Last Modified: 7/8/2022
Location: FL, PR, USVI
Business: Part A, Part B
To Medicare providers:
As you know, providers may at times receive incorrect payment (e.g., for services/items not covered, erroneously billed, etc.). When this happens, a refund should be sent to the MAC by the provider. Otherwise, an overpayment, which is a debt due to the Medicare program, will be established when the error is identified by the MAC.
Medicare expects providers to exercise care when billing and accepting payment and expects that providers will promptly bring incorrect payments to the MAC's attention. These submissions acknowledge your awareness of this expectation and confirm a measure of compliance. However, please be aware that the CMS Online Manual, Publication 100-08, Chapter 4, Section 126.96.36.199.1.3 states:
"The acceptance of a voluntary refund in no way affects or limits the rights of the Federal Government or any of its agencies or agents to pursue any appropriate criminal, civil, or administrative remedies arising from or relating to these or any other claims."
Thank you for your efforts to work in cooperation with First Coast to ensure proper and appropriate delivery of Medicare benefits.
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.