Medicare News
Enhanced Provider Enrollment Status Inquiry Tool
We have updated our online status tool to include the status of Phase 3 revalidation applications (i.e., requests issued after September 20, 2013). We apologize for the inconvenience and appreciate your patience as we worked through this issue. We request that you utilize the online tool as your source of information for application status so our Customer Service Representatives can be utilized for more complex inquiries.
Chapter 24 Section 24.2.C “Unsolicited Return of Money – Part A and Part B” of the Reference Manual has been updated
Please ensure that all required fields on the “Return of Monies to Medicare” form are completed. If the required claim specific information is not provided, we will phone develop to the provider. If phone development is not successful, all funds will be kept and applied to a manually established receivable within our system and appeal rights will be lost.
If you are returning an Overpayment due to a Medicare Secondary Payer (MSP) situation, the following items are needed to complete the appropriate adjustment activity:
- Primary Insurer’s explanation of benefits (EOB)
- Type of Medicare Secondary Payer involved
- Other Insurer Information
- Employer Information if Applicable
- Date of Loss (if available)
There is a section on the “Return of Monies to Medicare” form for this information to be provided. If this information is not provided up front, phone development will be needed to your office to obtain the missing information, which may cause a delay in your overpayment being processed. If information is not obtained during phone development, a full claim adjustment may be completed resulting in a balance due letter being generated to the provider.
Do not use the “Return of Monies to Medicare” form if you are making payment in response to an overpayment demand letter received.
If refunding a high volume of claims, we recommend that you list all the claim numbers and required data on an Excel spreadsheet. The Excel spreadsheet should be placed on a CD and forwarded along with your check and “Return of Monies to Medicare” form to the appropriate address listed above.
