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Timely filing when patient DID NOT update insurance

Howdy :)

A patient was originally seen about a year ago and provided no insurance information. They made a couple small payments on the 2 bills over the course of a year. Then, they called almost a full year after originally seen and, "Oh! Here’s my insurance – bill it, please!"

Ugh.

So we did. And they denied it as being wellllllllll past timely. (I’ll give you a minute to get over your shock.)

So… can we bill the patient for this because they DID NOT give us that info timely and we can back that up if need be?

We’re having a differing of opinions here. If you say we can, please provide a link to some sort of reference for this.

Thanks! :)

Medical Billing and Coding Forum

Copays for visits denied for timely filing

If a copay was collected for an office visit but the visit was never billed to insurance or the claim denied for timely filing, is the provider allowed to keep the copay? Technically an allowed amount was never adjudicated by the insurance company, so would it be wrong to keep the copay?

Medical Billing and Coding Forum

Timely Filing Issue

Wondering if anyone would be able to help or has recommendation for this scenario.
I was off on a medical leave for 6 mos and when I returned come to find out none of the billing was done have been catching up but getting denials for those 90 days Timely filing issues. Is there some type of forgiveness letter or suggestions anyone might have one how to appeal these denials some are the FHP/ICP or MMAI products others are Aetna Cigna etc.
Thanks
Barb

Medical Billing and Coding Forum

Cigna and UHC Timely

I need advice. I came into an office that had a big mess in December and took over the billing. So timely with the 2 insurance is an issue being they are 3 months behind. No matter how hard we work it is still an issue. They are counting holidays and weekends which I think is very unfair. I am struggling to get those up to timely. If they are seen on 11/23 and I have proof of timely of 2/23 that should count as timely in my opinion. They do not agree, other than an appeal is there a way to fight this? Any ideas on how to get ahead of this mess so these timely stop coming in?? I am desperate at this point.

Medical Billing and Coding Forum