decisionhealth Newsletters, Answer Books - 2007 Issue 10 (October)
Answer_Book / Claims_Filing / Avoid_the_penalty_for_late_claims
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Article Overview
This article explains a Medicare claims-filing topic focused on late claim submission and when a provider may be able to avoid a payment reduction. It is useful for billing and reimbursement staff, practice managers, and coders who need a general understanding of filing deadlines, supporting documentation, and CMS-based exception criteria. The piece references Medicare claims manual guidance and discusses what carriers may do when a late claim is reviewed.
Why This Topic Matters
Late claims can affect reimbursement, so understanding the general timing rules and the existence of possible exceptions helps providers evaluate whether a previously unsubmitted claim may still be payable.
What You Will Learn
- The general issue of late claim submission and possible payment reduction.
- The kinds of circumstances CMS recognizes as potential justification for a delayed filing.
- What documentation may be needed to support a late-claim explanation.
- What a carrier may do if it does not accept the reason for delay.
- How Medicare timing limits for claim submission are addressed in the article.
Who Should Read This
- Medical billers
- Coding professionals
- Practice managers
- Revenue cycle staff
- Healthcare providers submitting Medicare claims
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