Credit Balance Reports
Within 30 days after the end of each quarter all providers participating in the Medicare program are to complete a Medicare Credit Balance Report (CMS-838) to help ensure that monies owed to Medicare are repaid in a timely manner. The CMS-838 is specifically used to monitor identification and recovery of "credit balances" owed to Medicare. A credit balance is an improper or excess payment made to a provider as the result of patient billing or claims processing errors. A credit balance exists when a facility receives an overpayment for a Medicare service, for example:
- A facility is paid twice for the same service either by Medicare or by Medicare and another insurer
- A facility is paid for services planned but not performed or for non-covered services
- A facility is overpaid because of errors made in calculating beneficiary deductible and/or coinsurance amounts
- A facility bills and is paid for outpatient services included in a beneficiary's inpatient claim
CMS 838 Form
|CMS 838 Form and Instructions||The Credit Balanace Report complete instructions, Certification Page, and Details Page are available on the CMS website.|
|Noridian 838 Form [Excel]|| |
Facilities may recreate the CMS 838 in a spreadsheet program so they can enter the credit balance data electronically; for your convenience, Noridian has created a version of the CMS 838 in Excel that providers may download.
If you use the Noridian Excel format to submit your CMS 838 spreadsheet electronically, mail the spreadsheet on a disk along with the printed, signed certification page to Noridian.
|Certification Page Tutorial|| |
The Certification Page is required by each provider on a quarterly basis and accompanies the Credit Balance Report. Facilities without any credit balances during a quarter need to submit only the signed certification page for that quarter.
An officer (the Chief Financial Officer or Chief Executive Officer) or the Administrator of the facility must sign and date the certification page
Noridian has prepared a tutorial that offers hover-and-view instrucitons to assist providers in understanding the required elements of each section of the Certification Page.
|Detail Page Tutorial||A separate Detail Page must be completed for Part A and B of A. On the detail page, providers must enter information about each credit balance on a claim-by-claim basis.|
Provider-based Home Health Agencies must submit their CMS 838 to their Regional Home Health Medicare contractor.
Last Updated Jun 19, 2015