Last Modified: 9/8/2018
Location: FL, PR, USVI
Business: Part B
Overpayment forms
Providers, participating physicians, and other suppliers may occasionally receive improper payments based on Medicare regulations. Once an overpayment has been identified, any excess amount is considered a debt owed to Medicare and must be paid upon receipt of an overpayment notice.
Report an overpayment
Complete an overpayment refund form to notify First Coast Service Options (First Coast) of an overpayment prior to receiving a demand letter.
Request immediate recoupment
Learn how to have overpayments immediately offset as funds become available. This process is a convenient and cost effective way to pay demanded debt.
Dispute
To dispute an overpayment identified in a demand letter use the appropriate overpayment redetermination request forms listed below.
• Non-MSP (Medicare Secondary Payer)
• MSP
Extended repayment schedule
If you are experiencing financial difficulties in repaying debt, an extended repayment schedule may be considered. Complete the following information along with all supporting documentation:
Additional resources
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.
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