Medicare Financial Management Manual (Pub. 100-06), Ch. 12 § 10.10.1
Instructions for Completing the Medicare Credit Balance Summary Report
10.10.1 - Instructions for Completing the Medicare Credit Balance Summary Report
(Rev. 99, Issued: 06-30-06; Effective/Implementation Dates: 10-02-06)
Below are FI instructions for completion of the Medicare Credit Balance Summary Report.
Credit Balance Activities by Type of Provider for This Quarter
No. of Providers Required to Submit CMS Form 838 for This Quarter -- Show the total number of
providers, by type of provider, which were required to submit a credit balance report for the reporting
quarter. Do not include low utilization providers or any other providers that were not required to submit a
credit balance report.
No. of Providers With Submission of CMS Form 838 for This Quarter -- Show the total number of
providers, by type of provider, that submitted a credit balance report for the reporting quarter.
Number of Identified Medicare Credit Balances by Provider on CMS Form 838 For This Quarter -
Count the number of identified Medicare credit balance amounts that were reported, by type of provider,
from column 9 of the provider’s CMS-838 Detail Page for this quarter.
Amount of Identified Medicare Credit Balances by Provider on CMS Form 838 For This Quarter -
Show the total amount of identified Medicare credit balances that were reported, by type of provider, from
column 9 of the provider’s CMS-838 Detail Page for this quarter.
Total - Sum all columns.