Forum - Questions & Answers
Virginia Medicaid Overpayments
We have several patients that have a commercial insurance such as Anthem BCBS, or Southern Health as a primary insurance, and then VA state medicaid as a secondary insurance. Every single payment Medicaid made to us has resulted in an overpayment, so we are now trying to send the overpayments back to Medicaid. After reviewing the manual it's not very clear on what needs to be done. So far the information that we have gathered, states that we need to send a claim form (CMS-1500) and in box 22 mark that this is a resubmission and quote the original ICN. I'm not clear on which code to use. There is not a code that specifically states overpayment, and I really hate to code all these as Misc. Category resubmissions.... Anyone know what I am supposed to be doing here?
Virginia Medicaid overpayments
Every state Medicaid plan sets its own rules and procedures, so unless there is an expert on VA Medicaid on the site, these are impossible questions to answer.
Can you talk to anyone at the state?