Timely Filing

Timely Filing

Preparation

1. ​ Follow along with the Job Aid: Go to the Sharepoint and find Timely Filing Job Aid

2. ​Pay Attention and Take Notes as this will be showing only two claims for demostration

​Timely Filing Recognition

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​Claims for Timely Filing Review will pend with message code 41.

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​IMPORTANT: Note that this is a generic review message that can be applied to a claim for other reasons. The audit log must be reviewed carefully prior to processing to determine if the pend is for timely filing or for a different reason.

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​·   The timely filing limit is 12 months from the date of service for new claims.

·   The timely filing limit for replacement (corrected) claims is 12 months from the original paid date, with exceptions noted below.

·   If a provider submits a void claim, we will honor the void regardless of the received date

·   New claims that exceed the timely filing limit will be denied systematically.

·   For new claims with COB information, the system uses the payment date of the primary payer to determine timeliness.

·    Replacement and Void claims that exceed the limit will pend to the workbasket via TransSend with the message code 41 (Claim is manually marked as requiring a review).

​Timely Filing Recognition

​Timely Filing Recognition

​Replace

​Timely Filing Recognition

​Void