Medicare Secondary Payer and Overpayments

This section will provide you with information on Medicare Secondary Payer (MSP) & Overpayment information.

Medicare Secondary Payer (MSP) is the term used by Medicare when another payer pays primary to Medicare.

Medicare Secondary Payer (MSP) Conditional Billing Process

Medicare Secondary Payer (MSP) Billing Code Chart

Overpayments are Medicare payments a provider or beneficiary has received in excess of amounts due and payable under the statute and regulations.

OVERPAYMENTS

This section addresses the recoveries for which payment was made by Medicare in excess of amounts due and payable under statute and regulations. Medicare claims resulting in overpayments may be discovered:

• Internally
• Reported by providers or beneficiaries
• Medicare and other insurers

Immediate Offset Requests

If you choose NOT to appeal an overpayment or submit a refund check for an existing account receivable an immediate offset may be requested. Please fax a copy of the letter requesting early recoupment to 414-459-6007 Attn: 935 Appeals Recoupment prior to 30 days from the date of the original demand letter.

Overpayment Refund Form

Please indicate the appropriate reason for refund (and be as specific as possible). This form should be used:

• To return an unsolicited / voluntary refund.
  Complete and forward this form with your check to the applicable P.O. Box:

  MA/ME/RHHI/RI	NH/VT
  NHIC Medicare – 180 PO Box 5896 New York, NY 10087-5896	NHIC Medicare – 270 PO Box 5909 New York, NY 10087-5896

  
  
  Note: These P.O. Boxes are used strictly for the receipt of checks.
  
  
• To request a new account receivable with an immediate offset for a voluntary refund, (as opposed to an account receivable that has already been established). Complete and forward the form to:
  
  NHIC, Corp.
  P.O. Box 1000
  Hingham, MA 02044-1000
  
  
• When a provider discovers an overpayment and is not submitting a refund check. Complete and forward the form to:
  
  NHIC, Corp.
  P.O. Box 1000
  Hingham, MA 02044-1000
  

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MEDICARE SECONDARY PAYER

Medicare Secondary Payer (MSP) Voluntary Refunds

Medicare Secondary Payer (MSP) voluntary refund checks submitted by providers to NHIC are included with all other checks received at NHIC, Corp. As such, research is required to identify those checks as MSP voluntary refunds. In order to improve the timeliness for application of the monies returned and provide improved service to the provider community, please use the following guidelines when sending MSP voluntary refunds to NHIC:

Contact Information

MSPRC Contact Information

• Chickasaw Nation Industries, Inc. – Administration Services, LLC (CNI) - recovery Contractor for Medicare Secondary Payer (MSPRC). For issues such as Auto, No-Fault and Liability, Group Health Plans, and Workman’s Compensation, please direct your correspondence to:
  
  MSPRC (Auto, No-Fault, and Liability)
  P.O. Box 33828
  Detroit, MI 48232-3828
  
  MSPRC (Group Health Plans)
  P.O. Box 33829
  Detroit, MI 48232-3829
  
  MSPRC (Workman’s Compensation)
  P.O. Box 33831
  Detroit, MI 48232-3831
  
  
• For direct contact call the MSPRC phone line at 1-866-677-7220 8AM to 8PM Eastern Time



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04/22/2010