decisionhealth Newsletters, Answer Books - 2008 Issue 5 (May)
Answer_Book / Deadlines_for_Filing_Claims / Carrier_says_it_doesn_t_have_your_claim
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Article Overview
This article addresses a claims filing problem in which a payer or carrier reports that it does not have a claim that was supposedly submitted within the required timeframe. It is aimed at billing and claims staff who need general guidance on documenting the original submission and supporting timeliness when resubmitting the claim. The article discusses the situation at a high level and references a Medicare claims manual citation.
Why This Topic Matters
Missed or disputed claim receipt can affect whether a claim is treated as timely. Understanding the general documentation and resubmission considerations can help billing teams respond appropriately when a carrier questions whether a claim was actually filed on time.
What You Will Learn
- How to respond when a carrier says it does not have a claim that was reportedly submitted on time.
- What kinds of supporting information may be discussed in relation to proving the original filing date.
- Why documentation of the original submission matters in disputed claim-receipt situations.
- The type of Medicare reference cited in the article.
Who Should Read This
- Medical billers
- Coding staff
- Claims follow-up staff
- Revenue cycle personnel
- Compliance staff
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