#Bcbs timely filing limit for secondary claims code
You must file the appeal within 30 days of the date that appears on the remittance advice on which your claim first denied with error code 853 or 855. To be eligible for appeal, your claim must have been denied for error code 853 or 855 (Final Deadline Exceeded). A claim with this error code cannot be appealed.Īppeal procedures for error codes 853 or 855 ('Final Deadline Exceeded') If the date of service is more than 36 months when it is received by MassHealth, the claim will be denied for error 856 or 857 (Date of Service Exceeds 36 Months) on an RA. See the following section for the appeal procedures for these error codes If you exceed this deadline, your claim will be denied for error code 853 or 855 (Final Deadline Exceeded) on an RA. You have 18 months from the service date to resolve your claim, as long as the claim was received by MassHealth within 90 days of the EOB date. If you exceed this deadline, your claim will be denied for error code 853 or 855 (Final Deadline Exceeded) on an RA. See the following section for the appeal procedures for these error codesįinal submission deadline if you had to bill another insurance carrier before billing MassHealth. You have 12 months from the date of service to resolve your claim, if you originally submitted the claim within 90 days from the date of service. If you had to bill another insurance carrier before billing MassHealth, you have 90 days from the date of the explanation of benefits (EOB) of the primary insurer to submit your claim.įinal submission deadline. Initial claims must be received by MassHealth within 90 days of the service date. Usual turnaround time for Medicare/MassHealth crossover claims forwarded to MassHealth by the Massachusetts Medicare fiscal agent to be processed.
Average time for both electronic (EDI) and paper claims to process on a remittance advice (RA).
0 kommentar(er)
