Indiana’s Medicaid Managed Care Entities also have a 90-day filing limit. The new 90-day requirement reflects Anthem’s commitment to “simplify processes, improve efficiencies, and better support coordination of care.” The change also aligns Anthem with other commercial payers, including Aetna, Cigna, and United Healthcare, all of whom have 90-day timely filing limits for claims. “One hundred eighty days has been the Anthem Blue Cross and Blue Shield (Anthem) standard since 2007,” the payer explained. In 2016, when some professional and ancillary provider contracts inadvertently included a 90-day filing limit, Anthem issued a blanket correction, confirming their 180-day filing limit at that time. Beginning October 1, 2019, all claims will be subject to a 90-day filing requirement, and according to the payer, “Anthem will refuse payment if submitted more than 90 days after the date of service.”įor years, Anthem’s timely filing limit has been 180 days. Advanced Medical Practice Management does not accept any responsibility for any loss which may arise from reliance on information contained on this site.Anthem is changing their timely filing limit for professional claims. Sheet, verify insurance coverage to make sure you are billing the claim to theĬorrect primary carrier and most importantly, create workflows with checksĪnd balances to make sure all encounters on the schedule are billed out.ĭisclaimer: The materials contained on this website are provided for informational purposes only and do not constitute legal or other professional advice on any subject matter. Whatever your situation, acting fast can mean the differenceīetween a paid claim and a write off. AMPM has successfully appealed claims that were over 3 years old when we took over a new client’s Old AR. This is where a detailed letter explaining the situation is critical. However, if you did not file a claim in a timely manner, explain why. This can include EDI logs and insurance correspondence. In this case, you will need to produce documentation to show proof that the claim was sent and received within the allowed time frame. When a claim is denied for timely filing, this does not mean all options have been exhausted. If you actually filed a claim within the limits, you should certainly appeal. Can a denial for timely filing be contested? Finally, make sure you have timely filing limits for inpatientĬare because these limits may vary. Also, it is important to note that appeals for timelyįiling denials come with their own timely limits and should be listed on your The US, it is advisable to create a spreadsheet with filing limitations for the If a claim is received after the specified date, the carrier will deny the claim with no patient responsibility.Īs a medical billing company that services providers throughout Payers set their timely filing limit based on the date of service rendered. This time frame mayĮven vary for different plans within the same insurance carrier. Different payers will haveĭifferent timely filing limits some payers allow 90 days for a claim to beįiled, while others will allow as much as a year. Which a claim must be submitted to a payer. In medical billing, a timely filing limit is the timeframe within
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