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Government Programs: Overpayment Recovery Process Reminders

Posted June 1, 2017

A new overpayment recovery process was implemented for Blue Cross Medicare AdvantageSM and Blue Cross Community OptionsSM, or BCBSIL Medicaid, claims processed after Jan. 1, 2017. Here are some important reminders, related to this change: 

  • The Electronic Refund Management and Claim Inquiry Resolution tools on AvailityTM are no longer available for government programs claims.
  • Request for refund letters are sent by mail when overpayments are identified on government programs claims.
  • Please review your request for refund letter closely and remit your payment to the address indicated on the letter. Include a copy of your refund request letter along with your payment.

If you identify an overpayment and wish to send a voluntary refund, please proceed as noted below. Include appropriate documentation to identify your request (e.g., a copy of your Provider Claim Summary, or the Explanation of Benefits).

  • For claims paid prior to Jan. 1, 2017, or if you are unsure of the original claim payment date, send your refund payment to: Health Care Service Corporation, 25718 Network Place
    Chicago, IL 60673-1257
  • For claims paid on or after Jan. 1, 2017, send your refund payment to: Health Care Service Claims Overpayment, 29068 Network Place, Chicago, IL 60673-1290

Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSIL. BCBSIL makes no endorsement, representations or warranties regarding any products or services offered by third party vendors such as Availity. If you have any questions about the products or services offered by such vendors, you should contact the vendor(s) directly.