Experience. Integrity. Advocacy.
Experience. Integrity. Advocacy.

WPS Overpayment and Recoupment Process

Wisconsin Physician Services hosted their final Ask-the-Contractor Implementation Call on Monday, August 27, so that Indiana Part B providers and staff could submit any final questions related to the recent transition to WPS as the Jurisdiction 8 Medicare Administrative Contractor.

One topic that several callers asked about was the overpayment notification and immediate recoupment process.

When an overpayment is identified, the Overpayment Notification form (MSP or Non-MSP) should be completed and mailed to WPS (find the Payment Recovery correspondence address here for Indiana providers). Once the form is received, a claim adjustment will appear on the remit with a PLB reason code and an FB indication, and WPS will generate a demand letter for the overpayment.

Once the demand letter is received, providers can then complete the recoupment by faxing, emailing or mailing the Immediate Recoupment Request form, including the invoice number from the demand letter received from WPS.  A separate request is required for each PTAN; all fields must be completed; and the form must be signed by the Provider/CFO.  Requests will be processed within 10 business days of receipt, and the offset will then be noted on a future remittance advice with a WO code followed by a Financial Control Number, which is the invoice number from the demand letter.

The Immediate Recoupment Request form has a box that can be marked so that ALL FUTURE overpayments are set up for immediate recoupment once future Overpayment Notification forms are submitted. Per CMS guidelines, WPS would still respond to the Overpayment Notification form by mailing a demand letter, but no Immediate Recoupment Request forms would be necessary and the recoupment would be taken automatically not earlier than 16 days from the date of the demand letter. A WO code on future remittance advices would indicate that the recoupment was taken.

Providers have 30 days to refund Medicare money, including via recoupment, without accruing interest. Also, any recoupment occurring more than 30 days after an appeal decision by the Qualified Independent Contractor will not be considered a voluntary payment.

Immediate recoupment of all future overpayments may be discontinued at any time by submitting a request in writing, which will be processed within 10 business days.

Providers wishing to mail checks for refunds instead of initiating a recoupment should follow the Voluntary Refund Form Instructions.

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Charity Singleton Craig

Charity Singleton Craig is a freelance writer and editor who provides communications and marketing services for CIPROMS. She is responsible for creating, editing, and managing all content, design, and interaction on the company website and social media channels in order to promote CIPROMS as a thought leader in healthcare billing and management.

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