Identifying Specific Patients


Each overpayment letter mailed by Palmetto GBA contains one or more accounts receivable (AR) numbers as well as a list of the specific patients and dates of service included in the overpaid amount(s).  

The AR Number is the best way to identify the specific patients associated with overpayments. Please retain the letter containing the AR number(s) associated with each overpayment notification. There may be multiple overpayments included in a single letter. It may be helpful to make a list of patients associated with any overpayment letters you receive from Palmetto GBA and use this information to match up to the patient's Medicare number on subsequent remittance notices.  

Electronic Remittance Advice Notices (ERAs)

  • Some commercial software does not map the data on the PLB segment from Palmetto GBA’s ERA file to the ERA file you actually view. If you are not able to view AR numbers associated with ERAs, we suggest that you contact your software vendor directly.
  • Once you retrieve your ERA file, Palmetto GBA can no longer view or provide the AR numbers 

Standard Provider Remittance Notices (SPRs)

  • If a refund is not received within 41 days, we will begin recoupment procedures from future payments for your provider number and/or Tax ID number. Toward the end of your remittance notice, you will find a withholding (WO) reason code, followed by the claim adjustment number(s) and the patient's Medicare number associated with the overpayment(s). 

Example

  • An overpayment is created with AR number 751234567891234. You will receive a demand letter which will contain the total amount of the overpayment and the AR number(s) and patient's Medicare number(s) associated with the overpayment. We strongly recommend that you retain this information for future reference.
  • If a refund is not received timely, we will send you another remittance notice with the WO reason code followed by the claim adjustment number and the patient's Medicare number. The letter you received from Palmetto GBA, notifying you of the overpayment, will contain the name of the patient and the patient's Medicare number that is associated with the overpayment.




Last Updated: 01/04/2021