GN 02403.040:
Processing Returned Medicare Contractor's Checks and Medicare Overpayment Refunds Received in the FO
Effective Dates: 11/08/2001 - Present- Effective Dates: 02/14/2018 - Present
- TN 12 (04-00)
- GN 02403.040 Processing Returned Medicare Contractor's Checks and Medicare Overpayment Refunds Received in the FO
A. PROCEDURE - MEDICARE CONTRACTOR"S CHECKS- A. PROCEDURE - MEDICARE CONTRACTOR'S CHECKS
Send all returned Medicare contractor"s checks issued by the intermediary or carrier such as Blue Cross/Blue Shield, Aetna, Traveler"s, etc., to the intermediary or carrier who issued the check.- Send all returned Medicare contractor's checks issued by the intermediary or carrier such as Blue Cross/Blue Shield, Aetna, Traveler's, etc., to the intermediary or carrier who issued the check.
- Forward Medicare overpayment refunds not involving premium payments to the intermediary or carrier shown on the notice of overpayment unless the refund is submitted in response to an action generated by the PC. In those situations, forward the refund to the MATPSC.
- B. PROCEDURE - MEDICARE CONTRACTORS CHECKS
Handle returned Medicare contractor"s checks received in the FO as follows.- Handle returned Medicare contractor's checks received in the FO as follows.
- 1. Interviewer
- * Stamp the returned check “NOT NEGOTIABLE”.
- The check may already be stamped “NOT NEGOTIABLE” by the mailroom or reception area personnel. See GN 02403.004.
- * Enter the remittance into the system, using Trust Fund code “N” , and Reason code “Q”. Give the automated receipt to the remitter. Give remittance to remittance clerk. In addition to the receipt, DMS will also generate a forwarding instruction sheet indicating how the remittance should be handled.
- * Give the remittance to the Remittance Clerk
- REFERENCE: See MSOM DMS 003.006 and MSOM DMS 003.007 for how to obtain automated FO receipt.
- 2. Remittance Clerk
- * At the end of day, obtain FO Daily Receipt Listing and associate remittance with remittance.
- REFERENCE: See MSOM DMS 004.009 for how to obtain FO Daily Receipt Listing.
Form SSA-414-U3 will not be prepared and FO Remittance Transmittal will not be sent for returned Medicare contractor"s checks since the contractor is not required to acknowledge their receipt.- Form SSA-414-U3 will not be prepared and FO Remittance Transmittal will not be sent for returned Medicare contractor's checks since the contractor is not required to acknowledge their receipt.
- * Hand carry the check(s) and FODRL to the Remittance Supervisor.
- 3. Remittance Supervisor
- * Verify and reconcile all remittances for which receipts were issued that day, and sign and date the FODRL if it is in agreement with the listed remittances.
* Compare the check to any mailroom and reception area logs completed that day. Ensure that any returned Medicare contractor"s check logged in that day has been stamped “NOT NEGOTIABLE” and a receipt was issued.* Mail returned Medicare contractor"s checks daily to the issuing carrier or intermediary address as listed in the Intermediary Manual.- * Compare the check to any mailroom and reception area logs completed that day. Ensure that any returned Medicare contractor's check logged in that day has been stamped “NOT NEGOTIABLE” and a receipt was issued.
- * Mail returned Medicare contractor's checks daily to the issuing carrier or intermediary address as listed in the Intermediary Manual.
- C. PROCEDURE - MEDICARE OVERPAYMENT REFUNDS
- Process Medicare overpayment refunds not involving premium payments received in the FO, as follows.
- 1. Interviewer
- * Is refund received in cash?
- * If yes, follow procedure in GN 02403.009, Processing Cash Remittances Received in the FO. STOP.
- * If no, see GN 02403.040C.1.b.
- * Enter the remittance into the system for an automated FO Receipt. Use Trust Fund code “N” and Reason code “D”. Give the receipt to the remitter. In addition to the receipt, DMS will also generate a forwarding instruction sheet indicating how the remittance should be handled.
- REFERENCE: See MSOM DMS 003.006 and MSOM DMS 003.007 for how to obtain FO Receipt.
- * Give remittance to the remittance clerk.
- 2. Remittance Clerk
- * At the end of day, obtain FODRL and associate the remittance to it.
- REFERENCE: See MSOM DMS 004.009 for how to obtain FODRL.
- * Hand carry FO Daily Receipt Listing with related payment coupons and refund payments to the remittance supervisor at the end of the day.
- 3. Remittance Supervisor
- * Compare the refund to any mailroom and reception area logs completed that day. Ensure that any Medicare overpayment refunds logged in that day are on FODRL.
- * Record any discrepancies and resolve them with the remittance clerk/interviewer
- * If the refund is:
- * received with notice from the intermediary or carrier, forward refund to the intermediary or carrier shown on the notice of the overpayment.
- * submitted in response to an action generated by the PSC, forward the refund to the MATPSC, along with other remittances that are listed on the FORT.
The Medicare overpayment refund will not be listed on the FORT but will be included on the FODRL. * received and does not show the identity of the overpaid party or of the carrier or intermediary which made the overpayment, forward the refund with as much information as is available to the CMS Regional Office at the appropriate address listed in GN 02403.040D. based upon the overpaid party"s address using GN 02403.040E.- The Medicare overpayment refund will not be listed on the FORT but will be included on the FODRL.
