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Request a waiver for timely claims filing for services from 11/21/23-5/31/24 due to the Change Healthcare incident, ensuring compliance with Mass General Brigham Health Plan.
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What is Timely Filing Waiver Request Form?

The Timely Filing Waiver Request is a document needed to be submitted to the relevant address to provide some information. It has to be completed and signed, which can be done in hard copy, or via a particular software e. g. PDFfiller. This tool helps to complete any PDF or Word document right in the web, customize it according to your purposes and put a legally-binding electronic signature. Right after completion, you can send the Timely Filing Waiver Request to the relevant recipient, or multiple individuals via email or fax. The editable template is printable as well thanks to PDFfiller feature and options proposed for printing out adjustment. Both in electronic and in hard copy, your form will have a organized and professional outlook. It's also possible to turn it into a template for later, there's no need to create a new document over and over. All that needed is to customize the ready template.

Instructions for the Timely Filing Waiver Request form

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A timely filing waiver request is a formal appeal to request an exception to the usual deadlines for submitting claims or documentation.
Providers who are unable to submit claims within the standard time frames due to unforeseen circumstances are required to file a timely filing waiver request.
To fill out a timely filing waiver request, you must complete the designated form with your information, the reason for the delay, and any supporting documentation.
The purpose of a timely filing waiver request is to provide a way for providers to appeal for additional time to file claims when they face legitimate delays.
The information that must be reported includes the provider's identification details, explanation of the delay, claim details, and any pertinent documentation.
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