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.

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

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 fax a copy of the first page of the original demand letter and/or (if applicable) the spreadsheet with the form to: 781-741-3587.
  • 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.
• 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:
    
    Medicare Cash Accounting
    P.O. Box 9103
    Hingham, MA 02044-9103
    
    Note: This P.O. Box is 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:
    
    Medicare
    P.O. Box 1000
    Hingham, MA 02044-1000
     
  • When a provider / supplier discovers an overpayment and is not submitting a refund check.
    Complete and forward the form to:
    
    Medicare
    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. 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:

    

   New England

   Medicare Cash Accounting NHIC, Corp. P.O. Box 9103 Hingham, MA 02044-9103

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

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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06/19/2008