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Medicare Credit Balance Reporting Just Got Easier!


6/29/16

Credit balance reporting is a federal requirement to certify whether a provider has outstanding monies owed to the Medicare program. Any payment incorrectly made to providers must be returned in a timely manner. Medicare requires credit balance reporting on a quarterly basis and a failure to report will result in a delay or suspension of payment.
 
Federally Qualified Health Center’s (FQHCs) under the jurisdiction of the Medicare Administrative Contractor (MAC) National Government Services (NGS) may now report credit balances through its self-service portal, NGSConnex.  
 
NGSConnex is a web-based application allowing providers to research claim status, beneficiary eligibility, and patient demographics while providing additional financial capabilities. The inclusion of credit balance reporting in NGSConnex should expedite the credit balance reporting process and reduce costs by:

  • Eliminating the requirement to mail or fax CMS Credit Balance 838 detail reports and certifications
  • Ensuring timely receipt of reports
  • Promoting effortless and expeditious data entry that will allow the user to save, edit, view, and print current and previously submitted certifications and CMS 838 details forms
  • Circumventing CMS 838 form errors and resubmissions with data quality enhancement
     

This new feature of NGSConnex was made available on June 27, 2016, and is accessible on the “My Financials” tab of the NGSConnex portal. The portal may be accessed here.
 
Providers are encouraged to adhere to the time frames stipulated by CMS for credit balance reporting.  Complete instructions for Medicare credit balance reporting activities are provided here. Providers should keep in mind that although the reporting method changes, the required information remains the same.
 
What Does CohnReznick Think?

Providers should be diligent in reporting all credit balances within the time frames stipulated by the Centers for Medicare and Medicaid Services. Quarter three (Q3) reports may be submitted beginning on July 1st for the period ending June 30th. The credit balance report is still accepted by CMS under the current method of reporting and should be considered when NGSConnex is unavailable. This should prevent any warning letters or suspension of payment.

Contact
 
For more information, please contact Peter Epp, Partner, Healthcare Industry Practice, at peter.epp@cohnreznick.com or 646-254-7411 or Dolores Di Re, Manager, at dolores.dire@cohnreznick.com or 646-625-5703.

This has been prepared for information purposes and general guidance only and does not constitute professional advice. You should not act upon the information contained in this publication without obtaining specific professional advice. No representation or warranty (express or implied) is made as to the accuracy or completeness of the information contained in this publication, and CohnReznick LLP, its members, employees and agents accept no liability, and disclaim all responsibility, for the consequences of you or anyone else acting, or refraining to act, in reliance on the information contained in this publication or for any decision based on it.

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