Adjustments for Claims Beyond the 365-Day Submission Deadline Should Not Be Submitted Electronically

Claim adjustments with dates of service (DOS) beyond the 365-day submission deadline should not be submitted electronically. Providers who attempt to submit a claim adjustment electronically for a claim with DOS beyond 365 days will have the entire amount of the claim recouped. Requests for adjustments to claims with DOS beyond the 365-day submission deadline may be submitted using the Timely Filing process (a paper process) if the claim adjustment meets one of the exceptions to the claim submission deadline. Refer to the Submission topic (topic #744) in the Timely Filing Appeals Requests chapter of the Claims section of the ForwardHealth Online Handbook for information on the Timely Filing process.