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Published Date:01/04/2021
Printed Date: 9/22/2015
URL: http://palmgba.com/marlowe/redesign6/article.html
What is a Credit Balance (838) Report? Providers use the quarterly CMS-838 report to disclose Medicare credit balances. Medicare credit balance is an amount determined to be refundable to Medicare. Generally, when a provider receives an improper or excess payment for a claim, it is reflected in their accounting records (patient accounts receivable) as a "credit."
The CMS-838 is specifically used to monitor identification and recovery of "credit balances" owed to Medicare. A credit balance is an improper or excess payment made to a provider as the result of patient billing or claims processing errors.
There are two forms associated with the Credit Balance Report. Links to both forms can be found at the bottom of this page.
Examples of improper or excess Medicare payments include instances where a provider is:
Please note:
When is the credit balance report due? A completed CMS-838 must be submitted within 30 calendar days after the close of each calendar quarter.
Credit Balance Reports (CMS 838) for the quarters ending are listed below. Be sure to submit the report with all information required:
Due dates for each calendar quarter are listed below:
What happens if my credit balance report is not submitted on time, or was deemed not acceptable upon review?
How to submit a credit balance report 1. Palmetto GBA’s eServices:
Providers are strongly encouraged to submit their Credit Balance Report via Palmetto GBAs eServices. Providers can electronically submit the Credit Balance Report and PDF attachments online. You may access the form via the Financial Forms sub-tab located under the Financial Tools tab in eServices. Choose the "CMS-838 Credit Balance" option from the Select a Form dropdown menu. Complete the form and attach the actual Credit Balance Report. Once the form is successfully submitted, you will receive an inbox message advising you that the form was received by Palmetto GBA. You will get a second message with the Document Control Number (DCN) when the form has begun processing. You can use the DCN to look up form processing status and view your submitted forms. If a form is submitted over the weekend, the DCN may not be assigned until the next business day. Confirmation of receipt does not indicate acceptance of the report. The Credit Balance Report will still need to be reviewed for acceptability after submission. An officer or the Administrator of the facility must sign and date attached credit balance reports. To complete the submission process through the portal, the name and title of the person authorized to submit the form on behalf of the provider is required (electronic signature), along with a name and contact phone number. For more information, please review the Financial Tools Section in the eServices User Manual (PDF, 8.25 MB)
Providers are strongly encouraged to submit their Credit Balance Report via Palmetto GBAs eServices. Providers can electronically submit the Credit Balance Report and PDF attachments online. You may access the form via the Financial Forms sub-tab located under the Financial Tools tab in eServices. Choose the "CMS-838 Credit Balance" option from the Select a Form dropdown menu. Complete the form and attach the actual Credit Balance Report.
Once the form is successfully submitted, you will receive an inbox message advising you that the form was received by Palmetto GBA. You will get a second message with the Document Control Number (DCN) when the form has begun processing. You can use the DCN to look up form processing status and view your submitted forms. If a form is submitted over the weekend, the DCN may not be assigned until the next business day. Confirmation of receipt does not indicate acceptance of the report. The Credit Balance Report will still need to be reviewed for acceptability after submission.
An officer or the Administrator of the facility must sign and date attached credit balance reports. To complete the submission process through the portal, the name and title of the person authorized to submit the form on behalf of the provider is required (electronic signature), along with a name and contact phone number.
For more information, please review the Financial Tools Section in the eServices User Manual (PDF, 8.25 MB)
Providers may submit the completed 838 Certification Page, Detail Page and UB04s by fax to (803) 870-0147. It should be noted that this method will not provide confirmation that the submission was received.
Providers may mail the completed 838 Certification Page, Detail Page and UB04s to: Regular & Certified Mail Palmetto GBA, LLC Attn: Credit Balance Reporting PO Box 100308 Columbia, SC 29202 Overnight Courier Palmetto GBA, LLC Credit Balance Reporting 2300 Springdale Dr Building One Camden, SC 29020
Providers may mail the completed 838 Certification Page, Detail Page and UB04s to:
Regular & Certified Mail Palmetto GBA, LLC Attn: Credit Balance Reporting PO Box 100308 Columbia, SC 29202
Overnight Courier Palmetto GBA, LLC Credit Balance Reporting 2300 Springdale Dr Building One Camden, SC 29020
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Last Updated: 01/04/2021