Category summary: The winning issue is proof: show accepted receipt, a qualifying delay, payer error, or a policy-recognized exception.
Top codes in this category
How to work these denials
- Find the filing limit in the provider contract, provider manual, or product-specific policy.
- Build a date timeline: date of service, original submission, acceptance/rejection, correction, payer response, and denial date.
- Attach the strongest proof first: 277CA, payer claim number, clearinghouse acceptance, or portal confirmation.
- Explain why the claim meets the filing rule or a specific exception, using dates rather than general statements.
- Submit through the plan’s dispute/appeal channel before the appeal deadline runs out.
Evidence checklist
- Clearinghouse acceptance report
- 277CA or payer acknowledgement
- Original claim control number
- Provider manual excerpt
- COB/eligibility records if relevant
- Appeal timeline