CMS Pub. 100-06, ch. 3, § 200.3

Action to take:

1. Contractors shall cease recoupment on validated redetermination requests. (Refer to

Section 200.2.2 above).

2. If the contractor recouped funds prior to receiving and validating a redetermination

request on or after day 41 from the demand letter date, the amount recouped shall be

retained. (Contractors shall use their discretion to refund if the request was timely

received but recoupment did not stop timely).

3. Contractors shall continue to collect other debts not in an appeal status subject to 935.

4. Contractors shall apply any excess monies from a check payment to 935 overpayments

as a voluntary collection and update the system to reflect the collection as a check amount

and not as a recoupment.

5. Contractors shall not recoup (exception: immediate recoupment) or place in suspense

any monies related to 935 overpayment debt subject to “Limitation on Recoupment”

while

it is in an appeal status.

6. Debts continue to age and accrue interest on the outstanding amounts.

7. Contractors shall send a redetermination receipt notice to the provider within the

timeframes allotted in Section 200.2.2 above.

8. Construct a short paragraph, such as Exhibit 1 below. Contractors shall use the sample

letter as an example and can use their discretion to change the language to address the

overpayment accordingly, as needed:

Exhibit 1: Redetermination Receipt Notice:

Current Date

Provider Name

Address

City, State ZIP Code

Provider Number:

Demand Letter Number:

Account Receivable Number:

Dear Provider Name,

This letter serves as a notification that we have received your request for a

redetermination

for the above accounts receivable or the services at issue. All collection processes have

ceased on the unpaid balance of the accounts receivable, unless you have entered into an

extended repayment schedule, immediate recoupment or paid in full. Interest will

continue

to accrue on any outstanding unpaid balance of the overpayment as explained in your

demand letter. If you have any questions, please contact our office at the number listed

below. You

may also visit us at www._______________.com.

Sincerely,

(Name and title)