Anthem plans to shorten timely filing limit for claims

If you have a contract with one of Anthem’s commercial or Medicare Advantage plans, your window to timely file a claim may be shrinking. The company has reportedly notified all practices that have non-Medicare or Medicare Advantage contracts with them that:

Effective for all commercial and Medicare Advantage Professional Claims submitted to the plan on or after Oct. 1, 2019, your Anthem Blue Cross and Blue Shield (Anthem) Provider Agreement(s) will be amended to require the submission of all commercial and Medicare Advantage professional claims within ninety (90) days of the date of service. This means all claims submitted on or after October 1, 2019 will be subject to a ninety (90) day timely filing requirement.

The notice goes on to say that practices that object to this change can file a written appeal with the company within 30 days of receiving the notice and attempt to negotiate the timely filing limit. However, if you and Anthem can’t agree on a timely filing limit within 30 days, your contract will end no later than Oct. 1.

A shorter time limit for filing claims increases the importance of two office functions. First, you and your staff obviously have to be efficient about filing claims. Second, you have to accurately verify a patient’s insurance before or at the time of appointment because if you send an Anthem claim to the wrong insurer, you may not have time to send it again.

– Kent Moore, Senior Strategist for Physician Payment at the American Academy of Family Physicians

Posted on Aug 09, 2019 by Kent Moore