Health Net of Arizona has noticed a significant increase in provider claims denying for failure. Note: If the 95th or 120th day falls on a weekend or a holiday, the filing deadline is extended to the next business day.
PAST TIMELY FILING UPDATE
This will prevent denials on claims that are completely compliant otherwise. Provider Update - Timely Filing Reminders. The process for filing a claim for services rendered to a Veteran in the community varies depending upon whether or not the. We want to ensure the services you provide to your patients are received and processed for timely reimbursement. Transmission of claims using the current date for a past service date violates.
On an ongoing basis, set alerts on claims that are nearing the filing deadline. Pharmacy providers have 720 days from the service date to reverse a claim. The Patient Protection and ACA of 2010 amended the timely. To prevent future denials, work with key stakeholders to address any issues that are causing accounts to get stuck. Providers must file claims within a qualifying time limit to be eligible for Medicare reimbursement. We also recommend that you review all accounts that have aged past timely filing and review the most recent comment or status to identify the source of delay. Route those accounts to the correct person. Any claim approaching the 1-5 day deadline needs immediate attention. We recommend that you create buckets and assign a task force to any of the aging buckets that are approaching the deadline. 
Once you have the timely filing date calculated, create another derived field by subtracting timely filing date minus the current date to derive the age in days from timely filing deadline. Create a calculated field that = discharge date + the timely filing limit (by original insurance plan). Create a report that shows all open, billed accounts. Calculate the earliest age by discharge date that each claim was denied for timely filing. If your organization doesn’t have an existing timely filing table by payer, we recommend that you review your denials for timely filing by original insurance plan. We recommend working with with your Revenue Cycle Systems team to add timely filing requirements to your organization’s Payer Contract Matrix. Locate your timely filing limits, by payer.
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