MSP Overpayments - JF Part A

If Medicare demands an overpayment after a Medicare Secondary Payer (MSP) claim has paid, the MSP Form must be submitted along with the primary insurer Explanation of Benefit (EOB).

To avoid processing delays with the MSP Form, review the following:

• Use form for any MSP request pertaining to primary or secondary payment of claims
• Forward all inquiries for MSP recovery to Benefits Coordination & Recovery Center (BCRC)
• Include primary insurer EOB and/or documentation supporting insurance benefit with form
• Do not include a refund check with form
• Do not use form if requesting a Redetermination on an MSP claim that is not MSP-related
• Do not use form for a new claim submission
• Do not use form for situations that involve Veteran's Administration, PACMED or USFHP (US Family Health Plan). Use the Reopenings Form.

If sending a refund check, complete and submit MSP Voluntary Checks Form.