By: Amy Keil, Client Manager, RCM Solutions
- Do you review your monthly payment adjustments?
- Does your biller explain what they are writing off and why?
- Do you have anyone that can track your payment adjustments each month?
- Do you know how much money you are losing annually for submitting claims that are “past timely filing limits”?
If you answered no to any or all the above questions, you have troubles, my friend, right here in your adjustments.
A claim being denied for exceeding timely filing limits is an adjustment that should not be a frequent occurrence these days. With all the automation and electronic filing options, we should not see write-offs for past timely filing. However, if you are still doing things “old school” and sending hard copy reports by mail or fax, you will run the risk of timely filing on the billing of those reports/claims.
Most larger payers have a timely filing limit for claims set anywhere from 90-365 days, but some payers only have a 30- to 90-day window from the date of service, to bill out the claims. Yes, appeals can be done, but if the claims are received outside of these set limits, costly appeals won’t change the outcome.
Why you should monitor timely filing write-offs
I have a client that has been with the same biller for many years. In reviewing his end-of-month reporting, I discovered that every month there was a “past timely filing limits” write-off, averaging about $5,000. That is a write-off of more than $60,000 per year. Can any pathology group or lab afford to lose $60,000+ in revenue each year? I don’t think so!
To avoid this expensive write-off in your future, you need to make sure of a few things:
- Be sure you are reviewing your payment adjustments/write-offs every month.
- Make sure your biller is aware of the filing limits for all payers in your state.
- If you have any delays in billing setup, be sure the delays are within the payer’s filing limits.
- If your hospital/lab goes through a system upgrade/update, make sure that you don’t see a drop in your charges and payments.
- If you are still not sure whether some write-offs for timely filing are necessary, investigate a third-party audit. Our RCM Solutions Team specializes in both auditing and improving billing processes.
There are so many other legit write-offs in pathology billing, don’t let the avoidable ones affect your revenue. Contact us today for a free consultation!