Respond to a Demand Letter

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.


Last Updated Jan 16 , 2023

Overpayments and Next Steps

When an overpayment has occurred, a Demand Letter is issued. When a demand letter is received, providers have the following options:

Agree with the Overpayment:

  • Send Noridian a check for the owed money
  • Request an Immediate Offset

Disagree with the Overpayment

  • Submit a Rebuttal if the overpayment action will cause financial hardship (A rebuttal will not stop the recoupment activities)
  • Submit a Redetermination Request