BILLING NEWS

Denial of Claims Not Timely Filed

CR4041 clarifies that a determination relating to the untimely submission of a Medicare claim by a provider or supplier is not an initial determination and cannot be appealed.

Claims that are filed after the “timely filing period” will be denied as specified in the Medicare Claims Processing Manual, Publication 100-4, Chapter 1, Section 70.1. When a claim is denied because it was filed after the timely filing period, the denial will not constitute an “initial determination.” As such, the determination that a claim was not filed timely cannot be appealed.


SOURCE: Source
INDUSTRY NEWS TAGS: CMS


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