BC Advantage - 2006 Issue 8
Timely Filing Denials
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Article Overview
This article discusses timely filing denials from the perspective of provider reimbursement and contract management. It addresses how payer contracts, patient information issues, secondary coverage, and state or federal timing requirements can affect claim submission disputes. The piece is aimed at billers, coders, compliance staff, and practice managers who handle denial prevention and appeal preparation.
Why This Topic Matters
Timely filing issues can interrupt payment even when services were rendered and covered. Understanding the broad policy, contract, and workflow factors involved helps organizations reduce avoidable denials and better manage claim submission processes.
What You Will Learn
- How timely filing limits can vary by contract, payer type, and law
- Why payer disputes over submission timing arise
- What kinds of operational situations commonly contribute to timely filing denials
- How contract language and documentation practices are discussed in relation to claim submission timing
Who Should Read This
- Medical billers
- Coding professionals
- Revenue cycle staff
- Compliance personnel
- Practice managers
- Healthcare providers
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