Accelerated and Advanced Payment Nettings/Offsets Across Organization Affiliations

We are receiving an influx of calls to our Provider Contact Center with regard to recoupment of AAPs with providers questioning recoupments on funds they believe their practice did not receive.

Here’s What You Need to Know

CMS has implemented a change to begin netting/offsetting provider money across affiliated providers within the same TIN and also across workloads within a single organization. The CMS change brings consistency to all Medicare contractors regarding netting across organization affiliations.

Definition of Affiliated Providers

Affiliated providers are providers that share the same TIN number across multiple PTANs. It’s important to know that CMS policy is recouping based on the TIN rather than the PTAN. CMS instructs Medicare contractors to use the TIN to get the recoupment of the advanced payment regardless of which PTAN actually received the payment. We are asking you to collaborate with all affiliated providers under one TIN.

If you are part of a group, you did not receive an AAP, and you see the recoupment on your remittance advice; reach out to your other group providers to determine which PTAN received the AAP.

Any or each related provider (same TIN) to the PTAN that received the AAP will each offset 25% of the total RA amount. Any affiliate PTANs will offset 25% of their remaining amount on their RA after any regular AR or ERS offsets are made.

The National Government Services Provider Outreach and Education Team is conducting COVID-19 Advanced Payment, Repayment and Recoupment Process training and Let’s Chat sessions. Please visit the Webinars, Teleconferences & Events section on our website under the Education Tab for a schedule of events.

Accelerated and Advanced Payment Nettings/Offsets Across Organization Affiliations

Here’s What You Need to Know

Definition of Affiliated Providers

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