How do you handle a timely filing denial?

I would verify the payer's filing limit, confirm the original submission date, gather proof of timely submission or valid delay circumstances, and use the payer's reconsideration or appeal process if the denial appears incorrect.

A timely filing denial should not be appealed blindly.

I would review:

• The payer's applicable filing rule
• Date of service or other deadline trigger
• Original claim submission date
• Clearinghouse acceptance and payer acknowledgment
• Any rejection history
• Whether another payer or COB issue delayed filing

If the claim was truly late with no contractual exception, the balance may ultimately be provider responsibility. If the practice can prove timely submission or a recognized exception, the appeal should include that evidence.

• Verify the payer's actual filing limit.
• Use clearinghouse or payer proof.
• Review rejection history.
• Do not bill the patient automatically for provider filing failure.

A claim denies as late, but the clearinghouse report shows payer acceptance within 45 days of service. The appeal includes the acceptance report and requests reprocessing.

• Appealing without proof.
• Using the claim creation date instead of transmission date.
• Billing the patient for the provider's late filing without reviewing liability rules.

Explain your evidence trail, not just that you would 'appeal timely filing.'