Daily Rules, Proposed Rules, and Notices of the Federal Government
a. Foreign Medical Program (FMP) Registration Form, VA Form 10-7959f-1
b. Claim Cover Sheet—Foreign Medical Program (FMP), VA Form 10-7959f-2.
a. Veterans with service connected disabilities living or traveling overseas complete VA Form 10-7959f-1 to enroll in the Foreign Medical Program.
b. Healthcare providers complete VA Form 10-7959f-2 to submit claims for payments or reimbursement of expenses relating to veterans living or traveling overseas (except for the Philippines) with service-connected disability. VA will accept provider's generated billing statement, Uniform Billing—Forms (UB) 04, and Medicare Health Insurance Claims Form, CMS 1500 for payments or reimbursements.
An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The
a. Foreign Medical Program, VA Form 10-7959f-1—111 hours.
b. Claim Cover Sheet, VA Form 10-7959f-2—3,652 hours.
a. Foreign Medical Program, VA Form 10-7959f-1-4 minutes.
b. Claim Cover Sheet, VA Form 10-7959f-2-11 minutes.
a. Foreign Medical Program, VA Form 10-7959f-1-1,660.
b. Claim Cover Sheet, VA Form 10-7959f-2-19,920.
By direction of the Secretary.