What is timely filing?

Timely filing is the window a payer allows between the date of service and claim submission. Broker contracts commonly allow 60 to 180 days; state Medicaid programs often allow 12 months for initial claims. Corrected claims and appeals have their own, usually shorter, deadlines. A claim submitted after the window is denied for timely filing and the denial is rarely overturned.

Why timely filing matters for NEMT

Timely-filing denials are entirely self-inflicted. They happen when trips sit unbilled because a signature was missing, a driver forgot to close a trip, or the billing backlog grew. Bill daily, run a weekly unbilled-trips report, and set an internal deadline well inside the contractual one. Know each payer's window; they differ, and the shortest one sets your process.

Related terms

• Claim
• Remittance Advice
• Trip Log
• Denial
• Base Rate