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Medicaid Timely Filing of Claims

The Department for Medicaid Services sent a Provider Letter on March 8, 2024, regarding timely filing of claims. The timely filing edit has been suspended for several years and was resumed on 3/8/24. The provider letter mentioned that Medicaid must receive claims no more than 12 months from the date of service. The provider letter did not mention that when the timely filing edit was resumed, coinsurance claims would be affected as well. The timely filing edit for coinsurance claims is 6 months from the Medicare remit date. Just like inpatient claims there will be circumstances when the patient was not Medicaid approved within 6 months or 1 year. If the patient was not approved for Medicaid within 6 months from the Medicare remit date, you will need to submit documentation demonstrating timely filing to Medicaid. Below is the mailing address to submit the timely filing documentation to.

•       Claims Submission: P.O. Box 2101, Frankfort, KY 40602-2101

Click here to learn more.

•       Coinsurance

•       6 months from Medicare remit date

•       Send UB-04, Medicare remit, and Medicaid screen shot to show proof of timely filing.

Do you have questions? You may call us at (270) 726-4033 or email us at: accountants@hargisandassociates.com

Sarah McIntosh, President