Overpayment Refund Tip

Providers have the option to submit payment for any overpayment determined by Medicare. To avoid interest from accruing on the outstanding overpayment balance, timely payment is critical. Interest will accrue on the outstanding overpayment balance for each 30-day period that the overpayment remains outstanding as outlined in the initial demand letter.

Overpayments shall begin to recoup no earlier than 40 days from the date of the demand letter, unless a request for immediate recoupment has been received. If you have received an overpayment demand letter and it is currently at least 40 days from the date on the letter, you may want to consider your claims payment status prior to issuing a check for the overpayment.

If you are currently submitting claims to Railroad Medicare and they are processing for payment, these payments will offset on the overpayments that have reached at least 41 days old.  If you send a check for payment, it is likely the claims have paid and offset. In this case a special check has to be issued to you if you have no other outstanding overpayments. To avoid additional work for you, and additional actions by Railroad Medicare, please consider the amount of the overpayment versus the payment for your claims, as interest will accrue every 30 days on any unpaid overpayment balance.

CMS Regulation Reference: Publication 100-06, Chapter 3, Section 200.1.5 (PDF, 595 KB).