Scenario:
A patient delivered and her chart was audited. Going back to the patients New OB appointment to establish the pregnancy, an error was found with the coding on this claim. This claim will now be 9 months old.
I submitted a corrected claim to fix this issue, only to have this corrected claim deny for timely filing. I called and spoke with a rep and she said their time limit on corrected claims is 180 days from the date of service. Since this patient was pregnant, the problem wasnt resolved until 9 months later due to the patient being pregnant. I cannot find much information on specific payers websites so im not sure where to go from here.

What are the requirements for submitting the corrected claim to fix the error? Do we HAVE to submit a corrected claim? Is there an exclusion when the patient is pregnant?

Is this something i just have to appeal and how do i appeal a timely denial when the original claim was submitted within the time limit?

Thanks,
Cortney!