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Printed Date: 9/22/2015
Palmetto GBA offers immediate offset requests and electronic payments for Medicare overpayments and voluntary refunds in eServices.
If you are a provider administrator, you may access the Financial Forms subtab under Financial Tools. If you are a provider user, you must be granted permission to eCheck and eOffset by your provider administrator.
Access the Financial Forms subtab to submit immediate offset requests for Medicare overpayments or eCheck electronic payments for Medicare overpayments and voluntary refunds online. Just select the desired form from the drop-down menu and the form link will display at the bottom of your screen. Click on the form link and complete the form. You may attach PDFs up to 40 MB each in size. The total size of all attachments cannot exceed 150 MB.
Note: You have the option to request an immediate offset when you receive a demanded overpayment or make a permanent request for all future demanded overpayments. Voluntary refunds may be handled through eCheck submissions.
Once the form is submitted, you will receive a message in your message inbox either advising you how to correct the form for resubmission or that the form was submitted successfully. You will get a second message with the DCN when the form has begun to be processed. 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.
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Last Updated: 09/01/2020