decisionhealth Newsletters, Part B News - 2011 Issue 2 (February)
How to use two exemptions to the 12-month claims filing deadline
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Article Overview
This article reviews Medicare timely filing rules and the limited situations in which providers may get additional time to submit a claim. It is aimed at billing and coding professionals who need to understand when a standard 12-month filing deadline may be extended, what general documentation may be requested, and why these exceptions matter for claim acceptance.
Why This Topic Matters
Late claims are often denied unless a recognized exception applies. Understanding the scope of the exceptions and the need for supporting documentation can help billing staff avoid preventable denials and resubmissions.
What You Will Learn
- The general Medicare timely claims filing framework
- The types of situations that may trigger a filing extension
- The role of documentation when a filing exception is requested
- How retroactive entitlement notice can affect claim submission timing
Who Should Read This
- Medical coders
- Billing specialists
- Revenue cycle staff
- Medicare provider billing staff
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