Submit a completed CMS-838 to your fscal intermediary (FI) within 30 days after the close of each calendar quarter. Include in the report all Medicare credit balances shown in your accounting records (including transfer, holding or other general accounts used to accumulate credit balance funds) as of the last day of the reporting quarter. Report all Medicare credit balances shown in your records regardless of when they occurred. You are responsible for reporting and repaying all improper or excess payments you have received from the time you began participating in the Medicare program. Once you identify and report a credit balance on the CMS-838 report, do not report the same credit balance on subsequent CMS-838 reports.
Full Answer
What is a Medicare credit balance report?
Medicare credit balances are shown in your records for the reporting quarter, you must still have the form signed and submitted to your FI in attestation of this fact. Only a signed certifcation page needs to be submitted if your facility has no Medicare credit balances as of the last day of the reporting quarter. An electronic fle (or hard copy)
How do I print the Medicare credit balance report certification?
Providers can electronically submit the Credit Balance Report and PDF attachments online. You may access the form via the Financial Forms sub-tab located under the Financial Tools tab in eServices. Choose the "CMS-838 Credit Balance" option from the Select a Form dropdown menu. Complete the form and attach the actual Credit Balance Report.
How do I submit my credit balance report?
Credit Balance Reporting Requirements (FORM CMS-838) Effective immediately, all providers of health care services participating in the Medicare program are required to submit a Medicare Credit Balance Report (Form CMS-838). A completed Form CMS-838 is to be submitted on a quarterly basis. General
When should I submit a credit balance report (cms-838)?
Jan 31, 2020 · Each provider must submit a quarterly Credit Balance Report (Form CMS-838). If your facility has more than one provider number, a separate report should be submitted for each provider number. If you fail to submit a Credit Balance (CMS-838) form and/or certification page with all provider numbers identified, Medicare payments will be suspended as stated in 42 CFR …
Where do I send my Medicare credit balance?
Credit Balance Report (Form CMS-838)myCGS, secure Web Portal (preferred method):Refer to the myCGS User Guide, "Chapter 7: Forms Tab " for details. myCGS provides instant confirmation of receipt.Regular and Certified Mail:CGS Attn: HHH Credit Balance Reporting P.O. Box 20014 Nashville, TN 372022 more rows
How do I submit CMS-838?
A completed CMS-838 must be submitted within 30 calendar days after the close of each calendar quarter....Be sure to submit the report with all information required:Provider Name.Six digit PTAN.Correct quarter end date (including the correct year)More items...•Jan 4, 2021
How do I check my Medicare credit balance?
The current version of the Medicare Credit Balance Report (Certification Page and Detail Page) and instructions for its completion are available at www.cms.hhs.gov/forms. This report is identified as CMS Form 838 on the CMS Web site, and a replica of this form is in section 20 of this chapter.
What is a CMS-838?
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.
What is a credit balance audit?
Credit Balance Audit (CBA) Approach • Offers comprehensive integrated post adjudication financial audit. review of hospital credit balances by leveraging the payer and. provider's resources to identify the following: ✓ Duplicate/similar claim overpayments. ✓ Coordination of benefits (COB) errors.
What is Medicare 838 report?
Medicare credit balance is an amount determined to be refundable to Medicare.
What are some examples of improper Medicare payments?
Examples of improper or excess Medicare payments include instances where a provider is: Paid twice for the same service either by Medicare or by Medicare and another insurer. Paid for services planned but not performed or for non-covered services.
Why is Medicare overpaid?
Overpaid because of errors made in calculating beneficiary deductible and/or coinsurance amounts or. A hospital that bills and is paid for outpatient services included in a beneficiary’s inpatient claim. Credit balances do not include improper payments made when a Medicare processing system issue occurs.
What is a CMS 838?
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. There are two forms associated with the Credit Balance Report.
Can you use DCN to check status of a form?
You can use the DCN to look up form processing status and view your submitted forms. If a form is submitted over the weekend, the DCN may not be assigned until the next business day. Confirmation of receipt does not indicate acceptance of the report.
Does Medicare 838 report improper payments?
Credit balances do not include improper payments made when a Medicare processing system issue occurs. This overpayment will be recouped when the issue is corrected and the claim (s) are adjusted. Once you identify and report a credit balance on a CMS 838 report, do not report the same credit balance on subsequent CMS 838 reports.
How to complete a provider certification page?
To complete the Certification Page, enter the provider's name and provider number, and have the Officer or Administrator of the facility sign and date the page. Check one box to indicate what option pertains to your facility. Finally, enter information about your facility's contact person.
Where can I submit a detail page?
An electronic file (or hard copy) of the detail page is available from your FI. You may submit the detail page (s) on a diskette furnished by your contractor or by a secure electronic transmission as long as the transmission method and format are acceptable to your FI.
How long does it take for a zero balance to show up on a credit report?
It may take 24-48 hours for zero balance certifications to show in the credit balance status tool. It may take up to 10 days for credits to show in the credit balance status tool, as these are manually entered into our database.
What to do if you have no credits to report?
If no credits to report, check either the first or third block. Check the second block only when credits are reported. If your certification page meets all the requirements, your report can still reject if you reported credits. The detail page (s) must be completed in full.
What information is needed for Medicare Block 1-15?
All header information must be completed, including the provider number, quarter ending, Part A or B, and contact information for the person we can reach if questions arise. Blocks 1-15 should be completed in full, including the beneficiary name, Medicare Beneficiary ID number, and ICN.
Do you fax back a rejection cover sheet?
Your cover sheet or fax pages should contain the number from which the fax originated so we can fax back the rejection cover sheet along with your submission. The cover sheet will detail the reason for rejection. When we receive the report by mail (and again, they must be faxed); rejections are mailed.
When is a Medicare credit report required?
CMS requires a Credit Balance Report (CMS-838) be submitted within 30 days after the end of each quarter for all providers participating in the Medicare program. 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 ...
Who must sign certification page for a facility?
Facilities without any credit balances during a quarter need to submit only signed certification page for that quarter. An officer (the Chief Financial Officer or Chief Executive Officer) or Administrator of facility must sign and date certification page.
Is CMS a government system?
Warning: you are accessing an information system that may be a U.S. Government information system. If this is a U.S. Government information system, CMS maintains ownership and responsibility for its computer systems . Users must adhere to CMS Information Security Policies, Standards, and Procedures.
How long does it take to receive Medicare credit report?
The Medicare Credit Balance Report (CMS-838) (mailed or faxed) that are received within 30 days of the close of each calendar quarter are considered to be timely.
How long does it take to get a CMS 838?
To ensure timely receipt and processing, send the CMS-838/Certification within 30 days of the quarter end date using one of the options below. Do not submit duplicate Credit Balance Reports.
