Medicare Secondary Payer and 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

Guides & Forms

To enroll in Medicare as a provider or make changes to your existing Medicare information, you must complete a CMS-855 application.

• Medicare Secondary Payment Billing Guide
• MSP & Overpayment Immediate Offset Request Form
  This form is used to request an immediate offset for MSP and Non-MSP existing accounts receivables.
  Please submit a copy of the first page of the original demand letter and/or (if applicable) the spreadsheet.
  To ensure proper processing/handling for your request(s), this form must be completed in its entirety. Also, to prevent any additional charges, such as an interest accrual, please submit this form to us within 30 days.
  This form should only be used to request an immediate offset on an already existing accounts receivable. All other requests must be directed to the appropriate department to ensure a timely response.
• Overpayment Refund Form
  This form should be used:
  • To return an unsolicited / voluntary refund. Please complete and forward this form, so that receipt of your check is properly recorded and applied.
  • When a provider / supplier discovers an overpayment and is not submitting a refund check.
  
  NOTE: Indicate in the refund information box if you wish to request an immediate offset

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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. 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:

1. Include the acronym "MSP" on the refund checks.
2. Include the acronym "MSP" on the envelope containing the check.
3. Mail the MSP refund check as follows:

    

   Southern California	Northern California
   Medicare Administration - MSP Refund NHIC, Corp. P.O. Box 515301 Los Angeles, CA 90051-6601	Medicare Administration - MSP Refund NHIC, Corp. P.O. Box 951 Marysville, CA 95901-0951

More information on making voluntary refunds can be found at http://www.medicarenhic.com/providers/articles/volrefunds_1207.pdf

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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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03/13/2008