Overpayments

Respond to a Demand Letter

Table of Contents

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Form(s) you’ll need

Providers on Automatic immediate Recoupments

  • Do nothing as this automation process will automatically be done and will be reported back to you with an updated RA.

Providers NOT on Automatic Immediate Recoupments will attach a check to this form and include a copy of the demand letter.

When Medicare identifies that you have been overpaid, a receivable is created in the Medicare system and a demand letter is issued to the provider requesting payment. Timely reimbursement is required to avoid the overpayment accruing interest. Within the letter is information about:

  • The amount of the overpayment
  • Claim detail (if appropriate)
  • Appeal rights
  • Offset timeline
  • Extended repayment plan options, and
  • The address to mail your check to

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Timeline for Processing a Demand Letter

  1. Medicare identifies an overpayment
  2. Demand letter is mailed
  3. Provider is given 30 days from the date of the letter to pay the requested amount before the receivable starts accruing interest.
  4. If the provider decides to request immediate recoupment, the request must be received in writing and include a copy of the demand letter
  5. If a check is received, it will be applied toward intended receivables in the following manner:
    1. In the event there is interest, the check is first applied toward the interest owed and then applied toward the principal.
    2. If the intended overpayment has previously been offset or satisfied, CMS policy requires the check be applied toward any of the provider's or affiliated providers' outstanding receivables first before refunding the monies to the provider.

Reviewed 10/17/2024