Making Voluntary Refunds to NHIC Medicare

If you discover that an overpayment of Medicare funds has occurred, you are expected to notify the program and take appropriate actions to remedy the situation.

The protocol to make a refund to NHIC is as follows:

• Fill out the “Voluntary Refund Form” completely for each claim, or
• Submit a copy of the Remittance Advice (RA) or Medicare Summary Notice (MSN) with the claim highlighted and notated with the exact amount of the refund and the reason for the refund, or
• Submit a spreadsheet listing the following information for each claim:
  • Claim Internal Control Number (ICN) from the Medicare RA/MSN
  • Patient HIC Number from the Medicare RA/MSN
  • Patient’s Name as shown exactly on the Medicare RA/MSN
  • Date of Service
  • Procedure Code
  • Refund Reason
  • Refund Amount

Make checks payable to: NHIC-Medicare and Submit the refund to:

For Southern California

Medicare Cash Accounting, P.O. Box 515301, Los Angeles, CA 90051-6601

For Northern California

Medicare Cash Accounting, P.O. Box 391, Marysville CA 95901