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of the Commonwealth of Pennsylvania

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    ​Credit Balance Self-Review

    The Department of Human Services' Bureau of Program Integrity encourages all provider types to routinely assess their billing and record-keeping practices and voluntarily come forward and disclose any overpayments of Medicaid (or Medical Assistance (MA)) funds.

    The objective of the credit balance self-review is to identify payments made to providers that should not have been made or were received from other commercial health insurers, governmental health insurers, and/or other third-party payers.

    The self-review should be conducted every quarter and will require a review of your billing records to identify credit balance accounts that have been overpaid by MA. 

    The department recognizes that self-reviews provide viable opportunities for disclosure. The department is committed to promoting an environment of openness and cooperation.