Forum - Questions & Answers
Claim submission statute of limitiations
I recently discovered that claims that I submitted were missing charges rendered for vaccines, ppd tests etc.. Is there a standard length of time between submission of a claim for medical services, where corrections/additions to a previously paid claim will not be accepted? I know that the Blue Cross inruers say that they have 3 years to take back money that they feel have been paid incorrectly, but what about physicians? I thought we had one year to submit claims for services? Is this correct?
it varies
depends on the insurer. Medicare is one year. As an aside, PQRI codes must be submitted at the same time as the E&M code is submitted; you cannot go back and submit those codes at a later date.