Now, if you believed you had timely filing under control (Zamm!), but you just got hit with a timely filing-related denial (Thunk!), I have good news and bad news.
#AETNA TIMELY FILING 2020 DOWNLOAD#
Now, if you’re wondering why the standard Blue Cross Blue Shield timely filing deadline quietly avoided this cheat sheet, hold on to your Batmobile, because we included the timely filing deadlines for 33 different BCBS offshoots in the download below!
Keep in mind that while these are the payers’ standard filing deadlines, the deadlines listed in your individual payer contracts supercede these time frames 100% of the time. And like I always say, “With the right reminders, you can do almost anything-like squeeze into a suit with built-in abs.” Right? All super suits aside, here’s a payer deadline cheat sheet for participating providers, as adapted from multiple sources: Payerġ80 days from date of service (physicians)ĩ0 days from date of service (ancillary providers) But, you can use the chart below to remind you about your timely filing deadlines. So, how do you become a timely filing superhero? Well, unfortunately, there’s no sweet signal in the sky to warn you about timely claim submission danger. Furthermore, if you aren’t familiar with all of your timely filing deadlines and you end up submitting a claim late, you’ll be dealing with denials-the kind that typically can’t be appealed (Pow! Blap! Ouch!). So, while you and your staff are treating patients, determining diagnosis codes, and submitting claims, you also have to keep track of all your contracted requirements. That sounds simple enough, but the tricky part isn’t submitting your claims within the designated time frame it’s knowing what that time frame is, and that’s because there’s no set standard among all payers. For example, if a payer has a 90-day timely filing requirement, that means you need to submit the claim within 90 days of the date of service. Timely filing is when you file a claim within a payer-determined time limit. Whoops! I mean, check out these timely filing tips and download the cheat sheet below for reference. So, how do you know when your claim submissions are early, on time, or downright late? Look to the Bat-Signal for guidance, of course. Because with claim submissions, lateness isn’t only unacceptable it also causes denials. Or, maybe it’s because this rule truly applies in many situations-even in physical therapy billing. If you’re on time, you’re late.” Maybe I think that way because I have a Type A personality (holy organization, Batman). To order an official copy of these rules, contact the Office of Administrative Rules at (405) 521-4911.When it comes to punctuality, here’s my motto: “If you’re early, you’re on time. The official rules are published by the Oklahoma Secretary of State Office of Administrative Rules as Title 317 of the Oklahoma Administrative Code. If a claim for payment under Medicare has been filed in a timely manner, the Fiscal Agent must receive a SoonerCare claim relating to the same services within 90 days after the agency or the provider receives notice of the disposition of the Medicare claim.ĭisclaimer. The OHCA rules found on this Web site are unofficial. (c) To be eligible for payment under SoonerCare, claims for coinsurance and/or deductible must meet the Medicare timely filing requirements. (b) Claims may be submitted anytime during the month. A denied claim can be considered proof of timely filing. Payment will not be made on claims when more than 6 months have elapsed between the date the service was provided and the date of receipt of the claim by the Fiscal Agent. For dates of service provided on or after July 1, 2015, the timely filing limit, for SoonerCare reimbursement, is 6 months from the date of service. Federal regulations provide no exceptions to this requirement. (a) According to federal regulations, the Authority must require providers to submit all claims no later than 12 months from the date of service.
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