CommercialAdministrativeMedium impact
Provider-Identified Overpayments
Healthfirst·Provider Update
We identified it
Jun 20, 2026
Summary
Healthfirst now requires providers to refund any discovered overpayments within 60 days, along with specific documentation including claim numbers, member information, and explanation of the overpayment. Refunds must be sent to a designated Philadelphia address with detailed cover letter.
Action Required
Within 60 days of discovering any Healthfirst overpayment: Billing team must send refund check made out to 'Healthfirst PHSP, Inc.' to LB#8115 P.O. Box 95000 Philadelphia, PA 19195-0001. Include cover letter with: (1) overpayment reason, (2) specific claim numbers with member name/ID/dates of service, (3) contact person information, (4) supporting documentation. Establish process to identify and track overpayments to ensure 60-day compliance.