A new electronic Payment Adjustment Request form for fee-for-service Medicaid claims is now available for issues regarding overpayment and credit balance. Salt Lake City, UT 84145-0288 ; Contact Unemployment Insurance Overpayment Collections: Phone: 1-801-526-9235(1) When the claimant has been determined to be "at fault" in the creation of an overpayment, the overpayment must be repaid. 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. 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. This will bring you to the page to set up the direct deposit. You will need to fill out the information requested. The Notice of Overpayment will include information on how to appeal. You must appeal the overpayment within 90 days of the date on the notice.

Letter To Customer For Overpayment In Utah

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