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  • Novitas Refund Form

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Endered services: AR - PO Box 890091, Camp Hill, PA 17089-0091 PA - PO Box 890304, Camp Hill, PA 17089-0304 DCMA/DE - PO Box 890405, Camp Hill, PA 17089-0405 LA - PO Box 890090, Camp Hill, PA 17089-0090 MD - PO Box 890404, Camp Hill, PA 17089-0404 NJ - PO Box 890034, Camp Hill, PA 17089-0034 MS - PO Box 890128, Camp Hill, PA 17089-0128 TX - PO Box 890106, Camp Hill, PA 170890106 CO/NM/OK - PO Box 890105, Camp Hill, PA 17089-0105 Please select one provider: CO AR DCMA LA DE MD MS NJ OK.

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A voluntary/unsolicited refund made to Novitas when a provider has discovered an error, which resulted in an overpayment.

Call 1-800-MEDICARE (1-800-633-4227) if you think you may be owed a refund on a Medicare premium. Some Medicare Advantage (Medicare Part C) plans reimburse members for the Medicare Part B premium as one of the benefits of the plan. These plans are sometimes called Medicare buy back plans.

that Novitas Solutions, Inc. (Novitas) has been awarded a contract for the administration of Medicare Part A and Part B Fee-for-Service claims in the states of Arkansas, Colorado, Louisiana, Mississippi, New Mexico, Oklahoma, and Texas (A/B MAC Jurisdiction H).

Federal law requires the Centers for Medicare & Medicaid Services (CMS) to recover all identified overpayments. When an overpayment is $25 or more, your Medicare Administrative Contractor (MAC) initiates overpayment recovery by sending a demand letter requesting repayment.

Call 1-800-MEDICARE (1-800-633-4227) if you think you may be owed a refund on a Medicare premium. Some Medicare Advantage (Medicare Part C) plans reimburse members for the Medicare Part B premium as one of the benefits of the plan. These plans are sometimes called Medicare buy back plans.

We proudly serve as the MAC in charge of providing services to Part A and Part B providers within jurisdiction H and jurisdiction L. MACs provide support and claim-related information to other Medicare contractors, such as 800-MEDICARE.

Submit a Voluntary Refund Complete MSP Voluntary Checks Form in its entirety. Missing information may delay processing and could forfeit appeal rights. Indicate appropriate reason code for claim adjustment on. Include a check along with primary insurer EOB. Mail MSP Voluntary Checks Form to address provided on form.

Federal law requires the Centers for Medicare & Medicaid Services (CMS) to recover all identified overpayments. When an overpayment is $25 or more, your Medicare Administrative Contractor (MAC) initiates overpayment recovery by sending a demand letter requesting repayment.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232