Information and Instructions for Handling Overpayments

When You Notice an Overpayment

In the event of any overpayment, duplicate payment, or other payment in excess of the member’s benefits payable according to the member’s benefit plan, payment should promptly be remitted to BCBSNC by completing form G252 - Refund of Overpayment form and mailing it along with a check to:

Financial Processing Services
Blue Cross and Blue Shield of North Carolina
P.O. Box 30048
Durham, NC 27702-3048

When BCBSNC Notices an Overpayment

BCBSNC will send the provider a request asking for a refund of the overpaid amount. The standard overpayment recovery lookback period is 18 months from the time the provider received the payment, with the exception of BCBSNC Self-Insured Plans and the State Health Plan. BCBSNC Self-Insured Plans may elect to use a different overpayment recovery time period than the standard 18 month overpayment recovery period. The overpayment recovery period for the State Health Plan is 24months. No time limit applies to the initiation of overpayment recovery efforts required by a state or federal program or where there is suspected fraud or intentional misconduct involved.

For questions related to overpayments, call the Provider Blue Line^SM at 1-800-214-4844 or Inter-Plan Programs at 1-800-487-5522 and speak with a representative.

Financial Recovery Appeal Requests

Physicians, Physician Groups and Physician Organizations have the right to appeal refund requests issued by BCBSNC that concern overpayments on all lines of BCBSNC business except Dental, Federal Employee Plan (FEP) and Blue Medicare. For information regarding the process for filing a Level I Provider Appeal for Financial Recovery, click here.