90 days old claim of medicaid

[zahid]

medicaid claim has been denied due to timely filing .date of service is 7/9/2018.i m using delay reason code 7 and 8.anyone can guide me ?

[lupgain]

medicaid claim has been denied due to timely filing .date of service is 7/9/2018.i m using delay reason code 7 and 8.anyone can guide me ?

Third party processing delay or Code 7 of Medicare & Medicaid
1. Medicaid should not be primary in this scenario
2. Submit Claim with EoB of Primary to support your claim
3. You can also use Electronic Receipt from Clearing House, as proof that you submitted claim to the Primary in time (> 30 Days)

Delay in Eligibility Determination or Code 8 of Medicare & Medicaid
1. Kindly note what was changed, Beneficiary's coverage or eligibility date
2. What was the reason for the delay, Administrative delay, litigation or fair-hearings, appeal
3. When were you notified with correct notification of eligibility, one should bill within 30 days from then

[zahid]

DOS 6/4/2018. and primary insurance paid date 7/31/18. i use delay reason 7 then claim has been denied due to timely filing .now tell me what should i do?
thanks

[Michele]

This sounds like NY Medicaid.  In addition to the delay reason 7 you have to indicate what date the primary paid the claim.  If that date is not < 90 days ago it will still deny.

[zahid]

DOS 6/4/18 and primary insurance paid date 7/31/2018.what should be use delay reason ?

[Michele]

What was the reason for the delay?  In order to use 7 it would have been submitted by 10/31/18.  Is there another reason it was not submitted sooner?