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Bcbs timely filing how to#
Bcbs timely filing update#
Bcbs timely filing manual#
Bcbs timely filing verification#
Bcbs timely filing professional#

Please refer only to step #1 for a void with no re-bill. The void portion may be completed electronically or on paper. Void & Re-bill – This process involves two steps.

Bcbs timely filing manual#

This method is preferred as it requires no manual override.

Bcbs timely filing how to#

Detailed instructions on how to replace a claim electronically can be found in the Chapter 300, 837P Companion Guide.

Replacement claims – To replace a single service line or entire claim, enter Claim Frequency “7”.

incorrect provider number, incorrect date of service, incorrect procedure code, etc.) and NOT for the purpose of billing additional services. NOTE: The functionality of allowing replacement claims and claims to be re-billed following a void is for the purpose of correcting errors on previously submitted and paid claims (e.g.

Replacement or Void/Rebill of an entire claim or single service line – The Department will accept electronic transactions submitted through MEDI or via 837P files to void or replace a paid claim (includes claims paid at $0), or a claim that is pending to pay, if submitted within 12 months from the original paid voucher date.

Attach a HFS 1624, Override Request Form, stating the reason for the override to a paper claim form.

Bcbs timely filing verification#

Please ensure eligibility verification is for the date of service and not current date or date range.

Bcbs timely filing update#

Retroactive Participant eligibility – 180 days from the Department’s system update viewed on MEDI when verifying eligibility.Requests for override due to a provider file change must be requested within 180 days of a claim rejecting due to the discrepancy. Upon receipt of claims with an override request, HFS staff will verify that the claim(s) could not have been billed without the change to the provider file. Attach form HFS 1624, Override Request, stating the reason for the request to a paper claim form. The 180 day period shall begin with the date the enrollment, re-enrollment, or update was recorded on the provider file. New provider enrollment, provider re-enrollment, addition of a new specialty/sub-specialty, or addition of an alternate payee – applies only to those claims that could not be billed until the enrollment, re-enrollment, addition of a new specialty/sub-specialty, or payee addition was complete.Attach Form HFS1624, Override Request form, stating the reason for the override. Submit a paper HFS 2360, HFS 1443, HFS 2209, HFS 2210, or HFS 2211 with the EOMB attached showing the HIPAA compliant denial reason/remark codes. Medicare denied claims – subject to a timely filing deadline of 2 years from the date of service.Claims may be submitted electronically or on the paper HFS 3797 to the following address: Medicare crossovers (Medicare payable claims) – subject to a timely filing deadline of 2 years from the date of service.Timeliness for replacement claims, or a void & rebill transaction, is the same as that indicated below. The 12 month deadline extends to any exceptions that indicate a 180 day extension for all other providers. Claims received from a provider operated by a unit of local government with a population exceeding 3,000,000 when local government funds finance federal participation for claims payment – subject to a timely filing deadline of 12 months from date of service.Timely filing override requests for any exceptions that require a manual override must be submitted with an original paper claim form and any attachments to the following address (unless otherwise noted):Įxceptions to the 180 day Timely Filing Requirement are as follows:

Bcbs timely filing professional#

Timeliness of override requests received in the Bureau of Professional and Ancillary Services is determined by the date stamp. If the claim must be routed to a different unit for special handling, the paper claim will be physically date stamped on the day it is received in the unit. The first 7 numbers of the DCN represent the Julian date the claim was received. Upon arrival at the Bureau of Claims Processing, paper claims are assigned a document control number (DCN) within 24 hours. DME items that are covered by Medicare in certain situations should be submitted to Medicare and the Medicare timely filing guidelines listed for Medicare payable claims would apply.Ĭlaims addressed to a HFS post office box are received M-F between 8:30 am and 5:00 pm at a distribution center for further sorting and delivery to specified locations/units. Timely filing applies to both initial and re-submitted claims.ĭurable medical equipment and supplies (DME) identified on the DME fee schedule as not covered by Medicare are subject to a 180 day timely filing requirement and must be submitted to the Department within 180 days from the date of service.

Non-Institutional claims are subject to a timely filing deadline of 180 days from date of service.