If you receive a duplicate payment or a payment in excess of the contracted allowable amount for any covered service provided to a member with insurance plan that contracts with HNS, or receive payment for services you did not provide, or receive payment for services billed in violation of HNS and/or HNS contracted payor policies, those funds must be promptly refunded to HNS.
Please note: HNS providers should not send any refunds or overpayments directly to the contracted payor for services billed and paid though HNS.
HNS providers must promptly contact their HNS Provider Representative and inform them of the incorrect payment received. HNS will provide instructions to assure the funds are correctly refunded to the payor and any associated administrative fees are properly credited.
REFUNDS/OVERPAYMENTS
If you receive a duplicate payment, a payment in excess of the contracted allowable, payment for services that should not have been billed, payment for services you did not provide, OR if there are any inconsistencies in the amount actually paid by HNS, and the amount shown on your EOB/NOP and the amount actually due you from the payor, OR if the amount shown on your provider statement does not match the amount of your HNS check, you must notify HNS within 10 days of receipt of the payment..
HNS providers should never send any refunds or overpayments directly to the contracted payor for services billed and paid though HNS..
UNDERPAYMENTS.
If a claims or claims were adjudicated incorrectly by the payor, and the EOB/NOP reflects less than the contacted allowable, please contact your HNS representative and she will assist you in resolving the issue(s).
OVERPAYMENTS
If a claim or claims were adjudicated incorrectly and you received payment for services you did not provide, payment for services inappropriately billed, payment at higher than the HNS contracted allowable, or payments not otherwise due to you, you must contact HNS immediately to arrange to for the prompt repayment of those funds. HNS will provide instructions regarding how the refund(s) will be handled.
HNS reserves the right to determine how refunds/repayments will be repaid.
HNS may:
1). Require you to submit a certified check or money order, payable to HNS, for the amount of the overpayment . If repayment or refund is required by HNS, it must be submitted to HNS within 10 days of the date requested by HNS.
OR
2) Recoup, or allow the payor to recoup, the total amount of the overpayment from future HNS checks until the amount due has been repaid. If funds must be recouped from future checks, HNS reserves the right to recoup, up to the total amount due, all funds from any providers in a group practice who are receiving payment under the same EIN as the EIN of the provider who owes the payment to HNS.
Failure to promptly report an incorrect payment or any inconsistencies in the amount paid by HNS, and the amount shown on your EOB/NOP as the amount actually due you from the payor may result in termination the HNS network.
If a refund/repayment is requested by HNS, failing to repay the full amount pursuant to HNS requests may result in termination from the HNS network.
ADL Forms 
refunds / overpayments