WI · guidance
Wis. ForwardHealth Online Handbook, Hospice, Topic #530
Requirements
As stated in Wis. Admin. Code § DHS 106.04(5), the provider is required to refund the overpayment within 30 days of the date
of the overpayment if a provider receives overpayment for a claim because of duplicate reimbursement from ForwardHealth or
other health insurance sources.
In the case of all other overpayments (for example, incorrect claims processing, incorrect maximum allowable fee paid), providers
are required to return the overpayment within 30 days of the date of discovery.
The return of overpayments may occur through one of the following methods:
• Return of overpayment through the adjustment request process
• Return of overpayment with a cash refund
• Return of overpayment with a voided claim
• ForwardHealth-initiated adjustments
Note: Nursing home and hospital providers may not return an overpayment with a cash refund. These providers routinely receive
retroactive rate adjustments, requiring ForwardHealth to reprocess previously paid claims to reflect a new rate. This is not
possible after a cash refund is done.
Provenance
- Source
- www.forwardhealth.wi.gov
- Retrieved
- 2026-10-02
- Edition
- forwardhealth-hospice-2026-10-01
- Content hash
c7672c9e5c722ed3c81da3894da529e81064a9341dd8a9c9a3b0ca53d9f0348d
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