Medical Billing Forum

Billing => Billing => Topic started by: aajkaal on November 19, 2017, 06:54:26 PM

Title: UHC Time frame for Claims Submission
Post by: aajkaal on November 19, 2017, 06:54:26 PM
New Jersey - 90 days from date of service OR 180
days from date of service if submitted by a New
Jersey participating physician for a New Jersey Line
of Business member.

What does "New Jersey Line
of Business member" mean ?
Title: Re: UHC Time frame for Claims Submission
Post by: PMRNC on November 20, 2017, 09:05:11 AM
Meaning if the provider's state is different from NJ line of biz plan (NJ Plan) the members state governs the filing deadline.

Note also that Timely filing limits may differ for ERISA plan members. If it is a group health plan under ERISA, the plan's benefit summary determines the timely filing limit and trumps the carrier's timeline.
 
Also even with an AOB if provider is NOT participating they will not receive payment, the patient will.