Determining End Date of
Timely Filing Period—Receipt Date
A submission, as defined above, is considered to be a filed claim for purposes
of determining timely filing on the date that the submission is received by the
appropriate Medicare claims processing contractor. At this point, the
submission receives a permanent receipt date that remains part of the claim
record. Once a submission (or claim) passes edits for completeness and
validity described , it is accepted into the Medicare claims processing system.
The receipt date has two functions. It is used for determining whether the
claim was timely filed (see 70.4 below). The same date is also used as the
receipt date for purposes of determining claims processing timeliness on the
part of the intermediary. (See §80 for details on determining claims processing
timeliness.)
Determination of Untimely Filing and Resulting Actions
Medicare denies a claim for untimely filing if the receipt date applied to the
claim exceeds 12 months or 1 calendar year from the date the services were
furnished (i.e., generally, the “From” date, with the exception of the
“Through” date for institutional claims that have span dates of services, as
specified in §70.1). When a claim is denied for having been filed after the timely
filing period, such denial does not constitute an “initial determination”.
As such, the determination that a claim was not filed timely is not
subject to appeal.
