Certified Revenue Cycle Representative (CRCR) Practice Exam

Which statement is NOT true about timely filing limitations?

1. Payers will deny claims that are filed late

2. Payers will waive timely filing denials for claims filed over a year

3. Claims must be filed within a specified time frame

4. Providers must track filing deadlines

The correct answer is: Payers will waive timely filing denials for claims filed over a year

Timely filing limitations are critical in the claims submission process and play an essential role in the relationship between healthcare providers and payers. Understanding the nuances of these limitations is crucial for successful claim processing. Claims must be filed within a specified time frame is a true statement. Each payer has its own specific deadlines that providers must adhere to in order to ensure reimbursement, thus highlighting the importance of tracking and maintaining timely submissions. Providers must track filing deadlines reflects the necessity for healthcare providers to stay organized and aware of the deadlines imposed by various payers. This proactive management helps in avoiding denied claims due to late submission. Payers will deny claims that are filed late illustrates the consequence of failing to meet these timely filing requirements. If a claim is submitted after the prescribed period, it is typically denied, underscoring the need for strict adherence to filing timelines. On the contrary, the statement regarding timely filing denials being waived for claims filed over a year is not true. Payers generally do not waive the timely filing limitations simply based on the age of a claim. Most insurers impose firm deadlines after which claims will not be accepted, regardless of circumstances, reinforcing the importance of timely submission from the outset. Thus, the understanding of timely filing limitations encompasses strict adherence to deadlines