Medicare Overpayments

 

Overpayments are Medicare funds that you or a beneficiary has received in excess of the amount allowed payable under the Medicare statute and regulations.

Once a determination of an overpayment has been made, the amount of the overpayment is a debt owed to the United States Government via one of its Medicare contractors.

Voluntary Refunds

A voluntary/unsolicited refund may be made to a Medicare contractor when a provider has discovered an error, which resulted in an overpayment.

Unsolicited / Voluntary Refund Disclaimer
Discovery of an Overpayment
Reasons for Overpayment
Notifying Medicare of an Overpayment
Partial Refund
Return of Monies to Medicare Form
Voluntary Disclosures
Use of Statistical Sampling
Overage Checks

 

Solicited Refunds

When an overpayment is identified a claims adjustment will occur. This will create a receivable account which will issue a demand letter requesting repayment.

Initial Notice of Overpayment/Methods of Repayment
Discontinuing an Immediate Offset
Voluntary Refund Change with Demand Letters - Part B Only
Aggregation of Overpayment Amounts
Withheld for Offset
Uncollectible Overpayments
Tax Levies

 

Appeal

If you disagree with a refund request, you may choose to appeal the notice of overpayment. An appeal rights statement will be included in the initial refund letter.

Appeal of the Notice of Overpayment
Limitation of Recoupment Process (Medicare Modernization Act 935)
Understanding the Remittance Advice for Adjustments Subject to MMA Section 935

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