Medicare Claims Processing Manual (Pub. 100-04), Ch. 30 § 150.4
Time Limits for Making Refunds
150.4 - Time Limits for Making Refunds
(Rev. 1186, Issued: 02-23-07; Effective: 01-01-06; Implementation: 05-23-07)
A refund of any amounts collected must be made to the beneficiary on a timely basis.
Refund is considered to be on a timely basis only if made within the following time
limits:
•
If the supplier does not request an appeal of the initial denial or reduction in
payment within that time, the refund must be made to the beneficiary within 30
days after the date the supplier receives the remittance advice (RA).
•
If the supplier requests an appeal within 30 days of receipt of the notice of the
initial determination, the refund must be made to the beneficiary within 15 days
after the date the supplier receives the notice of the contractor’s determination of
the supplier’s appeal.