Medicare Financial Management Manual (Pub. 100-06), Ch. 4 § 70.7
Intent to Refer Letter (Rev.11787; Issued: 01-
70.7 - Intent to Refer Letter (Rev.11787; Issued: 01-
19-23; Effective: 04-21-23; Implementation: 04-21-23)
To comply with the DCIA requirements to provide specific notice to debtors before referring a debt for
cross servicing and/or TOP, contractors shall send an Intent to Refer (ITR) letter as their final demand
letter for all eligible delinquent debt. The contractor shall send the “final demand letter”, which is defined
as the last letter routinely sent to debtors to request payment, when or before the debt is 30 to 61 days
delinquent (60 to 91 days from the determination date). A sample ITR letter is included in Exhibit 1 of
this section.
The ITR letter shall be sent regardless of previous collections on the debt, unless there is an approved
current extended repayment agreement in effect.
When appropriate, the ITR letter shall include the amount of interest due, along with the date of the last
interest accrual. contractors may add additional wording to this letter that shall provide additional
instructions or clarification regarding the recoupment of the overpayment.
Contractors sending manual ITR letters should use their own language in the opening paragraphs to
explain the reason for the overpayment and the current balance, including interest accrued and the interest
rate.
The ITR letter shall be signed by the contractor official who routinely signs the demand letters.
The language in the ITR letter shall include a sentence that says: “If, after sixty calendar days from the
date of this letter we have not received such evidence, your debt, if it is still outstanding
and eligible for referral, shall be referred to the Department of Treasury or its designated Debt Collection
Center for cross servicing/offset.”