Keeping up current on any claim timely filing updates is crucial for your business!

Claims that are denied for timely filing can be rarely appealed and get paid. (Certain situations like COB/Natural disaster)

So, I always pay a close attention to any timely filling changes that are reported by the healthcare payers/plans.

Below please note the changes that took place for Self Funded (ASO) type of plans.

Find this type of information useful? Please follow my blog for more healthcare related information.

• Healthfirst: prior auth for codes 10/1/26
  If you are a NY provider that accepts Healthfirst members, then the blog post is for you! Starting 10/1/26 there will be new codes that will become effective and will require and auth. Codes that will require an auth through Healthfirst firecty: The codes that will be managed by EviCore: Please remember that patient benefits… Read more: Healthfirst: prior auth for codes 10/1/26
• Aetna: CA HMO provider disputes submission changes
  Announcement- if you are a provider that sees  California Aetna HMO plan; then effective immediately you should not submit the provider dispute through Availity portal and instead please mail the to folliwing address: P.O. Box 14020Lexington, KY 40512 As per Aetna- Fresno office is closed. Find this information useful? Follow my blog for more! #denialmanagement… Read more: Aetna: CA HMO provider disputes submission changes
• NY UHC Community Plan- no payment for 97161-97168 codes
  If you are a PT/OT provider in NY and accept UHC Community Health Plan patients? Then this blog post is for you! What is changing? UHC announced that for any DOS 12/1/26 and thereafter the codes 97161-97168 will be added to their non-covered code list. Coding: UHC states that this change will align with NY… Read more: NY UHC Community Plan- no payment for 97161-97168 codes
• NM UHC Community plan- avoiding costly denials
  If you are a provider in NM that accepts UHC Community Health plan- then this blog post is for you! As of 3/23/26- The New Mexico Health Care Authority (HCA) launched Turquoise Claims, as one system of entry point for fee-for-service claims. With this change came specific changes: What does this mean for NM UHC… Read more: NM UHC Community plan- avoiding costly denials
• FidelisCare: pre- pay claim review for COB – third party payers
  NY Providers- Do you have a patient that has FidelisCare and could potentially have a a case through workers comp or motor vehicle case? Then this blog post is for you! What is new? Which claims are subject to this process? Injury or accident Find this information useful? Follow my blog for more!