“When an end date for the national emergency period has been declared, there will be an additional 60-day extension of timely filing requirements for claim submissions following the last day of the national emergency period,” UHC clarified on its website. Effective for dates of service on or after August 26, 2021, claim corrections submitted via EDI to Tufts Health Plan that are over the timely filing limits for Tufts Health Direct, Tufts Health RITogether, Tufts Health Together MassHealth MCO Plan and Accountable Care Partnership Plans (ACPPs) and Tufts Health Unify, will no longer be accepted. Important Notes for Providers The Through date on a claim is used to determine the timely filing date. Most payers typically allow a 180-day timeframe from the date of service for a provider to submit a claim and be eligible for payment. This includes Aetna, UnitedHealthcare, Cigna, and several BCBS products. The one-year filing deadline applies to any claims for services provided on or after January 1, 2010. The exception to this timely filing rule pertains to USFHP: The timely filing of claims for USFHP is 90 days from the date on the COB EOB. Background and Purpose: As a good business practice, CLTS providers, including county waiver agencies (CWAs) in. “outbreak period” extends 60 days past the end of the national emergency, at which time the timely filing exception expires.įor example, if the national emergency had expired on March 1, 2021, the outbreak period would have ended 60 days later on April 30, 2021, at which time timely filing rules would go back into effect.Ĭommercial payers were not required to implement this policy, although many have. The newly enacted Patient Protection and Affordable Care Act amends the timely fling requirements on Medicare Fee for Service claims to one calendar year after the date of service. Once the declaration is allowed to expire, a corresponding 24 letter to Congress.Īfter the Trump Administration issued the emergency declaration on Ma(keep in mind this is distinct from the HHS Public Health Emergency), the Internal Revenue Service (IRS) and Department of Labor (DOL) issued a regulation that paused the timely filing requirements clock for claims that would have exceeded filing limitations during the national emergency period. Provider agreement specifically allows for additional time In Coordination of Benefits situations, timely filing is determined from the processing date.
For more information pertaining to timely filing requirements, the below resources are available: General Billing and Forms Manual - View Section 3. Timely filing extensions for claim submissions that were instituted by the IRS/DOL last March as part of a Covid-19 National Emergency declaration will be extended after President Joe Biden said he would extend the emergency in a Feb. Vermont Medicaid claims must be filed in a timely manner.