If you received an accelerated or advance payment, the Centers for Medicare & Medicaid Services (CMS) will begin to recoup any outstanding balance from any payments due to you from your Medicare claims. This process began as soon as 3/30/2021, depending upon the one-year anniversary of when you received your first advance payment.
CMS will show the recoupment on the remittance advices issued for Medicare Part A and B claims processed after the one-year anniversary of issuing the first payment. The recoupment will appear as an adjustment in the Provider-Level Balance (PLB) section of the remittance advice with a ‘WO” and identified with “CVD,” as in COVID-19 netting.
For institutional providers who get periodic interim payments, please note that CMS will not include COVID-19 Accelerated and Advance Payments (CAAPs) in the reconciliation and settlement of final cost reports. Instead, these will be recouped from your periodic interim payments.
Here is an example of how it will appear on a Medicare EOB:
To handle the recoupment adjustments in ChartMaker® Practice Manager we recommend the following:
- Create Payment Type for Medicare COVID Payback. To do this, click Administration > Transaction Tables > Payment Type. In the Payment Type dialog, enter the IH Code, Description, Currency , and check Include In Deposit as outlined below.
- Enter a System Payment for the Medicare COVID Payback Amount. To do this click Add-Ins > Payment > System Payment. Do note, that the Check Number, Payment Date, and Deposit Flag must match the main check for it to balance correctly. Also, the Amount value is negative.
- Create a Report for Medicare COVID Payback Tracking. To do this, click Reports > Daily > Payment Edit > Long. Modify the Select Criteria so that the Field Name = Payment Type Code, Operation = Equal To, and Value = IH Code for Medicate COVID Payback payment type (COVID in example above). Next, click the Edit button. In the New Configuration dialog, enter the Configuration Name (i.e., Report Name), and Description, and then click the Save as New button.
If you have any further questions regarding entering this information in Practice Manager, please contact Software Support at 1-800-487-9135, press 1 and 1 again for assistance.