CO29 denial code description and corrective action

• This denial occurs when a claim or appeal is submitted to the insurance company after the timely filing limit has expired.

Actions

• First, we need to verify the status of the claim. This can be done by checking the status through the insurance web portal or by calling the payer.

• The most important step is to determine whether the claim denial is valid or if the insurance has denied the claim by mistake.

• Call the insurance company and discuss the denial with the representative. If the claim is found to have been billed within the timely filing limit, request the representative to reprocess the claim. Be sure to note the claim number, representative’s name, and call reference number, and then follow up on the claim after the provided TAT.

• If the claim is denied due to the timely filing limit (TFL) being expired but proof of timely filing (POTF) is available, then we proceed with submitting an appeal.

• For submitting an appeal, we must calculate the timely filing limit starting from the processed date. If the limit has been exceeded, the claim will be denied again for exceeding the filing deadline. In such cases, we should consult with the provider. Some clients may still want us to submit the appeal even after the timely filing limit has passed, so we should proceed according to their instructions.

• Sometimes a claim is mistakenly billed to the wrong insurance, and after receiving the denial, it is then billed to the correct insurance, but by that time the timely filing limit of the new insurance has expired. In this case, we can use the proof of timely filing (POTF) from the first submission and proceed with submitting an appeal.

• Sometimes a claim is billed on the last day of the filing limit, but the insurance receives it a day later and denies the claim. In this case, we submit an appeal with proof of timely filing (POTF).

• If a claim or appeal was truly billed after the timely filing limit and no proof of timely filing (POTF) is available, then we proceed according to the practice SOPs in this case, which most often means writing off the claim.

Description