Insurance companies have a deadline for filing claims that are embedded in their contracts with providers. The timeline range can be flexible based on the contract with the provider. There is a probability of the first claim will be rejected after the timely filing limit, but when it is down into a mistake then, the provider or patient can address a timely filling appeal letter due to this issue.
How Do I Appeal A Timely Filing Appeal Letter?
Whenever you want to submit your appeal letter, factual evidence should be needed for supporting your statement due to the claim was already sent within the time limit. You need to ensure that all the documents included are factual. This is important to check all of the documents and to make sure that your claim is going out to the insurance companies and not getting a denial.
What Is Timely Filing Denial?
Claims denied usually leads to some error that appears in the claim. A common reason for this denial usually it is submitted with incorrect information. A minor error such as a misspelled identity, the wrong identification number can be issued by the insurance company that will make the document will be ignored until it getting a correction. In other cases, there also a time limit that was actually mentioned at the contract in the beginning and this is also important information to get your claim accepted.
How To Write A Good Timely Filing Appeal Letter?
The letter should include all the information needed regarding the patient. This information is identification number, claim numbers, patient’s identity, and date of service. Use formal business language in the letter. Then, the important part is when you state your reason for the appeal in the letter.
An Example Of A Timely Filing Appeal Letter
Dear Mr. Higgins,
This timely filing appeal letter is regarding the patient Gina Rodeep whose information is listed in the form above. I am appealing the timely filing due to the denial we received on Ms. Gina’s account on June 10, 2010. It appears that your records have not updated yet, because the timely filing limit H Group negotiated with X Insurance Company in our most recent contract signed on February 1, 2010, is 180 days from the date of service. We are no longer in the previous filing limit rule that was written in the previous contract.
Ms. Gina has seen in our office on 03-13-2010 for a — —- at which time Dr. Hilst Jam set and cast the — which healed properly with no surgery needed. We filed Mr. Gina’s claim on June 10, 2010, which was within our timely filing limit of 180 days specified in our most recent contract which came into effect on February 1, 2010. We kindly ask you to reconsider Claim 789 for this particular patient claim using.
For convenience, I have attached a signed copy of the contract dated February 1, 2010, between H Group and X Insurance Company together with the original copy of Claim 789 that was filed on June 10, 2010. Please contact me at the number or email address listed in the form if you have any questions or additional information.
May the explanation of this timely filing appeal letter can give you a good insight about writing down a new one. Hope this can be useful for your need for information.