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| Audit and Reimbursement Credit BalancesEffective with the Quarter Ended June 30, 1999, all credit balances must be submitted to AdminaStar Federal through the use of an Excel or Lotus spreadsheet template. Download either the Excel or Lotus file and instructions below, add your credit balances for the quarter, and send the completed file on diskette to your Intermediary at the address below. If you submit a Lotus file, it must have an extension of .wk4. If your facility is unable to use the Excel (v.5.0) or Lotus (wk4) template, then approval must be granted by your Intermediary prior to the end of the current quarter to use an alternate method of submitting your credit balances. The credit balance certification page can also be downloaded from this site. An original signature is required on the certification page.
A copy of the Credit Balance Certification form should be sent to the following:
Providers who are unable to download the Excel file for detail reporting and/or a copy of the certification form should call:
Some of the above files require Adobe Acrobat Reader. Download the Adobe Acrobat Reader. Some of the above files require WinZip. Download WinZip.
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