DME

[ddrennan]

I just took on a client who bought a DME's claims.  I have 70 boxes to go through and I believe they go back as far as 2005.  Can anyone tell me if I can collect any money on therse old claims?

[Michele]

Probably not going back prior to 2010, some not even that far.  Medicare now has a strict 'one year from the date of service' timely filing rule and each insurance carrier has their own rule as well.  It is difficult to collect on claims older than the timely filing rule allows.  Appeals can be filed, but you must have proof of submission as well as proof that action was taken.  Not an easy task.

[arms]

Sometimes depending on the denial reasons they will go 2 years back. 

I successfully received payment from United Healthcare on claims that had been pending info from provider and once I submitted they paid, did not even have to appeal. Same for some other commercial insurance plans.

And as Michele stated if you have proof of timely filing you have a shot.