The Department of Health Care Policy & Financing (the Department) recognizes some providers have had difficulties submitting claims during the transition to the new claims payment system, the Colorado interChange.
In an effort to ensure providers are appropriately paid for services to our members, the Department is extending the temporary timely filing extension for an additional six (6) months.
Effective May 12, 2017, the timely filing limit was extended to 240 calendar days.
Effective May 1, 2018, the limit will be changed back to 120 calendar days.
On May 1, 2018, all claims with a date of service (DOS) prior to January 1, 2018, will be outside the timely filing limit of 120 days, and providers will need to submit additional documentation to request a timely filing extension.
Examples of additional documentation are:
• A claim denial or payment on a Remittance Advice (RA) or 835 o Payment is not an adverse action, but will suffice as proof of timely filing, if the ICN of the denial or payment is referenced on the claim
• Claims that have been date-stamped by the fiscal agent or the Department and returned to the provider
• Provider enrollment letter for initial enrollment approval or a backdate approval (affiliations or updates are not acceptable reasons for late filing)
• Load letter for eligibility backdate
• Affidavit of delayed notification of member eligibility