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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.

Collecting and Reporting Retirement Dates on Medicare Claims

Do Not Cancel Claims in Medicare Secondary Payer (MSP) Situations

Medicare Secondary Payer (MSP) Conditional Billing Process

Medicare Secondary Payer (MSP) Billing Code Chart

Medicare Secondary Payer Fact Sheet for Provider, Physician and Other Supplier Billing Staff

Preparing MSP Claims

Reason Codes U680E, U680L and U680D

Submitting Medicare Primary Claims When There is a Medicare Secondary Payer File on the Common Working File

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

• Please fax a copy of the first page of the original demand letter and/or (if applicable) the spreadsheet with the: J14 Part A & B Immediate Offset Request Form to 781-741-3571.
• To ensure proper processing/handling for your request(s), this form must be completed in its entirety.
• This form should only be used to request an immediate offset on an already existing accounts receivable.

J14 Part A & B Immediate Offset Request Form

J14 Part A 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, Corp. PO Box 809086 Chicago, IL 60680-9086	NHIC, Corp. PO Box 809127 Chicago, IL 60680-9127

  
  
  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

Medicare Secondary Payer Recovery Contractor (MSPRC)

By Telephone
For your convenience, please have HICN/ Medicare Number when calling
MSPRC Main Number:
      1-866-MSPRC-20 or 1-866-677-7220
      Monday - Friday, 8:00 a.m. - 8:00 p.m., ET

TTY/TDD Number for the Hearing and Speech Impaired:
1-866-677-7294

By Mail
Group Health Plan (GHP) Inquiries and Checks (e.g. all GHP checks and inquires including Congressional, FOIA, Bankruptcy and QIC/ALJ)
      MSPRC - GHP
      P.O. Box 138856
      Oklahoma City, OK 73113

Non-Group Health Plan (NGHP) Inquiries and Checks (e.g. all NGHP checks and inquires including Liability, No-Fault, Workers Compensation, Congressional, FOIA, Bankruptcy, Liquidation Notices and QIC/ALJ)
      MSPRC - NGHP
      P.O. Box 138832
      Oklahoma City, OK 73113

Special Projects (e.g. all Product Liability Case Inquiries and Special Project Checks)
      MSPRC - Special Projects
      P.O. Box 138868
      Oklahoma City, OK 73113

By Fax
MSPRC Correspondence (On your fax coversheet, please identify your correspondence as GHP or NGHP)
      405-869-3309

* HICN/Medicare Number is required on all correspondence when mailing/faxing

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03/29/2012