Difference between filing limit and appeal limit in medical billing
Due to the deadlines established by the insurance companies for the services rendered, timely filing is essential in the field of medical billing. If a claim is filed after the deadlines have passed, it will be rejected because the timely filing limit has passed, costing you a significant amount of money. The elapsed time limit is described by the denial code CO29.
Health insurance providers have their own rules, and typically the window for filing claims on time is between 30 and 12 months after the date of service.
Late claims are not the insurers' responsibility. It is your duty as a provider to comprehend and abide by each payer's rules. Claim denials may be caused by incorrect information that was provided by the patient at the doctor's office, typographical errors made by the biller, or inaccurate information that was copied.
How to eliminate these denials?
You may still receive CARC 29 (Claim Adjustment Reason Code) even after timely filing a claim. In actuality, the submitted claim might occasionally be lost or never reach the insurer. The claim submission date to the payer and the clearinghouse is listed in this instance in a timely filing report by the clearinghouse. Send the insurer this report as an appeal to reverse the denial so that you won't suffer financial loss.
Submitting the Appeal
The law permits you to file an appeal, and as a denied claim, it will get a second look by the insurer who wasn't involved initially. An appeal is a request to reconsider the claim with supporting and rational documentation. You can only appeal if you have a valid reason for not submitting the claim in the first place.
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