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Updated process for submitting an overpayment/refund request

April 1, 2015

If your office receives an overpayment from Independence and you need to submit an adjustment to correct the overpayment, you can do so in one of the following ways.

The NaviNet® web portal

Participating providers with access to NaviNet should initiate an adjustment to correct an overpayment by selecting the Claim Inquiry and Maintenance transaction and then Claim Status Inquiry. From there you can enter one of the two appropriate search criteria options:

  • Billing Provider/Member ID/Date of Birth
  • Billing Provider/Member Last Name/First Name/Date of Birth

Once the search is complete, you can find a link to Claim Investigation through the Claims Search Results and Claim Details screens. Through the Claim Investigation link you can submit the credit and/or retraction request, which will appear on a future Provider Explanation of Benefits (Provider EOB) or Provider Remittance.

Overpayment/Refund Form

Offices that are nonparticipating with Independence or not yet NaviNet-enabled can submit their adjustment request using the Overpayment/Refund Form, which is located on the Provider Forms web page. Once the form has been completed, please mail it, along with a copy of the Provider EOB or Provider Remittance, to:

  • Independence Claims Overpayment
  • 1901 Market Street, 39th Floor
  • Treasury Services ? Misc. Cash Receipts
  • Philadelphia, PA 19103-1480

Note: The submission address for the Overpayment/Refund Form recently changed. Please ensure you are using the most recent version of the form.

If you have any questions regarding submitting an overpayment request, please contact Customer Service.

NaviNet is a registered trademark of NaviNet, Inc., an independent company.


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