Submitting FMP Claim
You are free to choose any hospital anywhere in the world, but it is necessary to submit your bill via fax according to the provided guide.
When submitting claims for reimbursement, the following Documentation must be included with the claim:
1. VA Form 10-7959f-2
2. Physician treatment plan
3. Therapist’s treatment plan
4. Receipt (if paid by Veteran)
The Physician Treatment Plan should include:
1. Diagnosis/brief description of the related function impairments for which physical rehabilitation is prescribed
2. Procedure rendered
3. Description of therapy program
4. Frequency and duration of treatment
5. Expected medical benefit
The Therapist’s Treatment Plan should include:
1. Diagnosis
2. Description of therapy program
3. Frequency and duration of treatment
4. Itemized billing invoice
5. Therapist’s signature
When submitting claims for reimbursement, the following Documentation must be included with the claim:
1. VA Form 10-7959f-2
2. Physician treatment plan
3. Therapist’s treatment plan
4. Receipt (if paid by Veteran)
The Physician Treatment Plan should include:
1. Diagnosis/brief description of the related function impairments for which physical rehabilitation is prescribed
2. Procedure rendered
3. Description of therapy program
4. Frequency and duration of treatment
5. Expected medical benefit
The Therapist’s Treatment Plan should include:
1. Diagnosis
2. Description of therapy program
3. Frequency and duration of treatment
4. Itemized billing invoice
5. Therapist’s signature