decisionhealth Newsletters, Coder Pink Sheets - 2006 Issue 2 (February)
You may not know it, but . . .
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Article Overview
This article summarizes Medicare claims guidance from CMS on timely filing requirements and what happens when a claim is denied as not timely filed. It is aimed at billing staff, coders, and compliance personnel who need to understand filing deadlines, limited exceptions, and the general handling of beneficiary charges when the provider misses the deadline.
Why This Topic Matters
Missing a Medicare filing deadline can affect whether a claim is considered appealable and can also affect what, if anything, may be billed to the beneficiary. Understanding the CMS guidance helps practices reduce denials and manage compliance risk.
What You Will Learn
- How CMS treats claims denied as not timely filed
- The general Medicare timely filing timeframe and noted exceptions
- The relationship between timely filing, appeal rights, and beneficiary billing
- Where CMS guidance discusses handling claims when part of a service was not filed on time
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle personnel
- Compliance officers
- Practice managers
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