Why Timely Claim Submission Matters: Avoiding Lost Revenue

In private practice, getting paid means not just seeing patients—it means staying timely and accurate with claims. Here's why every day counts.

✅ Timely Filing = Faster Payments Most insurers require claims to be submitted within 90 to 180 days from the date of service. Medi-Cal allows up to 6 months, but don’t push it.

❌ Miss the Deadline? Your claim could be automatically denied, even if it was valid.

✅ Retroactive Billing Is Limited With Medi-Cal, you can backbill up to 12 months, but only if:

• You applied within 30 days of service

• You were approved later

⚠️ Applied Late? You can only bill from the date of your application, not the service.

📅 CAQH & Timeliness Use CAQH ProView to track credentialing with insurers. If you’re not enrolled yet, you can’t bill—and you definitely can’t bill retroactively unless the plan explicitly allows it.

🔗 Keep These on Hand:

• Enrollment effective dates

• Claim submission logs

• Proof of timely application for credentialing

✅ Bottom Line: Being timely isn't optional. It's the difference between getting paid or writing off thousands in denied claims. Get credentialed early. Submit quickly. Stay compliant.

Need help tracking your enrollment, filing retroactive claims, or building workflows to submit on time? We can help.