I Have a Recoupment Question
Published 01/04/2021
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Brief Description
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If an overpayment is determined and a demand letter is sent to the provider notifying them of the amount owed to the Medicare program, and if payment is not received within the specified time period, all payments to the provider are recouped until the overpayment is collected. Recoupment of payments can also be made from affiliated providers.
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In an effort to address provider questions regarding refunds received from Palmetto GBA and reconciling these refund amounts to patient account activity, Palmetto GBA has implemented a refund notification process. When a refund is issued to a provider, Palmetto GBA will send out a standard refund notification letter.
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This interactive tool provides assistance in reconciling overpayment activity to patient account activity.
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Providers do not need to do anything to request standard recoupment after receiving a demand letter. Recoupment will begin automatically in accordance with the timeframe outlined in the demand letter received. Interest will accrue on the outstanding principal balance of the debt for each 30-day period in which a balance remains. If an outstanding balance remains on an overpayment in an eligible collection status, a final demand letter will be issued and the debt may be referred to the Department of Treasury for collection. |