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Printed Date: 9/22/2015
There are times when a provider will receive a primary payment from another insurance company after Medicare has paid as primary. When this happens, it is assumed that Medicare should be the secondary payer. If you receive two primary payments, you should refund Medicare’s payment in full. In order to refund the Medicare overpayment, the provider should adjust the claim to bill Medicare secondary.
Note: Medicare will allow adjustment claims to process past the Medicare timely filing limits in order to pay back a Medicare overpayment. The provider should add remarks on the claim that state they are adjusting the claim and need timely filing extended in order to pay back a Medicare overpayment.
Reference: CMS IOM Publication 100-05, Chapter 3, Section 10.4 (PDF, 234 KB)
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Last Updated: 03/28/2019