Credit Balances
CMS requires Credit Balance Reports be submitted within 30 days after the end of the quarter. If the reports are not received by the due date, suspension of payments may result. Please see the quarter ending and due dates listed below.
| Quarter Ending | Due Date |
| March 31 | April 30 |
| June 30 | Jul 30 |
| September 30 | October 30 |
| December 31 | January 30 |
The certification form must be completed, signed, and submitted whether or not there are credit balances to report. A certification form must be completed for each provider number. The CMS 838 form must be completed for all Credit Balances reported. Please include the provider name, provider number, reporting quarter, contact person, and phone number, reporting quarter, contact person and phone number. When completing the CMS 838 form, please ensure all columns are completed.
Please note that all Credit Balances must be accompanied by a UB04. If a UB04 is not attached a demand for repayment of the credit balance will be issued.
Do not hold your adjustments for the Credit Balance Report. Your adjustments should be submitted to our office as credit balances are recognized.
To download the Certification form, the CMS 838 form and instructions for completing the report, please use the links below.
Providers New to WPS
All Credit Balance reports must be mailed. WPS will not accept faxed reports.
Please mail to the following addresses:
WPS Part A
PO Box 1602
Omaha, NE 68101
For overnight mail:
WPS Part A
3333 Farnam, Suite 600
Omaha, NE 68131
Please ensure the correct forms (CMS Certification page and 838 report) are used and completed in their entirety. To access the most current versions of these forms, please use the links above.
We do send suspension notification letters 5 days after the due date if the reports have not been received. You will have 15 days from the date of the letter to submit your report. If the report is still not received suspension will occur at 100%. Once your report is received, the suspension will be removed and you will receive payment on your normal schedule.
Please contact us at 1-866-734-1521 if you have any questions.
Page Last Updated: Tuesday, 15-Jul-2008 10:38:00 CDT
