Refunds/Overpayments Forms - JD DME
Refunds/Overpayments Forms
- Accelerated and Advance Payment Form
- CMS 379 - Financial Statement of Debtor
- Extended Repayment Schedule (ERS) Request
- ERS Amortization Schedule
- Immediate Recoupment/Offset - When requesting immediate recoupment before automatic offset
- MSP Overpayment Refund Form - Refund related to Medicare Secondary Payer (MSP) claim
- MSP Overpayment Refund Spreadsheet - Subsequent attachment to above form for multiple requests
- Non-MSP Voluntary Refund Checks Form - Submit a refund not related to MSP - use when enclosing a check
- Non-MSP Overpayment Refund Spreadsheet - Subsequent attachment to above form for multiple requests
- Instructions Non-MSP Overpayment Refund Request - to submit an overpayment request not related to MSP - use when not enclosing a check
Se ha producido un error al procesar la plantilla.
Java method "com.liferay.portal.kernel.util.DateUtil_IW.parseDate(String, String, Locale)" threw an exception when invoked on com.liferay.portal.kernel.util.DateUtil_IW object "com.liferay.portal.kernel.util.DateUtil_IW@13c1b130"; see cause exception in the Java stack trace.
----
FTL stack trace ("~" means nesting-related):
- Failed at: #assign norModifieddateObj = dateUtil... [in template "medicare-velocity-templates-theme_SERVLET_CONTEXT_/templates/freemarker/content/free-form-text.ftl" at line 11, column 5]
- Reached through: #include "medicare-velocity-templates... [in template "10155#10193#74691" at line 1, column 1]
----
1<#include "medicare-velocity-templates-theme_SERVLET_CONTEXT_/templates/freemarker/content/free-form-text.ftl">
