MSP Post-Pay Adjustments

If you have received an overpayment because Medicare paid as the primary insurer and another insurance carrier should be the primary payer, follow the instructions on the voluntary refund form.

• A separate refund form is needed for each date of service needing adjustment.
• The reason code area must be completed assigning the appropriate MSP provision to the overpayment (no fault, Workers' Compensation, etc.).
• Include the explanation of benefits from the primary payer with the voluntary refund form.

You have two options:

1. Submit a check with the voluntary refund form. When the claim(s) is adjusted, Medicare will apply the monies to the overpayment.
2. Submit the voluntary refund form without a check and when the claim(s) is adjusted, Medicare will take back the overpayments through the offset process.