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Web overpayment refund notification form. In order for an overpayment refund to be processed in a timely manner, please submit a completed form with all refund checks. Web “overpayment” blue cross payment in excess of amount billed; Request for claim refund (rfcr). Web in order for an overpayment refund to be processed in a timely manner, please submit a completed.
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Web in order for an overpayment refund to be processed in a timely manner, please submit a completed form with all refund checks and supporting documentation. Web when an overpayment is identified by bcbsil, a refund request is sent to the provider (payee) explaining the reason for the request. Web standard appeal/grievance request form (pdf) provider certification form for expedited appeal (pdf) authorized representative designation form (pdf).