What Is Timely Filing?
Claims must be submitted within 180 days of the Date of Service (DOS) to be eligible for processing; this requirement is known as timely filing.
Timely filing is determined based on when the claim is received. The system checks that the Repricer Received date falls within 180 days of the DOS. If a claim is received after the 180-day deadline, it is typically denied as an Untimely Submission.
What to Do If a Claim Is Denied
If your claim is denied for untimely submission but you believe it was filed within 180 days, you may request a review by contacting our Support Team or submit a formal appeal. Your request must include documentation showing that the claim was submitted within the 180-day window.
Acceptable proof includes clearinghouse submission reports, provider portal claim history, electronic acceptance confirmations, or claim forms showing a provider signature date within the filing period. Written statements without supporting documentation will not be accepted.
If sufficient documentation confirms timely submission, the denial may be reversed and the claim will proceed through standard processing. If documentation does not support timely filing, the denial will remain in place.
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