The True Message Behind "Timely Filing" Denials: What’s Really Costing You Revenue?
When we talk about timely filing denials, most healthcare providers agree on one thing – these denials occur when claims are submitted beyond the payer’s designated time window. But if we stop there, we miss the bigger picture. The real question we need to ask is: Why wasn’t the claim submitted on time in the first place?
At CodeEMR, we work with a wide range of healthcare organizations – from small clinics to multi-specialty hospitals – and we’ve noticed a consistent pattern: timely filing denials are often symptoms of deeper coding issues. These denials are just the tip of the iceberg, masking more significant gaps in the revenue cycle.
Behind Every Timely Filing Denial Is a Missed Opportunity
It’s easy to assume a denial is solely due to a missed deadline. However, our experience shows that many so-called timely filing denials actually originate from coding errors, documentation issues, or workflow bottlenecks. Unfortunately, these root causes are often overlooked when denials are categorized under broad labels in denial management systems.
For instance, a claim may initially be rejected due to a coding error. If it’s not corrected and resubmitted quickly, it may eventually exceed the allowable filing timeframe. The final denial reason? “Timely filing.” The true cause? A coding denial.
This misclassification has consequences. When facilities bucket denials without pinpointing the exact issue, they lose visibility into the coding challenges affecting their reimbursement. This leads to lost revenue, repeat denials, and missed opportunities for improvement.
Are You Underestimating Your Coding Denials?
When we ask new clients about their rate of coding denials, we’re often told it’s low or negligible. But after a thorough audit, we frequently uncover a different story. The reality is that many organizations don’t track coding denials separately – they end up buried in categories like “timely filing” or “payer rejection.”
In truth, coding-related delays are among the most common contributors to timely filing denials. These can include:
- Incorrect or missing diagnosis or procedure codes
- Incomplete documentation
- Delays in coding due to staffing shortages or backlogs
- Lack of timely feedback between coders and billers
When coding is delayed or inaccurate, it creates a chain reaction that affects the entire revenue cycle.
The Hidden Impact of Coding Backlogs
Another key contributor to timely filing denials is the coding backlog – a growing pile of uncoded encounters waiting to be processed. These backlogs often occur due to limited resources, outdated systems, or lack of coding oversight.
While many practices aim to maintain low accounts receivable (A/R) days, they may write off claims denied for timely filing just to meet performance metrics. But this approach comes at a cost. Valuable revenue is left on the table, and avoidable denials are allowed to continue unchecked.
Don’t Let Write-Offs Become Your Default Strategy
Writing off claims may seem like the only option when faced with mounting denials, but that’s not a sustainable solution. Instead of accepting losses, organizations must address the root causes of these denials – especially those linked to coding inefficiencies.
By conducting a deeper analysis of your denial patterns, you can identify whether timely filing issues are truly deadline-related or a reflection of internal delays in coding and documentation.
How CodeEMR Can Help You Stay Ahead of Timely Filing Denials
At CodeEMR, we specialize in medical coding solutions that go beyond just transactional support. Our team of AAPC and AHIMA-certified coders work proactively to ensure accurate, timely coding – reducing your risk of missed deadlines and coding-related denials.
Here’s how we support your revenue cycle:
- Eliminate coding backlogs with scalable staffing
- Improve documentation accuracy with ongoing coder-clinician feedback
By partnering with CodeEMR, your internal team can shift their focus from chasing claims to driving performance and ensure the claims are coded right the first time.
Final Thoughts
Timely filing denials are more than just missed deadlines – they’re often red flags pointing to deeper process gaps. Don’t let these silent revenue leaks continue. By addressing the underlying coding issues, you can reclaim revenue, reduce denials, and bring greater transparency to your RCM operations.
Let CodeEMR’s expert coding team help you close the loop and recover what’s rightfully yours.
