Medicare Financial Management Manual (Pub. 100-06), Ch. 12 § 10.2
Checks Submitted by Providers
10.2 - Checks Submitted by Providers
(Rev. 99, Issued: 06-30-06; Effective/Implementation Dates: 10-02-06)
If a check is submitted by a provider for repayment of Medicare credit balances, the provider must also
submit a complete CMS-838 report (Detail and Certification Pages) with hardcopy UB-92’s.
• A check is necessary when a provider has terminated from the program and is no longer submitting
claims.
• When checks are deposited and adjustment bills are processed, the FI shall ensure that monies for
these credit balances are not collected from the provider twice.