Un-Timely Filing - ZERO Reimbursement

by  Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
August 26th, 2014

Be sure you have office procedures in place to keep an eye on the time frame of your claims: Claims denied by Medicare for “untimely submission” are not eligible for appeal. In fact most carriers do not afford you an appeal if timely filing is an issue; there are only a few exceptions.  Timely Filing can have a significant impact on your Revenue.

Insurance companies are shortening the time-line for timely filing, and why wouldn’t they? It is more money in their pockets and less in yours. Some payers have a claims filing time-line as short as 30-90 days, some as long as two years. Just to motivate you a little more the Healthcare Reform is working on shortening this time-line as well.  To read more about it (Click Here)

Pre-Claims Submission and Ways to Avoid Timely Filing Denials

 

If you do run into an incorrect timely filing issue there are some steps you can follow to secure payment (if it was denied in error)

 CMS Exceptions to the timely filing requirement include the following: Read more (Click Here)

 Keep in mind; generally if a claim was denied for timely filing the patient is not responsible for payment, this liability falls back on the provider.  It pays to be aware of your contractual agreements with your payers.

 

References:

Un-Timely Filing - ZERO Reimbursement. (2014, August 26). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/un-timely-filing-zero-reimbursement-1526.html

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