Effective Dates: 11/19/2019 - Present

Identification Number:
GN 02403 TN 35
Intended Audience:See Transmittal Sheet
Originating Office:DCBFM OFPO
Title:Procedures for Handling Remittances and Premium Payments in the Field Office
Type:POMS Transmittals
Program:All Programs
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part GN – General
Chapter 024 – Checks
Subchapter 03 – Procedures for Handling Remittances and Premium Payments in the Field Office
Transmittal No. 35, 11/19/2019

Audience

PSC: DS, IES, LDS;
OCO-OEIO: BIES, BTE, CCRE, CR, CTE, FCR, PETL, RECOVR;
OCO-ODO: BTE, CCE, CR, CST, CTE, CTE TE, DSE, PAS, PETE, PETL, RC, RCOVTA, RECOVR;
FO/TSC: CS, CS TII, CS TXVI, CSR, CTE, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

OFPO

Effective Date

Upon Receipt

Background

The Office of Financial Policy and Operations, Office of Payment and Recovery Policy made updates to this procedure by spelling out acronyms, updating links, and updating contact information for CMS regional offices.

Summary of Changes

GN 02403.040 Processing Returned Medicare Contractor's Checks and Medicare Overpayment Refunds Received in the FO

In the title of the policy Field Office (FO) has been spelled out.

Section A. Payment Center (PC) and Mid-Atlantic Program Service Center (MATPSC) has been spelled out.

Section B.1.b. Debt Management System (DMS) has been spelled out.

Section B. reference section links have been updated.

Section B.2.a. Field Office Daily Receipt Listing (FORDL) and Field Office Remittance Transmittal (FORT) has been spelled out.

Section C.3.c. Centers for Medicare and Medicaid Services (CMS) has been spelled out.

Section D. Name, address, and phone numbers of CMS regional offices have been updated.

Region 1-- Boston

CMS Boston Region Office of the Regional Administrator

Division of Financial Management and Fee for Service Operations

JFK Building

Suite 2325

Boston, Massachusetts 02203-003

617-565-1281

Region 2-- New York

CMS New York Region Office of the Regional Administrator

Division of Financial Management and Fee for Service Operations

Jacob K. Javits Federal Building

26 Federal Plaza

Room 3811

New York, New York 10278-0063

212-616-2505

Region 3--Philadelphia

CMS Philadelphia Office of the Regional Administrator

Division of Financial Management and Fee for Service Operations

801 Market Street

Suite 9400

Philadelphia, Pennsylvania 19107

215-861-4154

Region 4-- Atlanta

CMS Atlanta Region Office of the Regional Administrator

Division of Financial Management and Fee for Service Operations

Atlanta Federal Center

61 Forsyth Street

Suite 4T20

Atlanta, Georgia 30303-8909

404-562-7368

Region 6-- Dallas

CMS Dallas Region Office of the Regional Administrator

Division of Financial Management and Fee for Service Operations

1301 Young Street

Suite 714

Dallas, Texas 75202

214-767-6441

Region 5-- Chicago

CMS Chicago Region Office of the Regional Administrator

Division of Financial Management and Fee for Service Operations

233 North Michigan Avenue

Suite 600

Chicago, Illinois 60601

312-353-9087

Region 7-- Kansas City

CMS Kansas City Region Office of the Regional Administrator

Division of Financial Management and Fee for Service Operations

601 East 12th Street

Room 355

Kansas City, Missouri 64106

816-426-5033

Region 8--Denver

CMS Denver Region Office of the Regional Administrator

Division of Financial Management and Fee for Service Operations

1961 Stout Street

Room 08-148

Denver, Colorado 80294

303-844-2111

Region 9--San Francisco

CMS San Francisco Region Office of the Regional Administrator

Division of Financial Management and Fee for Service Operations

90-7th Street

Suite 5-300

San Francisco, California 94103-6706

415-744-3658

Region 10--Seattle

CMS Seattle Region Office of the Regional Administrator

Division of Financial Management and Fee for Service Operations

701 5th Avenue

Suite 1600

Seattle, Washington 98104

206-615-2399

GN 02403.040 Processing Returned Medicare Contractor's Checks and Medicare Overpayment Refunds Received in the Field Office (FO)

A. Procedure for 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 submitted refund is in response to an action generated by the Payment Center (PC). In those situations, forward the refund to the Mid-Atlantic Program Service Center (MATPSC).

B. Procedure - Medicare Contractors Checks received in the FO

Handle returned Medicare contractor's checks received in the FO as follows.

1. Technician

  • •

    Stamp the returned check “NOT NEGOTIABLE,”

NOTE: 

Mailroom or reception personnel may have already stamped the check “NOT NEGOTIABLE”. See GN 02403.004.

