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MassHealth - All Provider Bulletin 138

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Commonwealth of Massachusetts
Executive Office of Health and Human Services
Office of Medicaid
600 Washington Street
Boston, MA 02111
www.mass.gov/masshealth
MassHealth
All Provider Bulletin 138
November 2004
TO: All Providers Participating in MassHealth
FROM: Beth Waldman, Medicaid Director
RE: Credit Balance Overpayment Policy
Background
Providers participating in MassHealth are required to return overpayments
classified as credit balances to MassHealth within 60 days of their receipt.
Credit balances can occur, for example, if you have received payment from
MassHealth for a claim for which reimbursement has been received from third-
party payers, such as Medicare, private insurance, or worker’s compensation.
Administrative
MassHealth may impose administrative fines against providers who do not
Fines for Failure
return overpayments classified as credit balances within 60 days of their
to Comply
receipt (see 130 CMR 450.238(B)(7)). To avoid such administrative fines, you
should conduct periodic reviews of your financial records to identify and refund
credit balances owed to MassHealth.
Waiver of
From the time you receive this bulletin until December 30, 2004, MassHealth
Administrative
will waive its right to impose administrative fines on credit balances identified and
Fines
listed on the attached Credit Balance Response form (CBR). This waiver of
administrative fines does not apply to any previously conducted, current, or
scheduled audits or any Medicaid Fraud Control Unit activities.
Reviewing
You should review your records to ensure that you have identified all
Your Records
outstanding credit balances. Report your credit balances on the attached CBR
form. This form is also available on MassHealth’s Web site, where it can be filled
out on line and printed for submission. Note: This form will be available on line
only until the close of business on December 30, 2004. To access an online
copy of the CBR form, go to mass.gov/masshealth. Click on “MassHealth
Regulations and Other Publications.” Then click on “Provider Forms.”
(continued on back)
MassHealth
All Provider Bulletin 138
November 2004
Page 2
Reviewing
In order for your claims history to be adjusted, you must also submit a remittance
Your Records
advice highlighting the claim and the amount to be voided or adjusted.
(cont.)
Do not send a check to MassHealth.
A recoupment account will be set up for the amount of the credit balances listed
on the CBR form, and the corresponding remittance advice. Unless other
arrangements have been made, MassHealth will recover 100% of your claims
payments until the amount recovered equals the identified credit balance
amount.
Credit Balance
A fully completed and signed CBR form postmarked by December 30, 2004,
Response Form
should be sent to:
MassHealth
Financial Compliance Unit
The Schraffts Center
529 Main Street, Suite 1M2A
Charlestown, MA 02129
Questions
Contact MassHealth Provider Services at 617-628-4141 or 1-800-325-5231
with any questions you have about this bulletin
.
Address Business Phone No.
Name of Provider Provider No.
City/Town State Zip Business Fax No.
Credit Balance Response Form
Return to:
MassHealth • Financial Compliance Unit • The Schraffts Center • 529 Main Street, Suite 1M2A • Charlestown, MA 02129
Provider Contact Name (please print)
Signature of Authorized Person Completing Form Title Date
CBR-1 (10/04)
Member Name RID TCN
Dates of
Service
Credit
Balance Reason
continued on back u
Commonwealth of Massachusetts
Executive Office of Health and Human Services
www.mass.gov/masshealth
Member Name RID TCN
Dates Of
Service
Credit
Balance Reason
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