Get the free CMS-838 Medicare Credit Balance Report

08/03/2018PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICESFORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION

How to fill out cms-838 medicare credit balance

How to fill out cms-838 medicare credit balance

1. To fill out CMS-838 Medicare Credit Balance form, follow these steps:
2. Fill out the facility's Name and Address.
3. Enter the Medicare Provider Number.
4. Specify the month and year for which the report is being filed.
5. Enter the facility's Employer Identification Number (EIN).
6. Provide the contact person's Name and Phone Number.
7. Complete Part I: Patient/Resident Information by entering the patient's Medicare Health Insurance Claim Number (HICN), Name, and Date of Birth.
8. Fill out Part II: Creditable Balance Information by indicating the type of credit (refund, transfer, or other) and providing details of the credit.
9. Calculate the Total Creditable Balance.
10. Sign and date the form, including the authorized representative's signature, if applicable.
11. Keep a copy of the completed form for your records.
12. Submit the original form to the appropriate Medicare Administrative Contractor (MAC) as instructed in the form's instructions.

Who needs cms-838 medicare credit balance?

1. CMS-838 Medicare Credit Balance form needs to be filled out by facilities that have a creditable balance (refundable or transferable) with Medicare.
2. These facilities may include hospitals, skilled nursing facilities, home health agencies, hospices, outpatient physical therapy providers, comprehensive outpatient rehabilitation facilities, or others that bill Medicare for services provided.
3. The form helps these facilities report and return excess Medicare funds that are not owed or needed, ensuring compliance with Medicare billing requirements and regulations.

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What is cms-838 medicare credit balance?

CMS-838 is a form used to report credit balances that occur when Medicare payments are made in excess of the amounts owed for services provided, ensuring proper reimbursement.

Who is required to file cms-838 medicare credit balance?

Healthcare providers and suppliers that receive Medicare payments and have credit balances must file CMS-838.

How to fill out cms-838 medicare credit balance?

To fill out CMS-838, enter the provider's information, the patient details, the services rendered, the Medicare payments received, and the amounts overpaid, following the form's instructions.

What is the purpose of cms-838 medicare credit balance?

The purpose of CMS-838 is to report and reconcile any credit balances with Medicare to ensure that overpayments are identified and properly addressed.

What information must be reported on cms-838 medicare credit balance?

Information reported on CMS-838 includes patient identifiers, claim numbers, charges, payments received, and the amount of the credit balance.