Medicare Credit Balance Reporting Each provider is required to submit a Medicare Credit Balance Report (form CMS-838) by the end of the month following each quarter end, reflecting outstanding credits on their books at the end of the quarter. In accordance with Centers for Medicare & Medicaid Services (CMS) instructions, a facility’s interim payments may be suspended 21 days after the due date if we have not received the report. Reports are due by the 30 th day of the month following the end of each calendar quarter. For the quarter ended June 30, 2006, reports are due no later than July 30, 2006. A Credit Balance Report certification must be submitted on a quarterly basis for each Medicare provider number. If credit balance(s) are shown in your accounting records as of the last day of the quarter, the Credit Balance detail page must also be submitted. Please submit the claim detail portion of the report electronically. Note: Claims should be reported as credit balances only once. Please do not repeat a claim on subsequent reports. In addition to submitting reports, providers are required to repay all credit balances by the report due date. Submission of an adjustment to correct the claim constitutes repayment. A check may be submitted; however, an adjustment is still required in most cases. Adjustments should be submitted electronically. Interest may be charged on all outstanding credit balance amounts. If you have any questions about adjusting the claims, or you are having difficulty submitting them, please contact the Provider Inquiries call center at 1-888-855-4356. The certification page must be signed and dated by an Officer (Chief Executive or Chief Financial Officer) or the Administrator of your facility. If no credit balances are reflected in your records for the reporting quarter, the certification must still be signed and submitted attesting to this fact. Send the certification page containing the original signature and keep a copy for your records. If the Credit Balance Report (certification or claim detail page) is incomplete, contains incorrect entries, or has not been signed by an appropriate person, it will be returned to you for correction. If a correctly completed report is not received in our office, your facility’s interim payments may be suspended until we receive an acceptable Credit Balance Report. The CMS-838 certification page with original signature must be submitted hardcopy. The detail portion should be submitted electronically through the OMNIPRO SM online Credit Balance Reporting system, although hardcopy detail pages will be accepted. A hardcopy certification page must be filed even if the report is submitted electronically. The forms can be found at http://www.cms.hhs.gov/cmsforms/downloads/CMS838.pdf. |
