April 2, 2024
Dear Medicare Provider,
Thank you for being a partner in providing quality healthcare to our members.
As a reminder, providers are required by 42 C.F.R. §422.270(b), to refund all amounts incorrectly collected from its Medicare patients. This includes reimbursements owed due to claims adjusted by the health plan when the member had previously paid the provider or provider office.
Reimbursement is expected to be completed within a reasonable timeline and can be in the form of a check payment, member account credit, and/or other forms as deemed appropriate by the member/provider. Non-Compliance with timely reimbursement to make member whole can lead to Civil Monetary Penalties (CMP) imposed by CMS.
Thank you for continuing to provide our Medicare members with high quality and compassionate care. If you have questions about this requirement, please contact Provider Services.
Sincerely,
Wellcare from NH Healthy Families
