Non-MSP Overpayment Refund Request - JA DME

Please use one of the following options to submit your Overpayment Request.

Option 1: Submit your Overpayment Request through the Noridian Medicare Portal

(Note: This option is not available if you have an OIG corporate integrity agreement or for submitting requests on claims under review by the RAC, UPIC, SMRC or other review contractor.)

To submit an Overpayment Request through the Noridian Medicare Portal:

1. Access the Noridian Medicare Portal
   • Portal Link: https://med.noridianmedicare.com/web/jadme/topics/nmp
   • Select Login
   • Sign into the Noridian Medicare Portal
2. Select Claim Status or Appeals
3. Find the claim you want to adjust by entering the search criteria into the Claim Status Inquiry or Begin New Appeals form and selecting it from the results
4. Under Related Inquires, select Self Service Reopening
5. Follow the prompts on the screen to submit your Overpayment/Reopenings request

Option 2: Submit your Overpayment Request through the mail

For quicker resolution of the overpayment, please enclose a check along with the form when sending your request through the mail.

To submit an Overpayment Request through the mail:

1. Fill out the Non-MSP Voluntary Refund Checks Form available on the Forms page here:
   • https://med.noridianmedicare.com/web/jadme/forms
2. Mail the filled form and your check to the address on the bottom of the form