What to Do After the Validated Redetermination is Received

200.3 - What to Do After the Validated Redetermination is Received (Rev. 12261; Issued:09-22-23, Effective: 12-11-23; Implementation:12-11-23) Action to take: 1. Contractors shall cease recoupment on validated redetermination requests. (Refer to Section 200.2.2 above). 2. If the contractor recouped funds prior to receiving and validating a redetermination request on or after day 41 from the demand letter date, the amount recouped shall be retained. (Contractors shall use their discretion to refund if the request was timely received but recoupment did not stop timely). 3. Contractors shall continue to collect other debts not in an appeal status subject to 935. 4. Contractors shall apply any excess monies from a check payment to 935 overpayments as a voluntary collection and update the system to reflect the collection as a check amount and not as a recoupment. 5. Contractors shall not recoup (exception: immediate recoupment) or place in suspense any monies related to 935 overpayment debt subject to “Limitation on Recoupment” while it is in an appeal status. 6. Debts continue to age and accrue interest on the outstanding amounts. 7. Contractors shall send a redetermination receipt notice to the provider within the timeframes allotted in Section 200.2.2 above. 8. Construct a short paragraph, such as Exhibit 1 below. Contractors shall use the sample letter as an example and can use their discretion to change the language to address the overpayment accordingly, as needed: Exhibit 1: Redetermination Receipt Notice: Current Date Provider Name Address City, State ZIP Code Provider Number: Demand Letter Number: Account Receivable Number: Dear Provider Name, This letter serves as a notification that we have received your request for a redetermination for the above accounts receivable or the services at issue. All collection processes have ceased on the unpaid balance of the accounts receivable, unless you have entered into an extended repayment schedule, immediate recoupment or paid in full. Interest will continue to accrue on any outstanding unpaid balance of the overpayment as explained in your demand letter. If you have any questions, please contact our office at the number listed below. You may also visit us at www._______________.com. Sincerely, (Name and title)