Voluntary Refunds
If you identify a Medicare overpayment and are voluntarily refunding with a check, use the Overpayment Refund Form to submit the request. This will ensure we properly record and apply your check.
NOTE: Type directly into the required fields on the Overpayment Refund Form, then print. Illegible forms may cause a delay in processing.
- Ensure the following information is included:
- Patient's Medicare ID Number
- Date(s) of service
- Claim number
- Reason for refund
- Refund amount
- For refunds that are MSP-related, include the EOB or the payment allowed and paid by the primary insurer
Medicare Refund Helpful Tips:
- Always complete the physician/refund portions and use the reason codes listed on the bottom of the form to identify the reason for your refund.
- When refunding for multiple beneficiaries, please be sure to include sufficient documentation to show how much money is being refunded for each claim.
- If you are sending multiple overpayments from a single office or practice, send one check.
- We recommend that you refund no more than 20 Internal Claim Numbers (ICN, also called CCN) per check.
- Send separate checks for overpayments previously requested (demand letters) from those that are being voluntarily refunded.
- Send separate checks for beneficiaries being refunded due to Medicare Secondary Payer (MSP) from those being refunded due to Non-MSP.
- When refunding due to MSP, please be sure to include the primary insurance's explanation of benefits. This is needed in order to determine the correct primary insurance allowed and paid amounts.
- When sending a check to cover a large number of adjustments, CGS recommends sending the required information on a CD in Microsoft Excel. The CD and check can be mailed to one of lockboxes listed below:
- If you are unable to send the information via a CD, it can be sent in an encrypted email to CHECK.DOCUMENTATION@cgsadmin.COM.
- Mail your check along with the required documentation associated with the refund. Please remember to utilize the helpful hints section above. If your request is for MSP, please address to MSP Overpayment Recovery:
- Make the check payable to "CGS Administrators, LLC." and mail to the appropriate address:
Kentucky Providers:
CGS Administrators, LLC - Part B Kentucky
PO Box 957065
St. Louis, MO 63195-7065Overnight Delivery:
CGS Administrators, LLC - Part B Kentucky
Lockbox 957065
3180 Rider Trail South
SL-MO-R1LB
Earth City, MO 63045Ohio Providers
CGS Administrators, LLC - Part B Ohio
PO Box 957352
St. Louis, MO 63195-7352Overnight Delivery:
CGS Administrators, LLC - Part B Ohio
Lockbox 957352
3180 Rider Trail South
SL-MO-R1LB
Earth City, MO 63045
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. If development is needed for coordination of benefits, please allow up to 120 days for processing.