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Audit and Reimbursement

Accelerated Payments - View reasons a provider may request an accelerated payment as well as the Provider Request for Accelerated Payment Form, Accelerated Payments Calculation, and Accelerated Payment Request Certification.

Audit - View Bad Debt, Wage Index, Diagnosis Related Group (DRG), Resource Utilization Group (RUG), Method Billing, and other financial related topics information.

Cost Reports - View timelines, submission requirements, mailing and contact information, requests for copies, and the Provider Statistical and Reimbursement (PS&R) system information.

Credit Balance Reports - Access the CMS 838 format, Noridian's Excel spreadsheet template, Certification Page, and Details Page instructions.

Forms - View Audit and Reimbursement related forms.

Interim Rate Review - View Year-End Interim Rate review information, timelines per provider's fiscal year end, provider types, and the Tentative Settlement (TS) review.

Overpayments - View Demand Letters, Immediate Offset Request, Overpayment Interest Rates, Sending Part A Overpayments Checks information.

Periodic Interim Payments (PIP) - View information in regards to providers who receive bi-weekly Medicare Periodic Interim Payments (PIP).

PRRB and Hearing - View the Provider Reimbursement Review Board (PRRB) process and Intermediary appeal hearing contact information.

Rebate Summary Letters - View information regarding rebate summary letters sent to providers to explain B2 and provider submitted check refunds found on the Remittance Advices.

Voluntary Refund/Self Disclosure Process - Providers should follow the processes defined when they feel they may have a potential self-disclosure or voluntary refund they need to complete to Medicare.

Wage Index - Access the Hospital Wage Index Development Time Table, Pension Plan Costs and workshop, and the Wage Index Prefunding Worksheet.

Resources

Last Updated May 15, 2017