Small Business Health Options Program (SHOP) FAQ
Guidance for FAQ regarding 820 Transaction and Companion Guide
Program Area: Small Business Health Options Program (SHOP)
Question: Will Non-Sufficient Funds Transactions (NSFs) and refunds have a distinct payment type code, so issuers can distinguish NSFs and refunds from billing adjustments?
Answer: NSFs are specified using ADJ Payment Type Codes, and the FF-SHOP will recoup NSF amounts by adjusting the issuer total payment amount. In addition, the FF-SHOP will not request refunds from issuers; instead the FF-SHOP will recoup the amount from subsequent issuer payments.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: July 16, 2014
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