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Thread: Medicare Advantage Refund Request

  1. #1
    Join Date
    Apr 2007
    Fort Wayne Indiana

    Default Medicare Advantage Refund Request

    AAPC: Back to School
    Doe any one know if CMS has a time period for refund requests? Can they go back unlimited number of years and request a refund?

    The NGS Medicare 101 manual doesn't state anything. I have also reviewed the CMS IOM Chapter 3 - Overpayments and Chapter 4 - Debt Collection and I was unable to find any thing that states a time frame for refund requests. NGS customer service was unable to provide an answer either.

    Thanks in advance for any replys!

  2. #2


    If you look in the Federal Register you should be able to do a search to find the information. However, the CMS guidelines state that you must refund the money no more than 30 days after the account becomes a credit balance. Also, they can request refunds far back but, more than likely they will recoup the money from a future remittance if you do not refund.
    Tammy A. Lovely, CPC, CPMA, CMRS

  3. #3
    Join Date
    Apr 2007
    Fullerton/Buena Park, CA

    Talking CMS refund recoup

    From the last Medicare seminar I went to, I believe they stated that CMS can only recoup refunds from physicians as far back as four years. If medicare is requesting the refund you have upto 30-days to refund the money.

    Jennifer D.

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