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:
When is the Medicare credit balance report due?
Credit Balance Reports Are Due October 30, 2018. This notice is a reminder that the Medicare credit balance report for the quarter ending 09/30/2018 is due by 10/30/2018.
What happens if I don’t complete the Medicare credit balance report?
The Medicare Credit Balance Report is required under the authority of sections 1815(a), 1833(e),1886(a)(1)(C) and related provisions of the Social Security Act. Failure to submit this report may result in a suspension of payments under the Medicare program and may affect your eligibility to participate in the Medicare program.
What is a Medicare a credit balance?
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 and another insurer A facility is paid for services planned but not performed or for non-covered services
How do I return the Medicare credit balance report certification?
It is important that you sign and return the Medicare Credit Balance Report Certification. If you have a credit balance, please submit the electronic Medicare Credit Balance report 838 on a diskette or CD-ROM. A paper copy of the completed Medicare Credit Balance report 838 is still acceptable.
How do I submit my Medicare credit balance?
Providers use the quarterly CMS-838 report to disclose Medicare credit balances....When is the credit balance report due?QuarterQuarter EndCredit Balance Report Due1stMarch 31On or Before April 302ndJune 30On or Before July 303rdSeptember 30On or Before October 304thDecember 31On or Before January 30Jan 4, 2021
What is Medicare credit balance report?
A Medicare credit balance is an amount determined to be refundable to the Medicare program for an improper or excess payment made to a provider because of patient billing or claims processing errors. Each provider must submit a quarterly Credit Balance Report (Form CMS-838) .
Who has to file a Medicare credit balance report?
Providers must report credit balances resulting from MSP payments on the CMS-838 if they have not been repaid by the last day of the reporting quarter.
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 Medicare 838 report?
Medicare credit balance is an amount determined to be refundable to Medicare.
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 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.
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.
When is the correct quarter end date?
Correct quarter end date (including the correct year) Signature and title of a company administrator or officer dated after the last date of the quarter for which the report is being submitted (March 31, June 30, September 30, or December 31)
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.
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.
What happens if a credit balance is already reported in a previous quarter?
If a credit balance has already been reported in a previous quarter, your obligation has been fulfilled. It is not to be reported again on a subsequent period report. 2.
What is a quarterly Medicare report?
The quarterly report is to include all new Medicare credit balances not reported on a previous quarterly report. In addition, your quarterly reports should not contain previously demanded Recovery Auditor claims, Accounts Receivable demands, Clerical Re-openings, or those claims previously submitted as voluntary refunds.
What is credit balance web based status tool?
For your convenience, please use our online Credit Balance Web-based Status Tool! This tool will allow providers to confirm receipt and check the status of quarterly Credit Balance reports. This tool, above anything, is your only true confirmation that your report has been received and withholding avoided.
Can I get a Medicare credit balance report on CD-ROM?
If you have a credit balance, please submit the electronic Medicare Credit Balance report 838 on a diskette or CD-ROM. A paper copy of the completed Medicare Credit Balance report 838 is still acceptable.
Credit Balance Report Due Dates
CMS requires Credit Balance Reports to be submitted 30 days after the end of the quarter. The quarter ending dates and their corresponding due dates are listed below.
Completing the Medicare Credit Balance Report (Form CMS-838)
Instructions for completing Form CMS-838 are located in the CMS Internet Only Manual (IOM), Publication 100-06, Chapter 12 . Providers can also refer to the instructions on Form CMS-838 itself.
Providers with Extremely Low Medicare Utilization
Providers with extremely low Medicare utilization do not have to submit Form CMS-838. A low utilization provider is defined as a facility that files a low utilization Medicare cost report or files less than 25 Medicare claims per year.
Submitting a Medicare Credit Balance Report
Credit Balance reports should be faxed to (608) 223-7550. If you are unable to fax your report, please mail your report to one of the addresses listed below.
