BCBSNC Commercial Plans (including out-of-state plans).Primary Claims must be submitted by 12/31 of the year following the date of service.Ĭorrected Claims must be filed within 36 months from the date the original claim was filed.Ĭlaims must be submitted within 18 months from the date of service. It is important to note that payors expect physicians to conduct timely follow up on outstanding claims and to take appropriate action to resolve the issues within the established timelines. As a general rule, paper claims received from the provider are mailed to the payor within three business days of receipt.As a general rule, all claims received electronically (via HNSConnect ® or Office Ally™) are electronically transmitted to the payor within two business days of receipt.As HNS has no control over the delivery of mail by the USPS, or by payor processes, HNS is unable to provide proof of if or when the payor receives paper claims or documents sent by HNS. Such claims (and documents) must be mailed by HNS, via the USPS, to the payor and when claims are mailed, the "date received" established by the payor is the date the payor representative opens the envelope and date-stamps the claim. HNS cannot provide evidence of timely filing for any paper claims which are submitted with attachments OR for corrected claims (or for any document(s) which cannot be electronically transmitted to the payor).HNS can provide evidence of timely filing IF the claim was successfully electronically transmitted by HNS to the payor, and was transmitted consistent with the payor timely filing requirements.Payors will only reconsider claims previously denied for timely filing if proof of timely filing is included with the resubmission, and the proof meets the payor's criteria for acceptable evidence of timely filing. Most importantly, generate an aging report each month, promptly investigate, and take appropriate follow up action regarding any claims with dates of service in excess of 30 days.Claims with attachments must be mailed by HNS to the payors therefore, proof of timely filing cannot be provided. Ensure you and your staff only submit an attachment to a paper claim when the attachment is required in order for the claim to be adjudicated. Corrected claims are mailed by HNS to the payors, therefore proof of timely filing cannot be provided. A corrected claim should ONLY be filed when you have received the EOB, and a change is required relative to the information included on the originally submitted claim.
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