Timely Filing of ASC Claims
Failing to meet timely filing requirements for claims can cost your ASC money. In some cases, delays in filing may result in non-payment of the claims.
Be familiar with your managed care contracts’ timely filing deadlines. When negotiating, aim for a one-year timely filing deadline, as is required by Medicare. However, if your ASC has already accepted some "boilerplate" contracts which may contain filing language that greatly restricts the time period (e.g., 15 or 30 days to file a claim), this could come back to haunt you.
Short deadlines may not always affect your ASC. However there are several reasons why claims may be occasionally delayed, such as:
- delay in receiving operative notes;
- short staffing limits ability to perform timely coding and billing;
- inadequate patient insurance or demographic information received; and
- clearinghouse not checked for accepted/rejected claims
These happen more often that you may think. If you have contracts that include a short filing deadline, you may want to revisit and renegotiate this clause with your managed care representative.