Overpayments

Noridian collects provider overpayments through the acceptance and settlement of cost reports, claims account receivables, and through the quarterly credit balance analysis. Cost report settlement overpayments can be realized at the Initial cost report acceptance, Tentative Settlement, Final Settlement, Rate review, or Reopening of an already finalized report.

On this page, view the below information.

Demand Letters

After Noridian issues a demand letter for a cost report settlement, providers have 15 days to make payment before the claims payment system (FISS) is set up for withholding. Providers have 30 days from the date of the letter to reimburse Medicare before interest will accrue on the outstanding balance. Claims Account Receivables are demanded when the receivable balances have been outstanding without FISS system collection for over 60 days. On Claims Account Receivable balances, withholding is constant through the entire collection process. Interest will begin to accrue (in 30-day increments) on balances remaining uncollected over 90 days.

The date of the demand letter (not the day after) is the first day of the first 30 day period. Example: Demand letter is dated October 10. A check would need to be received on or before October 24 (day 15). If the balance is still outstanding on November 8 (day 30), interest will accrue on November 9 (day 31).

Per CMS regulations, all checks being sent by providers to payoff settlement overpayments must be received in our office within 15 days of the demand. As a means of collecting settlement overpayments, all unpaid balances will be put on withhold if a check is not received by day 15 of the demand. All demand letters ask providers to notify our office immediately if a check is being sent and provide the name and phone number of the overpayment specialist in charge of collection efforts. If the check will be sent using certified mail, please notify Audit Support of the tracking number as well as the check number and the amount of the check.

Send a Part A Overpayments Check

When submitting a check to Medicare for a Part A provider overpayment:

  • Include a copy of demand letter to help ensure monies are applied properly
  • Make check out to "Medicare Part A." Include provider number and applicable fiscal year end on check
  • Mail check and demand letter copy to appropriate address available on the Mailing Addresses webpage

Overpayment Interest Rates

Medicare Regulation 42 CFR Section 405.378 provides for the charging and payment of interest on overpayments to Medicare providers. The Secretary of Treasury certifies an interest rate quarterly by using the most comprehensive data available on consumer interest rates. Interest is assessed on delinquent debts in order to protect the Medicare Trust Funds. See Overpayment Interest Rate for the Past Five years webpage.

Extended Repayment Schedule

To review the guidelines for Extended Repayment Schedules (ERS), see CMS Change Request (CR)9423.

If you are interested in requesting an ERS, please email JE Providers ERS at JE-ERS@noridian.com.

Immediate Offset Request

Providers may elect to have Noridian immediately take the next issued payment for the provider and apply it to a specific, defined overpayment or they may elect to have all future overpayments immediately "offset" from the next scheduled payment(s). The election of this process does not eliminate a provider's rights to an appeal. Complete and submit the Immediate Offset Request Form.
 

Last Updated Aug 09, 2018