prepare an analysis of CHAMPVA covering rates by code, market position, and underpaid areas, and email it to you within 5-10 business days. Need it faster? Book a demo.
What Insights reveals
How CHAMPVA pays
See how CHAMPVA reimburses across procedures and markets, benchmarked against the peer plans competing for the same cases. Not a raw rate sheet, a read on where it sits.
Geographic footprint
See where CHAMPVA concentrates and how its presence shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for CHAMPVA and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive CHAMPVA's volume, so you know where a rate change moves the needle.
Whether you're an ASC benchmarking a contract or a provider team looking CHAMPVA up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with CHAMPVA
- Payer ID
- 10061 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to CHAMPVA through a clearinghouse.
- Eligibility verification
- Coverage and benefits for CHAMPVA members are verified before the date of service, through a clearinghouse using payer ID 10061or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with CHAMPVA directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of CHAMPVA the way it pays.
- What is CHAMPVA's payer ID?
- CHAMPVA's electronic payer ID is 10061. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to CHAMPVA through a clearinghouse.
- How do ASCs verify eligibility for CHAMPVA members?
- Eligibility and benefits for CHAMPVA members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 10061) or through the payer's provider portal.
- Does CHAMPVA require prior authorization for ASC procedures?
- Prior-authorization requirements for CHAMPVA are set per plan and per procedure. Confirm whether an authorization is required with CHAMPVA directly before the date of service.
- What type of payer is CHAMPVA?
- CHAMPVA is a payer organization.
- How does CHAMPVA compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where CHAMPVA pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is CHAMPVA paying my ASC below market?
- Put your own CHAMPVA contract next to the peer benchmark in DataLily AI and you'll see the gap by procedure and market, the fastest way to know whether you're leaving money on the table.