Help with CO Medicaid Timely Filing

[Steve Verno]

All you might be able to do is read the provider manual regarding the appeals process and sumit your appeal with supporting documentation.  

or

you might contact provider relations at your Medicaid vendor.

When we got timely filing denials, we sent our initial paper claims via certified mail/return receipt.  When they started denying for timely filing, we appealed per the medicaid manual and provided the certified mail and return receipt.  Our electronic claims would go through our clearinghouse where we received reports:  (1) receipt by clearinghouse, (2) submitted to carrier and (3) acknowledgement of receipt by carrier from clearinghouse.  All 3 reports went with the appeal that was per medicaid manual.  

You might wish to bring this to the attention of the State Medicaid regulatory agency.  But, the proof is on you to prove timely filing by you or anyone you replaced.  

I found that Colorado Medicaid has a 365 day time limit for claims submission.  You can find this in the billing manual on the medicaid website, so why you are getting a timely filing denial if your claims are within this one year timeframe is unknown, unless you are working claims older than a year old or you took over from someone else and you found a bunch of unpaid claims which you're trying to get paid.  Again, if your claims fall within Medicaid's guidelines, follow the medicaid appeals process or contact provider relations. 
not knowing any other info, this is all that can be recommended.  

[levantou]

Hello. I've been having trouble with certain claims getting sent electronially to CO medicaid. So I tried to do paper claims on CO 1500 form (per CO medicaid rules). However, now they are denying these claims for timely filing. Reading up on the current rules, I have to submit LBOD information. However, I'm not sure what to include with this. I never received a denial from Medicaid because the claims were never "received" on their end. All I really have is a screen print showing the date I originally billed (within timely filing). Any help in this issue would be greatly appriciated.