Don’t Write-Off Timely Filing Denials

Practice administrator recovered over $60,000 in unpaid claims that would have otherwise been written off.

As the dust settles post-COVID, I am sure many are faced with unpaid claims on their accounts receivable (A/R) reaching the good old timely filing status! Unfortunately, staff shortages and many other moving parts have left us all in this situation. I was surprised to discover that this was not an isolated problem, and recently, I received a tip on how to win timely filing appeals that is too good not to share.

By happenstance, I received a call from an American Academy of Ophthalmic Executives (AAOE) member, asking for input on electronic health record (EHR) vendors. On this day, the call was from Jennifer Rispo-Maguire, the practice administrator for Burlington County Eye Physicians. After some small talk and feedback on vendor options, I took full advantage of having a practice administrator on the phone to ask a few questions of my own. Specifically, I wanted to see if she had any insights for appealing timely filing denials since we saw these more regularly. As it turns out, she discovered a loophole with the help of her peers on E-Talk that the payer community has not communicated widely.

Rispo-Maguire stated, “We recently discovered I have been successful in recouping some of these funds by appealing these rejections based on the Federal Register, Vol. 85 No. 86, which states insurances are not permitted to deny claims for timely filing reasons while the Nation is under a National Emergency, which President Trump declared a National Emergency on March 1, 2020 and President Biden extended on March 1, 2021.”

Access the Federal Register, Vol. 85 No. 86

According to Rispo-Maguire, she is appealing the denials with a cover letter and a copy of the Federal Register. So far, she has recovered over $60,000 in unpaid claims that would have otherwise been written off. If you have unpaid claims on account, we recommend running a report on all timely filing write-offs over the last 24 months and make a second attempt at appealing.

Contact us for a free consult with insights on running reports for a mass appeal

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