Timely Filing

[kita...]

Hi everyone. I was under the impression that timely gives you about 180 to appeal a claim right? And I was also under the impression that when you begin an appeal, it extends your time being that you started one. I hope I said it right. But is that correct?

[Michele]

There is no universal time filing limit.  Each company has their own rules.  For example, Fidelis NY only gives 60 days from the date the claim was processed.  You have to check with each carrier.

[kita...]

Does it normally extend with appeals and correspondence?

[Michele]

Actually no.  I see mostly where they allow less time for appeals.

[PMRNC]

Keep in mind that patients with ERISA plans follow their own plan timely filing limits which may be different than a carrier or provider contract timely filing limit. If plan is ERISA get a copy of the SPD from the patient to determine timely filing, don't go by the carrier's or contracts guideline.

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