Claims filing differs in case of different insurance carriers. Each insurance carrier has a time frame to adhere to. It can be as less as 30 days or as long as two years. If this time limit is not maintained, chances are that the claim may be denied for reasons of untimely filing. At times there are instances of claims being denied by the insurance carrier for the said reason even though the claim was made within the time frame. There may be other reasons as well for denials of claims, but it is extremely important for the biller to respond timely. Of course, it will actually be a problem if the filing was not done within the specified time limit.
Most of the claims are submitted containing all of the correct information about the patient and the treatment given to him / her but it might be a typographical error by the biller or a factual error of the patient giving incorrect insurance card at the healthcare facility. Chances are also that the biller had noted down the incorrect information as it was passed on from the patient.
Filling up the Claims Submission Form
Apart from fixing the above mentioned issues and resubmitting the claims with the correct information, it might still be denied for reasons of timely filing and then comes the appealing part. A few carriers have separate forms for that whereas others don’t. Those insurance companies that do, they insist and only accept an appeal when it is filled in their prescribed form.
- If the form contains a box citing the reason as untimely filing, it needs to be checked / ticked. If there is space given for mentioning reason for the denial, ‘denied for timely filing’ should be put.
As a result of the fast changing necessities by the American health insurance companies, medical billing and revenue management have created the necessity for specialized billing services. Herein comes the role of outsourced medical billing. One of the most trusted experience holders in this field is MedicalBillersandCoders.com, whose billing solutions are designed for improving the revenues and decrease the reimbursement days of claims.
A good cash flow can be maintained only if the claims are filed in a timely way. The billing aspect comes right after treating the patients. After all, that is what keeps a hospital running. So, trust your financial health with the experts they have customized services for 42 specialties all over the US.