Reporting of Recoupment for Overpayment on the Remittance Advice (RA) with Patient Control Number
The Centers for Medicare and Medicaid Services (CMS) changed reporting of recoupment for overpayment on the Remittance Advice (RA) as a response to provider request per Change Request (CR) 6870 for Fiscal Intermediary Standard System – FISS and Multi Carrier System – MCS and 7068 for VIPS - Viable Information Processing Systems. It has been brought to CMS’s attention that providing the Patient Control Number as received on the original claim rather than the Medicare Health Insurance Claim Number (HICN or HIC Number) would enhance provider ability to automate payment posting. This would also reduce the need for additional communication via telephone call that would reduce cost for providers as well as Medicare. This CR instructs FISS, MCS and VIPs to replace the HIC number being sent on the RA with the Patient Control Number received on the original claim, if available. This CR also updates requirements as instructed in CR 7268 (935 Limitation on Recoupment- Duplicate payment after Favorable decision for HIGLAS Users) to coincide with these changes.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: July 19, 2012
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