For Providers: How Do I Correct a Medicare Advantage Overpayment?

If you've received an overpayment, don't return the check to us. We will recover overpayments by deducting them from future claim payments to you. We call this method of recovery an offset.

How to correct an overpayment

1. If you notice an overpayment for a non-dental claim, you can either notify our Provider Inquiry area or complete and send the Request for Offset Form (PDF) to the email or street address on the form.

2. The Provider Inquiry representative helps determine if the payment was truly an error and advises you if and when the recovery process will begin.

  • If we receive an incomplete form, or if the information about your claim adjustment is unclear, we'll call you to make sure everything is accurate. If we're unable to reach you, we'll return the form by mail with a request for more information.
  • If we notice an overpayment for a non-dental claim, we'll adjust your claim. The amount due is collected from future payments. After 30 days, we'll send you a letter that details overpayments that were not recovered from future claim payments. You'll also receive a notice of claim overpayments that are outstanding after 60 days. After 60 days, you're required to make a payment via check.
3. You have dispute rights if you don't believe that the amount to be recovered or the reason we give is correct.

Medicare Plus BlueSM PPO disputes

Medicare Advantage Part D and Prescription Blue 

  • Pharmacies with questions about AWP or MAC pricing should contact BCBSM's Technical Pharmacy Help Desk at 1-800-437-3803.

Dental disputes

  • Call 1-844-876-7917, 8 a.m. to 7 p.m. Eastern time, Monday through Friday Automated information is available 24/7
For appeals write to:
Blue Cross Blue Shield of Michigan
ATTN: Provider Appeals
P.O. Box 49
Detroit, MI 48231
 

 

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