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SHPBN-2016-067 Standardized Timely Filing

Date: 09/26/16

Updates to Timely Filing Timeframes for First-Time Claims & Corrected Claims

Sunflower Health Plan will observe the standardized timely filing requirements effective with dates of service on or after January 1, 2016. Sunflower will enforce these standardized timely filing requirements effective with claims received on or after October 1, 2016.

PROVIDERS HAVE:

  • 180 Days – to submit claims from the Date of Service (DOS) or from the date of eligibility determination
  • 180 Days – to submit claims when the member has other insurance, from the date on the primary payer’s EOP
  • 365 Days – to submit corrected claims from the date on the EOP

Claims received prior to October 1, 2016, will not be affected.

 

If you have questions about this bulletin or other provider resources, please contact our Customer Service at 1-877-644-4623.