What is the primary consequence of missing timely filing limits in claims processing?

The primary consequence of missing timely filing limits in claims processing is the denial of payment for submitted claims. Timely filing limits are established by insurance companies and dictate the timeframe within which a healthcare provider must submit a claim after the service has been provided. If a claim is submitted after this period, the insurance payer is likely to deny the claim due to lateness, meaning the provider won’t receive payment for the services rendered.

This situation not only affects the revenue cycle for the practice but also requires additional administrative efforts to potentially appeal the denial, which could lead to further delays in payment. Understanding and adhering to these limits is crucial for maintaining healthy cash flow and ensuring the financial sustainability of healthcare practices.