Are you still using paper to submit your quarterly CMS-838 Credit Balance Report via fax or mail?
You can now submit your quarterly Credit Balance Report and submit a refund electronically via eServices. These features are easily accessible from the Financial Tools tab within eServices.

What’s in it for you?

• Avoid penalty withholding due to lost mail or faxes not received
• Immediate confirmation of receipt by Palmetto GBA
• Assigned a Document Control Number (DCN) that allows you to verify status via eServices
• Electronically attach PDF file(s) to submit the Credit Balance Report as well as additional documentation with your request. You may also attach the detail page using the Microsoft Excel form available on our website to reduce issues with page size and readability.
• Use eCheck feature via Palmetto GBA’s eServices to submit any applicable refund electronically
• Save money on postage
• No more lengthy mail time
• No more busy fax signal

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, 7.78 MB)

• Medicare Credit Balance Report Certification Page Form (PDF, 1.06 MB) 

• Publication 100-06, Chapter 12 (PDF, 188 KB)