Immediate Recoupment Request Form - Electronic/E-mail Automatic Response

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Thank you for using the National Government Services Immediate Recoupment Request Form - Electronic/E-mail. Your request has been received and will be processed within 10 business days.

If you selected the Current and Future Overpayments immediate recoupment option, please be aware that you will still receive demand letters as new overpayments are established. Please retain those demand letters for future reference.

No additional follow-up notices will be issued regarding your request. Any money recouped through the immediate recoupment process will be indicated on your remittance advice.

Regards,

National Government Services, Inc.
Medicare Fiscal Intermediary