We have identified the following overpayment and are in good faith voluntarily refunding all monies collected in error. Complete the Redetermination Request Form in its entirety.If they actually overpaid you, yes you must pay them back. We inform people about the fact and amount of the overpayment, their right to appeal, and the options to repay or, in some cases, receive waivers for the debt. Debtors will be encouraged to repay the debt in monthly installments of no less than. Please download the form, complete each field and print. Include the form with your refund so we can properly apply the refund and record the receipt. Overpayments are Medicare payments to a provider, or beneficiary who received the amounts that are due and payable under the statute and regulations. To request an appeal, fill out the "Appeal Form" found here.

Overpayment Letter To Insurance Company In Cook

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