A backdate approval letter (new enrollments, affiliations or updates are not acceptable reasons for late filing).Claims that have been date-stamped by the fiscal agent or the Department and returned to the provider.The following are examples of acceptable proof of timely filing: If any of the scenarios listed below apply, but the claim in question is still within the 365-day window, a waiver is not needed and the provider only needs to resubmit the claim. How can a provider qualify for a timely waiver (override)? The previous ICN must be referenced on the claim, even if the claim is over 365 days. Providers must also resubmit claims every 60 days after the initial timely filing period (365 days from the DOS) to keep the claim within the timely filing period. What should providers do if the initial 365-day window for timely filing is expiring? Providers are required to submit the initial claim within 365 days, even if the result is a denial. What date is used when considering timely filing deadlines? A claim is considered filed when the fiscal agent documents receipt of the claim.

A timely filing waiver or a previous Internal Control Number (ICN) is required if a claim is submitted beyond the 365-day timely filing period.

What is the deadline for meeting timely filing requirements? Providers always have at least 365 days from the DOS to submit a claim.

Blue shield timely filing limit 2020