Make sure to include a refund form with your overpayment checks

When sending a refund check to us for an overpayment, it’s important that you also include a completed refund form. This completed form allows us to apply the refund to the correct claim overpayment.

When are refund checks necessary?

We’ll send a letter requesting repayment in the following cases*:

  • Professional providers: $200+ overpayment
  • Facility providers: $5,000+ overpayment

This letter is the only form of notification your office will receive. You’ll then receive a monthly statement of any outstanding overpayments until the overpayment is settled and no longer has a balance due.

For overpayments less than the amounts listed above, we’ll make the necessary corrections and adjustments on a future remittance advice.

*Occasionally, we may make necessary adjustments automatically even if the overpayment amount exceeds the refund check threshold (i.e., in the event we need to reprocess claims for multiple providers due to an error).

Where can you find the refund form?

Click here to download a fillable and printable refund form (also available here in our Provider Manual). Complete this form, explaining the reason for the refund, and mail it in with your check to:

Priority Health
Attn: Overpayment Refunds
1705 Reliable Parkway
Chicago, IL 60686

Find more information

Find additional details, including timelines for recovering overpayments, in the Corrections to payments section of our Provider Manual.