- * received and does not show the identity of the overpaid party or of the carrier or intermediary which made the overpayment, forward the refund with as much information as is available to the CMS Regional Office at the appropriate address listed in GN 02403.040D. based upon the overpaid party's address using GN 02403.040E.
- D. LIST OF CMS REGIONAL OFFICES
- All correspondence is mailed to CMS Regional Offices at the appropriate address below.
- Northeast Consortium
Region 1--Boston CMS/Boston Regional Office Beneficiary Services/Contractor Operations Branch JFK Building Room 2325 Boston, Massachusetts 02203 617-565-1188- Region 1--Boston CMS/Boston Regional Office Beneficiary Services/Contractor Operations Branch JFK Building Room 2325 Boston, Massachusetts 02203 617-565-1188
Region 2--New York CMS/New York Regional Office Beneficiary Services and Providers Branch 26 Federal Plaza Room 3811 New York, New York 10278-0063 212-264-4488- Region 2--New York CMS/New York Regional Office Beneficiary Services and Providers Branch 26 Federal Plaza Room 3811 New York, New York 10278-0063 212-264-4488
Region 3--Philadelphia CMS/Philadelphia Regional Office Division of Beneficiaries, Health Plans and Providers The Public Ledger Building, Suite 216 150 S. Independence Mall West Philadelphia, Pennsylvania 19106 215-861-4154- Region 3--Philadelphia CMS/Philadelphia Regional Office Division of Beneficiaries, Health Plans and Providers The Public Ledger Building, Suite 216 150 S. Independence Mall West Philadelphia, Pennsylvania 19106 215-861-4154
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- Consortium Administrator--New York RA
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- Southern Consortium
Region 4--Atlanta CMS/Atlanta Regional Office Division of Benefit Services Atlanta Federal Center, 4th Floor 61 Forsyth St., SW, Suite 4T20 Atlanta, Georgia 30323-8909 404-563-7150- Region 4--Atlanta CMS/Atlanta Regional Office Division of Benefit Services Atlanta Federal Center, 4th Floor 61 Forsyth St., SW, Suite 4T20 Atlanta, Georgia 30323-8909 404-562-7150
Region 6 Dallas CMS/Dallas Regional Office Division of Beneficiaries, Health Plans and Providers 1301 Young Street Room 833 Dallas Texas 75202-4348 214-767-6427- Region 6 Dallas CMS/Dallas Regional Office Division of Beneficiaries, Health Plans and Providers 1301 Young Street Room 833 Dallas Texas 75202-4348 214-767-6427
- Consortium Administrator
- Atlanta RA
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- Midwest Consortium
Region 5--Chicago CMS/Chicago Regional Office Division of Beneficiary Services 233 N. Michigan Avenue, Suite 600 Chicago Illinois 60601 312-886-6432- Region 5--Chicago CMS/Chicago Regional Office Division of Beneficiary Services 233 N. Michigan Avenue, Suite 600 Chicago Illinois 60601 312-886-6432
Region 7--Kansas City CMS/Kansas City Regional Office Division of Beneficiary Services Richard Bolling Federal Building 601 East 12th Street, Room 242 Kansas City, Missouri 64106-2808 816-426-5233- Region 7--Kansas City CMS/Kansas City Regional Office Division of Beneficiary Services Richard Bolling Federal Building 601 East 12th Street, Room 242 Kansas City, Missouri 64106-2808 816-426-5233
- Consortium Administrator--KC RA
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- Western Consortium
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Region 8--Denver CMS/Denver Regional Office Customer Relations Branch Colorado State Bank Building 1600 Broadway, Suite 700 Denver, Colorado 80202-4367 303-844-2111- Region 8--Denver CMS/Denver Regional Office Customer Relations Branch Colorado State Bank Building 1600 Broadway, Suite 700 Denver, Colorado 80202-4367 303-844-2111
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Region 9--San Francisco CMS/San Francisco Regional Office Division of Benefit Services 75 Hawthorne Street 4th and 5th Floor San Francisco, CA. 94105-3901 415-744-3501- Region 9--San Francisco CMS/San Francisco Regional Office Division of Benefit Services 75 Hawthorne Street 4th and 5th Floor San Francisco, CA. 94105-3901 415-744-3501
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Region 10--Seattle CMS/Seattle Regional Office Division of Beneficiaries, Health Plans and Providers 2201 Sixth Avenue MS/RS-42 Seattle WA 98121 206-615-2317- Region 10--Seattle CMS/Seattle Regional Office Division of Beneficiaries, Health Plans and Providers 2201 Sixth Avenue MS/RS-42 Seattle WA 98121 206-615-2317
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- Consortium Administrator--Denver RA
- E. LIST OF STATES IN CMS REGIONS
- The States in each CMS region are listed below.
- CMS REGIONS
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- STATES IN EACH REGION
- I
- BOSTON
- Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont
- II
- NEW YORK
- New Jersey, New York, Puerto Rico, Virgin Islands
- III
- PHILADELPHIA
- Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia
- IV
- ATLANTA
- Alabama, North Carolina, South Carolina, Florida, Georgia, Kentucky, Mississippi, Tennessee
- V
- CHICAGO
- Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin
- VI
- DALLAS
- Arkansas, Louisiana, New Mexico, Oklahoma, Texas
- VI
- KANSAS CITY
- Iowa, Kansas, Missouri, Nebraska
- VI
- DENVER
- Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming
- IX
- SAN FRANCISCO
- American Samoa, Arizona, Nevada, California, Guam, Hawaii
- X
- SEATTLE
- Alaska, Idaho, Oregon, Washington
x
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