Timely Filing of Claims
Recently, WPS Medicare began seeing a dramatic increase in the number of providers experiencing claim denials when the provider submits claims past the timely filing limit for submitting claims. Although WPS Medicare recognizes many providers must submit claims after Medicare’s timely filing limit due to circumstances beyond their control, WPS Medicare must deny any claim submitted after the time limit for filing the claim expires.

To be eligible for Medicare reimbursement, providers and suppliers must file claims within a qualifying time limit. Providers must file claims with Medicare by the end of the calendar year following the Fiscal Year, which runs from October 1 to September 30, in which the provider performs the service or Medicare denies the claim. To summarize, providers have at least 15 months from the date of service to file claims.

For complete information concerning Timely Filing of Claims, Patient Responsibility, Claims Subject to the 10 Percent Payment Reduction, Claims Denied Past the Timely Filing Limit Cannot be Appealed, and How to File a Waiver to Extend the Timely Filing Limit, please refer to the following WPS Medicare Website:
http://www.wpsmedicare.com/j5macpartb/departments/claims/2009_1214_payreduction.shtml