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Part A FAQs – Overpayment Recovery

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Additional Tips for Overpayment Recovery Requests

When faxing information to the Overpayment Recovery department, please use the following fax number.

Forms – The Redetermination form should be used for Appeal purposes only (requesting appeal). The correct form to use for Overpayment Recovery issues can be found on the Part A Forms page.

When sending in multiple checks, please attach documentation for each check. OPR has identified issues where there is only one piece of documentation attached to the first check. The checks are processed separately; this results in development for the remaining checks, potentially causing a delay in processing.

Reason for Refund – If the reason for refund is the "Wrong Number of Services," please do not refer to the reason as "Billing Error." Use "Other" for the reason and identify the correct number of services as well as the CPT so the adjustment can be processed correctly.

When another carrier is Primary to CGS Medicare, please include a copy of the Primary Insurance's EOB. This will assist OPR to coordinate the benefits correctly.

Please include the beneficiary's name, Medicare ID number, date of service, and reason for refund on all Overpayment Recovery correspondence. Also, include a contact person's name and telephone number in case there are additional questions regarding your OPR request (not the practice or physician's name.)

Please include the CGS Medicare EOB as documentation if the claim is over 1 year old.

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