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.

• Molina Health newsletter claim reconsideration/appeal process
  The new process is available through Availity. What changed? Only 2 simple options available: claim payment inquiry/reconsideration  and claim payment dispute/appeal. Claim payment Inqury- this option should be used for the following: Claim Payment Dispute- this option should be used for the following: Find this information useful? Follow my blog for more!
• Michigan Medicaid: Community health workers billing
  This blog post is educate the providers how to properly bill for community health workers. The blog post applies to services provided in Federally Qualified Health Centers (FQHCs). Proper Billing: Find this information useful? Follow my blog for more!
• Healthfirst-new DME third party vendor
  Effective for DOS 6/1/26- Integra Partners will manage all prior authorizations for DMEPOS provider requests. This new update applies to all Healthfirst plan types. There is an update DMEPOS authorization list that can be found here. Some of the DMEPOS that require an auth and a request needs to be sent to Integra Partners: Requesting… Read more: Healthfirst-new DME third party vendor
• EmblemHealth Commercial Plan: new facility transfer policy
  This new policy applies to transfer of patient from one acute facility to another one for the same related care. What is new? For the complete new reimbursement policy, click here. Find this type of content useful? Follow my blog for more!
• UHC: Gold Program- list updated- 4/1/26
  If you are a provider that participates in UHC Gold Program, then this blog post is for you! What is the update? Affected Plans: Updated list, effective 4/1/26: For the complete list, please click here. Find this information useful? Follow my blog for more!