Required Timeframes for Debt Collection Process for Provider Overpayments

10.1 - Required Timeframes for Debt Collection Process for Provider Overpayments (Rev. 259, Issued: 01-15-16 Effective: 02-16-16, Implementation: 02-16-16) Listed below are the general timeframes for most overpayment debt collection activities. There may be instances, due to specific circumstances related to the debt, where these timeframes will not apply. Timeframes (Based on Date of Demand Letter) Medicare Contractor Day 1 The accounts receivable (AR) is created, the initial demand letter sent. Contractors shall ensure that the dates for establishing the AR, creating the demand letter and mailing the letter are the same. Day 15 Deadline for provider rebuttal request. A rebuttal does not delay recoupment. Day 16 Immediate Recoupment, if requested by the provider starts by day 16. Day 16 Recoupment shall begin for overpayments not subject to Limitation on Recoupment provisions of Section 935 (f)(2) of the MMA unless the debt is in an excluded category (ERS Request, an approved ERS, appeal or bankruptcy). Day 31 Interest shall begin to accrue if overpayment is not paid in full by day 30. Day 41 If not paid in full by day 40, recoupment begins for overpayments subject to Limitation on Recoupment provisions of Section 935(f)(2) of the MMA unless in an excluded category (ERS Request, an approved ERS, appeal or bankruptcy). Day 90 The contractor shall attempt to contact the provider by telephone if the debt is 60 days delinquent and not in a status excluded from referral to Treasury. Day 61-90 The contractor shall send the ITR on eligible delinquent debts. Day 126-150 Eligible delinquent debt shall be referred to Treasury. At least 7 days prior to referral to Treasury The contractor shall make a second call to the provider before the debt is referred to Treasury. Prior to Referral to Treasury (DME Only) The DME contractor shall follow instructions in IOM Pub. 100-8, Chapter 15, related to surety bond collection requirements.