![]() The rule change being posted for public comment is updating a specific paragraph in policy that had not been previously updated with the correct timely filing limit. The limit remains at 6 months from the date of service to submit a timely claim, and then once a claim is submitted timely, the provider has 6 more months to resubmit the claim if necessary, see OAC 317:30-3-11.1. These rule changes do not change the timely filing limits in the main section of policy that deals with timely filing, OAC 317:30-3-11. For institutional claims, the timely filing period begins as of the DOS listed in the Through field of the Statement Covers Period of the UB-04. ![]() One would think 6 months would be ample time but as of late I have become increasingly skeptical in SSA's ability to assist a non-tech savvy citizen, or if the citizen has to troubleshoot their online SSA account. Provider Manual Filing Claims - General Information Plan claims must be submitted within 365 days of the date of service (DOS). Timely filing: NON-CONTRACTED PROVIDERS: Initial Claim: 6 months from the date of service. If OKDHS is not able to verify someone's SSI through their means it can be a significant challenge on the client to acquire that information from the SSA to provide to OKDHS. For questions regarding claims, call BCBSAZ Health Choice: Toll-free: 80 Maricopa County: 48 Pima County: 52. Paper claims submitted over 90 days from. You can work through the appeal process to find out if a different outcome is possible. Administratively, I think this makes sense, I am but slightly hesitant due to the challenges Social Security has had during the pandemic. HIPAA mandates that any claim submitted beyond the timely filing limit must include a numeric delay reason code. Sometimes you might disagree with a claim being denied.
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