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Refunding an Overpayment

An overpayment refund request can be initiated by CGS (a "demand") or the refund can be voluntarily issued by you as the "debtor." The latter is known as a voluntary refund.

When CGS DME MAC Jurisdiction B determines that a provider/supplier has been overpaid, we will issue a refund request which will be sent to the debtor in the form of an overpayment demand letter. This demand letter will include a document control number (DCN) that must be referenced in any communication with the contractor. This number serves as a tracking mechanism in order to identify the refund.

The debtor has 30 days from the date of the demand letter to refund the contractor. If the overpayment is not paid within the timeframe specified in the initial demand letter, interest begins to accrue on the refund amount. If full payment is not received by the 40th day from the date of the initial demand letter, the recoupment process will begin in the form of an offset. Current and future payments will be offset until the overpayment is completely recouped. If you would prefer to refund the debt through the offset process, you can complete the Immediate offset formPDF.

NOTE: Please attach demand letters with checks to prevent possible offset from your Medicare check(s) in error.

When a provider/supplier believes that an overpayment has been received and makes an unsolicited voluntary refund, it is accepted by the contractor regardless of the amount. The DME MAC Jurisdiction B Overpayment Refund FormPDF, or a similar document containing all of the required information, should accompany every unsolicited/voluntary refund so that the receipt of check is properly recorded and applied. If the specific Patient/HICN or MBI/Claim number information is not provided, no appeal rights shall be afforded.

NOTE: If you are returning an overpayment due to Medicare Secondary Payer (MSP), please attach copy of primary insurance explanation of benefits (EOB).

NOTE: If the unsolicited voluntary refund does not satisfy the overpayment, the same rules will apply regarding the overpayment demand letters. In addition, the same interest and offset rules will apply if the overpayment is not satisfied in a timely manner.

NOTE: The acceptance of a voluntary refund as repayment for the claim specified in no way affects or limits the rights of the Federal Government, or any of its agencies or agents, to pursue any appropriate criminal, civil, or administrative remedies arising from or relating to these or any other claims.

Please allow CGS 60 days from the date of receipt to process voluntary refunds and allow 20 days from the date of receipt to process demands.


Extended Repayment Schedule (ERS)


Reference:

When sending in checks to CGS, please use the address below to prevent possible delays in processing claims-related payments:

CGS Administrators, LLC – DME JB
PO Box 953479
St. Louis, MO 63195-3479

Overnight Delivery:

Through October 13, 2023:

CGS Administrators, LLC - DME JB
Lockbox 953479
1005 Convention Plaza
SL-MO-C1WS
St Louis, MO 63101

Beginning October 14, 2023:

CGS Administrators, LLC - DME JB
Lockbox 953479
3180 Rider Trail South
SL-MO-R1LB
Earth City, MO 63045

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