Reporting Principal and Interest Amounts When Refunding Previously Recouped Money on the Remittance Advice (RA)

Effective July 5, 2016, CMS is making it easier for providers who receive a favorable appeals decision to identify the claim and/or the refund of principal and interest paid by Medicare. Currently reporting of refunded principal and interest amounts for all related claims on the Remittance Advice (RA) is shown as one lump sum amount. Providers have the money but are not able to identify the claim and/or the refund of principal and interest paid by Medicare. MACs are required to report the principal and interest separately, and to provide individual claim information. Specifically, the reporting will be in the Provider Level Balance (PLB) segment of the 835. This applies to electronic remittance advice (ERA) only.

Source: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R1639OTN.pdf