We have identified the following overpayment and are in good faith voluntarily refunding all monies collected in error. Use this guide to help you and your staff properly assess refund requests from health plans.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. In order for an overpayment refund to be processed in a timely manner, please submit a completed form with all refund checks and supporting documentation. If we have identified an overpayment and request a refund, please mail the check along with a copy of the overpayment request letter we sent you. Instead of receiving the paper request for claim refund letter, you can opt to receive a daily or weekly e-mail summarizing overpayment requests from BCBSTX. Complete the Redetermination Request Form in its entirety. In the event that you have received overpayment, please return the funds to Cigna HealthcareSM at: Cigna Healthcare P O Box 188012