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58 11/2005
Overpayment Recovery Procedure
Blue Cross Blue Shield Healthcare Plan of Georgia has an automated deduction
collection process in an effort to recover payments issued in error and when routine
collection efforts have not been successful. This process is outlined below:
• The first notice is mailed to the provider’s business office asking for payment
within 30 calendar days.
• If payment is not received before the 30 calendar day period ends, a second notice
is mailed to the provider asking for payment within 30 calendar days.
• If the account remains open after a total of 60 calendar days has passed, auto-
deduction will occur.
• Resulting remittance advices will report the item(s) deducted and will include the
related contract numbers to assist the provider.
• Remittance remark code “06” identifies that a claim payment has been offset and
applied to correct a previous claim payment or deducted to resolve an
overpayment.
• Remittance remark code “14” notifies the provider that this claim has been offset
against a corrected claim.
• Remittance remark code “24” notifies the provider that this claim was overpaid and
that a separate claim has had an amount auto-deducted in order to resolve the
overpayment.
Note: All procedures are evaluated periodically to determine “Best Business Practices” and to remain
consistent with business standards. Please be assured every effort will be made to collect the refund
without activating the automated deduction collection process.
For questions concerning overpayment by the health plan, please call 800-241-
7475 from 7:00 am – 7:00 pm, Monday through Friday. For the State Health
Benefit Plan (SHBP) call 800-626-6402 from 7:00 am – 8:00 pm, Monday through
Friday.