  • •

    Enter the remittance into the system, using Trust Fund code “N” , and Reason code “Q,”

  • •

    Give the automated receipt to the remitter, and

NOTE: 

In addition to the receipt, Debt Management System (DMS) will also generate a forwarding instruction sheet indicating how to handle the remittance.

  • •

    Give the remittance and the forwarding information to the Remittance Clerk.

For more information on how to obtain automated FO receipt see MS 01103.006 and MS 01103.007 .

2. Remittance Clerk

  • •

    At the end of day, obtain Field Office Daily Receipt Listing (FORDL) and associate payment received/checks with remittance (see MS 01104.009); and

  • •

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

NOTE: 

We will not prepare form SSA-414-U3 nor send Field Office Remittance Transmittal (FORT) for Medicare contractor's checks since the contractor is not required to acknowledge their receipt.

3. Remittance Supervisor

  1. a. 

    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. b. 

    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. c. 

    Mail returned Medicare contractor 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. a. 

    Is refund received in cash?

  2. b. 

    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 MS 01103.006 and MS 01103.007 for how to obtain FO Receipt.

  3. c. 

    Give remittance to the remittance clerk.

2. Remittance Clerk

  1. a. 

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

    REFERENCE: See MS 01104.009 for how to obtain FODRL.

  2. b. 

    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. a. 

    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. b. 

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

  3. c. 

    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.

      NOTE: 

      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 Centers for Medicare and Medicaid Services (CMS) Regional Office at the appropriate address listed in GN 02403.040D. based upon the overpaid party's address usingGN 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 Region Office of the Regional Administrator
Division of Financial Management and Fee for Service Operations
JFK Building
Suite 2325
Boston, Massachusetts 02203-0003
617-565-1281

Region 2--New York

CMS New York Region Office of the Regional Administrator
Division of Financial Management and Fee for Service Operations
Jacob K. Javits Federal Building
26 Federal Plaza
Room 3811
New York, New York 10278-0063
212-616-2505

Region 3--Philadelphia

CMS Philadelphia Region Office of the Regional Administrator
Division of Financial Management and Fee for Service Operations
801 Market Street
Suite 9400
Philadelphia, Pennsylvania 19107
215-861-4154

Consortium Administrator--New York RA

 

Southern Consortium

 

Region 4--Atlanta


CMS Atlanta Region Office of the Regional Administrator
Division of Financial Management and Fee for Service Operations
Atlanta Federal Center
61 Forsyth Steet., SW
Suite 4T20
Atlanta, Georgia 30303-8909 
404-562-7368

Region 6 Dallas

CMS Dallas Region Office of the Regional Administrator
Division of Financial Management and Fee for Service Operations
1301 Young Street
Suite 714
Dallas, Texas 75202
 
214-767-6441

Consortium Administrator

 

Atlanta RA

 

Midwest Consortium

 

Region 5--Chicago

CMS Chicago Region Office of the Regional Administrator
Division of Financial Management and Fee for Service Operations
233 North Michigan Avenue
Suite 600
Chicago, Illinois 60601
 
312-353-9087

Region 7--Kansas City

CMS Kansas City Region Office of the Regional Administrator
Division of Financial Management and Fee for Service Operations
601 East 12th Street
Room 355
Kansas City, Missouri 64106  
816-426-5033

Consortium Administrator--KC RA

 

Western Consortium

 

Region 8--Denver

CMS Denver Region Office of the Regional Administrator
Division of Financial Management and Fee for Service Operations
1961 Stout Street
Room 08-148
Denver, Colorado 80294
303-844-2111

Region 9--San Francisco

CMS San Francisco Region Office of the Regional Administrator
Division of Financial Management and Fee for Service Operations
90-7th Street
Suite 5-300
San Francisco, California 94103-6706
415-744-3658

Region 10--Seattle

CMS Seattle Region Office of the Regional Administrator
Division of Financial Management and Fee for Service Operations
701 5th Avenue
Suite 1600
Seattle, Washington 98104
206-615-2399

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
I BOSTON Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont
II NEW YORK New Jersey, New York, Puerto Rico, Virgin Islands
III PHILADELPHIA Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia
IV ATLANTA Alabama, North Carolina, South Carolina, Florida, Georgia, Kentucky, Mississippi, Tennessee
V CHICAGO Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin
VI DALLAS Arkansas, Louisiana, New Mexico, Oklahoma, Texas
VI KANSAS CITY Iowa, Kansas, Missouri, Nebraska
VI DENVER Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming
IX SAN FRANCISCO American Samoa, Arizona, Nevada, California, Guam, Hawaii
X SEATTLE Alaska, Idaho, Oregon, Washington
GN 02403 TN 35 - Procedures for Handling Remittances and Premium Payments in the Field Office - 11/19/2019