Skip to Main Content

Print | Bookmark | Email | Font Size: + |

How Long Do I Have to Refund an Overpayment?

When CGS determines that a provider/supplier has been overpaid, a refund request 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, the recoupment process will begin in the form of an offset. Current and future payments will be offset until the overpayment is completely recouped.

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 C Overpayment Voluntary Refund FormPDF, or a similar document containing all of the required information, should accompany every voluntary refund so that the receipt of check is properly recorded and applied. If the specific Patient/HICN or MBI/Claim number is not provided, no appeal rights shall be afforded.

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.

IMPORTANT INFORMATION:

  • Please attach demand letters with checks to prevent possible offset from your Medicare check(s) in error.
  • If you are returning an overpayment due to Medicare Secondary Payer (MSP), please attach a copy of the primary insurance Explanation of Benefits (EOB). If you are unsure if Medicare should pay as the primary or secondary insurer, please review the MSP section of this website.
  • 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.

Related Information

Related Education

spacer

26 Century Blvd Ste ST610, Nashville, TN 37214-3685 © CGS Administrators, LLC. All Rights Reserved