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Back  RFI # 271: Reporting refunds in the 835

Formal vs. Informal Help Informal Formal

Submitter

Betsy Clore

Description

When we send refunds to payers on claims they have overpaid, they are reporting details of refunds on the 835 back to us in various ways. What is the proper way to do this?

Response

For overpayment situations, refunds should be reported in PLB segment using either qualifier 72, if the overpayment was identified by the provider, qualifier WO if the overpayment was identified by the payer or qualifier B3 (Medicare use only) if the overpayment was a result of payment from multiple payers.
Submission 6/22/2005
Status Date 9/16/2005
Status F - Final
Primary References
Document 004010X091A1
Section2.2.8
Page28
Set ID835