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As I said before, this is a question that comes up all the time in coding, billing and the practice management courses that I work with, so I just thought I’d go over it one more time for students that had never heard me talk about it before. Q: “Please explain filing limits with insurance claim processing” for the initial claim as well as the appeal process. A: Basically, we’ll be covering information about how all insurance companies do enforce filing limits for both initial claim submission, and for appealing claims. So, you really need to know your payer filing limits and create a cheat sheet for your demographic area. When filing or appealing a claim, you want to be absolutely sure that you get those claims in early because there were always technical problems or if you’reusing snail mail, things get lost in the mail. It happens more often than not, so if a doctor gives you a charge today and expects you to transmit it tonight and thinks it’s going to be OK because the cutoff is tomorrow, I can bet you that it didn't’t go through for some reason. There’s always a delay and the insurance companies do look for specific proof of when they received it in order for you to get paid. You want to pay also attention to notifications of changes regarding time constraints. For years, we were dealing with a year and a half with Medicare, and then they changed to one year submission, so pay attention to any of your payer’s notifications because they will send them to you via email if you sign up on their website. Lastly, when you do your aging, the follow-up — I can’t say it enough, just pay attention to your follow-up because you can see trends there, as far as claims not being paid, and you can see “Gee, if this bunch didn't’t get paid, there might be a problem, *?? And so forth. Filinlimitmi—
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