Overpayment Forms and Tools
The following are the different forms that are available when an overpayment has been identified.
- Offset Request Form
- Overpayment Recovery Request Form
- Voluntary Overpayment Refund Form
- Overpayment Interest Calculator
When sending in checks to CGS please use the address below to prevent possible delays in processing claims-related payments:
CGS, LLC
DME MAC Jurisdiction B
PO Box 953479
St. Louis, MO 63195-3479
Debt Collections
If CGS has not received requested payments by 120 days after the initial demand letter the debt will then be referred to the Department of Treasury.
Appeals
- If you do not agree with an overpayment, please see our Appeals section for additional information.
Bankruptcy
- Filed bankruptcy and need to notify CGS? Please send a copy of the bankruptcy notification given by the courts to the address below:
CGS
PO Box 20007
Nashville, TN 37202-0010
Fraud
- CoventBridge Group – UPIC Midwestern (Unified Program Integrity Contractor) for IA, IL, IN, KS, KY, MI, MN, MO, NE, OH, & WI
- Qlarant – UPIC Southwest (Unified Program Integrity Contractor) for AR, CO, LA, MS, NM, OK, & TX
- Safeguard Services, LLC – UPIC Southeast (Unified Program Integrity Contractor) for AL, FL, GA, NC, PR, SC, TN, VA, VI, & WV
Location Change
- Was there a change in company location? The National Supplier Clearinghouse issues Medicare billing privileges to suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS), and also maintains supplier files that contain information collected via the CMS 855S enrollment form.
Offset Request
- If interested in processing debt for immediate offset please use the Offset Request Form.