Timely filing denials are the most common denials that we deal with at TheraThink when a new provider brings us their old claims to see if we can help.

In these cases, there is nothing we can do if the claims were not submitted within the timely filing window.

Timely filing for Medicare in one year.  Most other insurance companies have the year to date, a 90 day window, or a 60 day window.  It is important to submit your claims immediately, especially if they are with a new patient, to ensure they are filing correctly, or if they are filed incorrectly, that they are refiled within the timely filing window.

If a claim was filed within the timely filing window and then denied, you will be able to correct that claim and resubmit it after the timely filing window, as the claim is on file within the timely filing window.  So if you have the wrong date of birth or your diagnosis code is being denied because it’s unspecified, for example, you will be able to refile after the timely filing window and be okay.

If you tried to file within the timely filing window but it failed, you can appeal the claims with the insurance’s claims department, providing evidence that they were filed within the timely filing window, but filed incorrectly.  This is an arduous process that will really effect your revenue cycle but it can be done.

Our Advice

File your claims weekly or every other week at minimum.

At TheraThink we file your claims daily so we know if any information we have on file is incorrect as fast as possible.