How to Submit a Medicare Credit Balance Report (CMS-838)

As a healthcare provider or facility that accepts Medicare payments, you are required to submit a Medicare credit balance report each quarter. This report ensures that you have accurately billed Medicare for the services you provided and have refunded any overpayments. In this article, we will discuss the steps required to submit a Medicare credit balance report.

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Step 1: Gather the Necessary Data

Before submitting a Medicare credit balance report, you need to gather all the necessary information. This includes:

• Your provider or facility's National Provider Identifier (NPI).
• The total amount of Medicare payments received for the reporting period.
• The total amount of credit balances identified for the reporting period.
• Any overpayments refunded during the reporting period.

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Step 2: Complete the CMS-838 Report

The Medicare credit balance report can be completed using the Centers for Medicare & Medicaid Services' (CMS) Form CMS-838. This form can be found on the CMS website or through your Medicare Administrative Contractor (MAC). Here is a link to the CMS-838 form: www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS838.pdf

The form requires you to provide the information mentioned in Step 1, as well as additional information such as the date the credit balance was identified and the reason for the credit balance.

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Step 3: Submit the Report

Once you have completed the Medicare credit balance report, you will submit it to your fiscal intermediary (FI) within 30 days after the close of each calendar quarter. The submission process varies depending on the MAC, so be sure to check their website for specific instructions. Most MACs accept electronic submissions through their online portals, while others require submissions via mail. Be sure to follow the instructions provided by your MAC to ensure your report is submitted correctly and on time.

Instructions on completing and submitting your report can be found at the bottom of the CMS-838 form

Step 4: Keep a Copy for Your Records

After submitting the Medicare credit balance report, be sure to keep a copy for your records. This is important in case you are ever audited or need to refer back to the report in the future.

To conclude, submitting a Medicare credit balance report is an important part of ensuring compliance with Medicare billing regulations. By following these steps, you can ensure that your report is completed accurately and submitted on time. If you have any questions about the Medicare credit balance report or the submission process, be sure to contact your MAC for assistance.