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

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.

1. Interviewer

  1. 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.

  2. 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.

  3. 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

  1. 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.

  2. Hand carry the check(s) and FODRL to the Remittance Supervisor.

3. Remittance Supervisor

  1. 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.

  2. 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.

  3. 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

  1. Is refund received in cash?

  2. 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.

  3. Give remittance to the remittance clerk.

2. Remittance Clerk

  1. At the end of day, obtain FODRL and associate the remittance to it.

    REFERENCE: See MSOM DMS 004.009 for how to obtain FODRL.

  2. 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

  1. 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.

  2. Record any discrepancies and resolve them with the remittance clerk/interviewer

  3. 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.

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 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

 

Consortium Administrator--New York RA

 

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 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

 

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 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

 

Western Consortium

 

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 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 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

 

Consortium Administrator--Denver RA

E. LIST OF STATES IN CMS REGIONS

The States in each CMS region are listed below.

CMS
REGIONS
 STATES IN EACH REGION
IBOSTONConnecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont
IINEW YORKNew Jersey, New York, Puerto Rico, Virgin Islands
IIIPHILADELPHIADelaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia
IVATLANTAAlabama, North Carolina, South Carolina, Florida, Georgia, Kentucky, Mississippi, Tennessee
VCHICAGOIllinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin
VIDALLASArkansas, Louisiana, New Mexico, Oklahoma, Texas
VIKANSAS CITYIowa, Kansas, Missouri, Nebraska
VIDENVERColorado, Montana, North Dakota, South Dakota, Utah, Wyoming
IXSAN FRANCISCOAmerican Samoa, Arizona, Nevada, California, Guam, Hawaii
XSEATTLEAlaska, Idaho, Oregon, Washington

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0202403040
GN 02403.040 - Processing Returned Medicare Contractor's Checks and Medicare Overpayment Refunds Received in the FO - 11/08/2001
Batch run: 01/27/2009
Rev:11/08/2001