You know the old saying, ‘what goes up must come down’ right? Well with billing it is a bit different, ‘with all claims submissions also come denials.’ Regardless of how many times the patient demographics are reviewed, scrubbed for errors and eligibility checked, there will always be denials. Be sure to know these for when the insurance is taking too long to pay a clean claim, you will have the law easily accessible to aid in a speedy resolution often with interest. Tip: Along with timely filing limits, many states have prompt payment laws. You should know both to ensure you do not miss out on any revenue. Depending on how the law is written and what is stated in your contract, one or the other may take priority. That timeline may differ from your insurance contracts. Over the years, various states have adopted legislation that requires providers to submit claims within a specific timeframe. Step 2Įvaluate the regulations and guidance in the states where you provide services for any timely filing requirements to insurance companies. Watch for our next blog dedicated to this topic. Tip: Do not forget about provider enrollment. Any portion that is not, may cause you to lose revenue. All follow up needs to be completed within the timely filing limits. The extended time of six months will allow for unexpected delays in the filing process including delayed addendums, electronic data file challenges, or other unanticipated circumstances such as a patient providing updated insurance information. If you have less than six months from the date of service to submit, be sure to include this section the next time there is an opportunity to renegotiate the contract. Review your contracts and amendments on a routine basis for timely filing requirements as well as each time your agreement is renegotiated or updated. Know your contractual obligations for each insurance company. How can you ensure you are not losing money from a lack of timely filing? Step 1 Unfortunately, all too often, you as the provider of service, do not even know it is happening. While it seems easy enough to meet a preset timeline, there can be many challenges and hiccups along the way. These limits are imposed timelines by government payors, commercial payors, and even state mandates. Essentially, timely filing limits are specific timelines that a claim for services rendered must be received by the insurance company. One of the changes over the last quarter-century in the billing and revenue cycle process has been the introduction of timely filing limits. Tick Tock, Pay Attention to the Clock, or Timely Filing May be Locked! Click the play button below to listen to the audio version of this blog.
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