Question: Our payer says we are not in compliance with "timely filing" requirements when we file paper claims for an unlisted-procedure code. What can we do?
Pennsylvania Subscriber
Answer: Many payers require electronic claims as proof of timely filing. But on many occasions, you must provide full documentation and therefore file a paper claim -- such as unlisted-procedure code claims, modifier 22 (Unusual procedural services) and reduced or discontinued service (modifier 52 or 53) claims.
The solution is simple: File the claim electronically and then submit paper documentation separately. Be sure to include a note with the paper claim (or better yet, have a stamp made) explaining, "This is not a duplicate claim. This documentation supports an electronic claim."