Part B Insider (Multispecialty) Coding Alert

Published on Sun Oct 10, 2010 PDF

If you typically wait until you receive Medicare's third warning that you need to refund an overpayment to your MAC, you'll soon be out of luck.

In the past, if you received an overpayment from Medicare, your MAC would usually send you an initial demand letter, a follow-up latter, and an "intent to refer" letter. However, CMS noticed that most providers either pay on the initial demand or wait until the final notice--so the agency announced on Nov. 9 that it is no longer sending a follow-up letter.

Effective Nov. 1, MACs were instructed to send an initial letter to practices that owed money back to the Medicare program. Recoupment begins 41 days after that letter. If an overpayment is not paid within 90 days of the initial letter, providers will get a final letter explaining CMS's intention to refer the debt for collection, and provider appeal rights will remain unchanged, CMS announced.