Corporate

April 2, 2019

Medicare Credit Balance Quarterly Reminder

As a reminder, the Medicare Credit Balance Report for the quarter ending March 31, 2019 is due in our office postmarked by April 30, 2019.

A Medicare credit balance is an amount determined to be refundable to the Medicare program for an improper or excess payment made to a provider due to a claim submission or processing error. Each provider must submit the Medicare Credit Balance Report (CMS-838)External PDFand certification for each individual PTAN within 30 days of the quarter end date.

Submission Methods

The Medicare Credit Balance Report may be submitted by using one of the following options. Please choose ONE option and do not submit duplicate reports.

myCGS Portal Benefits and Tips:

  • Use the Forms tab to complete the CMS-838 electronically.
  • Attach up to 5 documents in a PDF format (each up to 5MB in size). NOTE: The first attachment must be the signed CMS-838 Credit Balance.
  • When the submission is complete, you will receive a confirmation message in the Messages tab.
  • Within 24 hours, you will receive a message that includes a Submission ID and instructions on how to check the status.
  • For additional information, please reference the following resources:
  Part A Home Health and Hospice
Fax: 1.803.462.2584
MCBR Receipts
Attn: Credit Balance Reporting
1.615.664.5987
MCBR Receipts
Attn: Credit Balance Reporting
Regular and Certified Mail: CGS
Attn: Credit Balance Reporting
P.O. Box 20023
Nashville, TN 37202
CGS
Attn: HHH Credit Balance Reporting
P.O. Box 20014
Nashville, TN 37202
Fed Ex/UPS/Overnight Courier: CGS
J15 Credit Balance Reporting
2 Vantage Way
Nashville, TN 37228
CGS
J15 Credit Balance Reporting
2 Vantage Way
Nashville, TN 37228

Avoid Rejections and/or Payment Suspensions

Listed below are the most common errors and resolutions to help avoid rejections and/or suspension of payments.

Type of Error

Resolution

Proper documentation not submitted when there is no credit balance.

Each provider must submit a quarterly Credit Balance Report (Form CMS-838).External PDF

    • If you have low Medicare utilization, as specified in the Provider Reimbursement Manual, CMS Pub. 15-1, Ch. 24, §2414.4 BExternal Website, or file less than 25% Medicare claims per year, you do not have to submit Form CMS-838.  However, you do need to submit the Certification Page and a letter indicating that you are a low Medicare utilization provider.

Incorrect calendar quarter ended date

The quarter ending dates are:

  • March 31
  • June 30
  • September 30
  • December 31

On the CMS-838 Certification Page, include the month, day and year for the appropriate quarter (e.g., 3/31/19 or March 31, 2019).

Credit balance submitted to the incorrect Medicare Administrative Contractor (MAC)

If you submit claims to more than one MAC, review the claim information (on the remittance advice, Direct Data Entry (DDE) or myCGS Claim Status) and ensure the credit balance is reported and submitted to the MAC that processed the claim.

Missing or incorrect certification date

On the CMS-838 Certification Page, a date must be present and it must be on/after the quarter end date.

If you have general questions related to the Credit Balance report, contact the appropriate Provider Contact Center below.

  • Home Health and Hospice – 1.877.299.4500 (Option 1)
  • KY/OH Part A – 1.866.590.6703 (Option 4)

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