Avoiding Medicare timely filing deadlines

Avoid Untimely Claim Denials

To avoid receiving an untimely claim denial for services rendered from October 1, 2008 through December 31, 2009, Highmark Medicare Services must receive these claims prior to 4:00 PM Eastern Standard Time (EST) on Thursday, December 30, 2010.  Once received electronically, they must also be accepted on the initial acknowledgement report and the next day edit report.  Our business office will be closed on Friday, December 31, 2010, in observance of the New Year’s Day holiday.  Therefore, any electronic claims that are received and accepted by Highmark Medicare Services after 4:00 PM EST on Thursday, December 30, 2010, will not be considered received until our next business day of Monday, January 3, 2011, due to our standard system operating hours. We recommend you submit these claims at least 2-3 business days prior to December 30, 2010, to allow time for potential report error resolutions and claim resubmissions.    

All claims for services furnished on January 1, 2010 and after, must be filed with Highmark Medicare Services no later than one calendar year (12 months) from the date of service or the claim will be denied as being past the timely filing deadline.  Please remember the holiday at the end of the year and the first of the year and submit your claims before one year from the date of service for timely processing.

For more information, please refer to Medicare Learning Network (MLN) Matters Articles MM6960 and MM7080.

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