In today’s complex healthcare landscape, submission of accurate claims is just a part of the question. One of the most easily preventable yet frustrating reasons for revenue loss is missing payer filing deadlines. These deadlines can vary from payer to plan, and in case you fail to meet them, results can be automatic denials without any option to appeal. in easy words, you lose income for your practice.
Let’s discuss how we can avoid leaving the earned money unattended due to deadline errors of filing.
Understand the Timely Filing Limitations
Every insurance payer, whether Medicare, Medicaid, or any commercial insurer, has its own set of timely filing limit, which typically ranges from 90 days to 1 year from the date the service was taken. For instance:
- For Medicare: 1 month from the date of service
- Medicaid (different for every state): Ranges from 90-180 days
- Commercial payers: varies from 90 days to a year
All these deadlines are applied to initial claim submission, and in some rare cases, to correction of claims or appeals as well. In case of even missing one deadline means forfeiting reimbursement, regardless of whether the care was delivered appropriately.
Top Strategies to Avoid Filing Deadline Errors
- Use of Real-Time Claims Tracks
Try investing in a practice management system billing platform that helps in providing real-time tracking. Such tools can flag claims nearing their filing deadlines and alert the billing staff to take a step before it’s too late.
- Establish a Daily Claim Submission Routine
Avoid wasting time waiting to batch submit claims on a weekly basis. Instead, try adopting a process of submitting claims within the span of 24-48 hours of the service date. This provides your team plenty of time for addressing any issues and still meet filing limits.
- Verify Insurance and Patient Information at Check-In
Many of the filing issues are generated from a simple and small data error. Make sure your front-desk staff have the skill to verify insurance details, eligibility, and patient demographics at each and every visit.
- Monitoring and Reprocessing Denials
Suppose if the claim is denied, it may require correction and resubmission within a very limited period of time than the original submission window. Quick turnaround is the key solution waiting for a long time causes you to miss the second deadline as well.
- Keep a Reference Sheet for Payer Policies
Maintain a current record of each payer’s resubmission instructions, appeal windows, and timely filing regulations. Your billing staff will be able to act promptly, precisely, and without hesitation thanks to this.
- Train and Cross-Train Staff
Make sure your front desk and billing staff are aware of how their responsibilities impact timely filing. Frequent training sessions can lower the chance of mistakes and keep everyone in sync.
- Consider Outsourcing to an Expert Billing Partner
Working with a specialized RCM or medical billing service can help guarantee that filing windows are never missed if your internal staff is overworked. These partners frequently have procedures in place to maximize timely claim submission and make use of sophisticated systems.
