Receiving a CO 29 denial can be a major setback for healthcare providers and practice managers, impacting both your operations and revenue stream. This denial code means your claim was submitted after the insurance company’s required filing period. Understanding timely filing limits and taking proactive measures can help prevent this issue and keep your practice running smoothly.
Understanding Timely Filing Limits
Each insurance provider sets its own time limits for submitting claims, known as timely filing limits. These deadlines vary based on the insurer and the type of plan. While some payers may allow a year or more, others impose strict deadlines of 90 or 120 days.
Common Timely Filing Limits:
- Medicare, United American Ins, Humana Medicare Advantage, Medicare Railroad, Tricare: 1 year
- Aetna: 120 days
- Amerigroup: 180 days for participating providers, 1 year for non-participating providers
- Blue Cross Blue Shield (BCBS): 12 months (depends on provider contract)
- Cigna, Kaiser Permanente, United Health Care, VA: 90 days
- Humana Commercial, Coventry, WellCare: 180 days
- Bankers Life: 15 months
What to Do When You Receive a CO 29 Denial
A CO 29 denial indicates that the claim was filed outside the accepted window. Here’s how you can address it:
- Verify the Submission Date: Ensure that the claim was submitted within the specified timeframe.
- Provide Justification for the Delay: If there was a valid reason for the delay (e.g., system errors, mail delays), provide detailed documentation to support your case.
- Submit an Appeal with PDR: If you believe the claim was wrongly denied, file an appeal along with a Provider Dispute Form (PDR) to contest the denial.
Strategies to Prevent CO 29 Denials
Preventing CO 29 denials is key to maintaining your revenue cycle. Implement these strategies to minimize the risk:
- Track Timely Filing Limits: Use a system to monitor deadlines for each payer and make adjustments as needed.
- Adopt Claim Submission Software: Utilize software that helps automate claim submissions and sets timely filing reminders.
- Regularly Review Aging Claims: Routinely review unpaid claims to catch those approaching the filing deadline.
- Stay Updated on Payer Guidelines: Insurance providers often update their policies. Stay informed of any changes to avoid missing filing windows.
Conclusion
By understanding the importance of timely filing limits and adopting proactive strategies, you can significantly reduce the occurrence of CO 29 denials. This approach helps to maintain cash flow, reduce administrative burdens, and keep your practice’s financial health intact.
For further assistance, Claims Med can guide you through the complexities of healthcare billing and claims management. Our team of experts specializes in claim submission, tracking, and appeals, ensuring that you get the reimbursement you deserve. Get in touch with Claims Med today to learn more about how we can support your practice’s revenue cycle!