Wiki Claims- Question

[mcolvin73]

I have recently started billing for a private practice . She had a previous biller who had worked for her for 4 years. She let her go this April and with me recently taking over I have found that there are hundreds of timely claims that were never submitted, some that date back to 2020. My question is we are migrating to a new PM , since these claims are of course going to be denied with them being so old do I even have to process these out ? I did not know if there was a law i had missed about old claims .

 

[TThivierge]

Hi Mcolvin
It is too late to bill those per payer regs most want claims for treatments billed in 90 days to less than a year. I' d just create an adjustment code for untimely billing due to being so old. I would not share that these were not billed with the payer to the patient either. No you do not have to process them out by transmitting or sending to the payer which they will reject and might want to audit your practice since sent so late. Things happen but keep a record of what happened so you cannot get blamed.
I hope I helped you some what in this dilemma.
Lady T

 

[deepshikha]

I fully agree with Lady T. However, I think Medicare, B/C claims have one-year to get paid. Sort out your claims by DOS and submit them without delay; mght get some payment soon. Hope this may help you little bit.