Medical Billing Forum
Billing => Facility Billing => : Philip July 06, 2009, 03:59:13 PM
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Hi,
I submitted a paper claim to HUMANA for our Homehelath agency and is denied because of the wrong HIPPS code. I did correct the claim and send it . Usually how long it will take to get the corrected claim payment? I called them and they said its in processing state. But they didn't said how long it will take. Please advise
Thanks
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it varies....it can be anywhere from 30 days to never....there is really no average, it depends on the payor, the service, and the reason for the resubmitted claim. it does take longer for paper however.
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It's really hard to estimate something like this, but I would guess it would take a paper claim about 30 days. That is strictly an educated guess based on experience. Companies vary greatly, especially if the claim was submitted as a corrected claim.
Michele
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Thanks a lot. I am planning to call them and do follow up once in a week . I hope we will get the money within 30-45 days :(
Thanks
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It can also vary based on
(1) provider contract
The provider contract can specify that claims are paid 45 days after receipt of the claim or on a reasonable timeframe with the word reasonable being left up to the insurance company.
(2) State Law
Some states have prompt pay laws.
http://www.donself.com/documents/prompt-pay.doc
(THis document is 6 years old and changes may have been made.)
(3) Patient benefit contract.
All claims are paid in a reasonable timeframe.