There are times when a claim is denied for being submitted outside of a payer’s timely filing window. If the claim was originally submitted within that window, but wasn’t received by the payer due to a clearinghouse issue, we can provide you with proof of timely filing to submit to the payer. After reviewing this proof of timely filing, insurance payers may reprocess the claim accordingly.
Important: Our team can only provide proof of timely filing for claims that were submitted electronically through your SimplePractice account.
In this guide, we'll cover:
- What is a timely filing window?
- When is proof of timely filing required?
- How do I request proof of timely filing?
What is a timely filing window?
Insurance payers require that a claim be submitted within a set period of time after services were provided. This is referred to as a timely filing window. Payers have different timely filing limits, with some being 90 days, and others being a full year. Because this varies, we recommend contacting a payer directly to confirm their requirements.
When is proof of timely filing required?
If a claim is submitted after a timely filing window has passed, the payer will usually deny the claim. If the claim was originally submitted within that window, but due to an issue with the clearinghouse, wasn’t received, proof of timely filing can be submitted to the payer. This will show that you originally submitted it in time and the payer may reprocess the claim.
If a claim was submitted for the first time after the window had already passed, proof of timely filing won’t be useful. In this case, we recommend working with the payer directly on an appeal.
How do I request proof of timely filing?
Our team can provide you with proof of timely filing for a claim that was submitted electronically through SimplePractice.
To request proof of timely filing, submit a help request with the clearinghouse reference number for the claim(s) in question. The clearinghouse reference number is listed at the top of the claim:
We’ll work with our clearinghouse and provide you with electronic data and an appeal letter template that you can submit to the payer.
Important: A clearinghouse reference number is the only way our team can provide you with proof of timely filing. Because of this, we always recommend downloading a claim and saving its clearinghouse reference number before deleting it in your account. Additionally, if a claim was downloaded and submitted outside of SimplePractice, we're not able to provide proof of timely filing. When a claim is downloaded, the PDF represents a new claim, and box 31 on the PDF will populate with the day the claim was downloaded.