How Do I Appeal An Overpayment?
Take these actions when you receive the demand letter to refund an overpayment:
- It is in your best interest to immediately refund the requested amount. This will help you avoid an offset and accruing interest.
- File your appeal using the online Redetermination Request Form
- Select YES in the Overpayment Appeal section of the form
- Indicate who requested the overpayment (Medical Review, UPIC, CERT, SMRC, OIG, Recovery Auditor (RAC) etc.)
- Submit your appeal to the appropriate DME MAC using the information provided on the form.
- Submission via the myCGS Web Portal:
- Use the Reprocessing tab or the Redetermination button on the Redetermination Claims Status screen.
- Submission via fax:
- Send your fax to the Overpayment Redetermination Fax Line at 615.664.5907.
- Submission via mail:
- CGS
Overpayment Appeals
PO Box 23917
Nashville, TN 37202
- CGS
- Submission via the myCGS Web Portal:
Written reopening requests should be made using the current Medicare Reopening Request form. If you wish to send a written request instead of using the Medicare Reopening Request form, be sure to include the following information:
- The beneficiary's name and Medicare ID (MBI)
- The specific services(s) and/or item(s) for which the reopening is being requested and the specific date(s) of service, and
- The name of the person filing the request
Incomplete requests will be returned along with an explanation for the return. You will be instructed to resubmit your request.