Payment Adjustment Request

Payment Adjustment Request. MDHS’s Payment Adjustment Request must be used for reporting any necessary adjustment(s) by the child care provider to MDHS with 10 (ten) business days of ledger submission. This form is available on the MDHS website. Child care providers must submit this request, along with supporting documents, to MDHS to report any of the following: A. Overpayment/Underpayment – If a child care provider discovers an over-payment or under-payment on the payment ledger. The child care provider must submit supporting sign-in/sign-out sheets in order for the adjustment to be processed. Questionable payments or incorrect payments shall be adjusted during the next regularly scheduled payment cycle. Once MDHS processes the overpayment/underpayment request, payments will be issued/deducted from the next month payment. B. Certificate Error - Any error listed on the child care certificate that will cause payments to calculate incorrectly must be submitted to MDHS. Such errors include, but are not limited to: 1. Incorrect payment rates 2. Incorrect care type (full-time vs full-/part-time) 3. Incorrect date of birth for the child C. Duplicate Children on the Ledger - If a child care provider discovers that a child is listed more than once on the payment ledger. Providers should claim payment for the certificate that has the accurate payment amount for the child. The duplicate entry should be listed as absent “A” for correct payment.