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Service Line Level Adjudication (SLLA)

CHAMPVA has moved from Claim Level Adjudication to Service Line Level Adjudication for claims processing.

  • Claim Level Adjudication sums up all service lines and then calculates payment, deductible and cost share amounts.
  • Service Line Level Adjudication calculates payment, deductible and cost share amounts for each service line.

CHAMPVA underwent this initiative to honor a federal health care instruction, HIPAA 5010 mandate, to report payment, deductible, and cost share information at the service line level. But, most importantly, it affords our staff the opportunity to provide both our beneficiaries and their providers with a more detailed, customer service-centric explanation of how we process submitted claims.

CHAMPVA paper explanations of benefits (EOBs) will not reflect this change and will look the same. At this time the only way to receive a detailed EOB is to subscribe to Change Healthcare (formerly Emdeon Inc.) for 835 electronic remittance advice (ERA).

For more information on 835 ERA and how to submit electronic claims, please view Electronic Claims — Information for Providers.

NOTE: Only health care providers who submit electronic claims will receive an 835 ERA.