This brief but important letter notifies a customer that he or she has overpaid you. It can serve as a very good customer relations letter.A new electronic Payment Adjustment Request form for fee-for-service Medicaid claims is now available for issues regarding overpayment and credit balance. The salary overpayment resulted because . 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. We have identified the following overpayment and are in good faith voluntarily refunding all monies collected in error. 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.

Sample Overpayment Letter To Customer With Payment In Utah

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