No Claim on file

No Claim on File

1. Pre-assessment:

1. Always check the clearinghouse or scrubber whether the claim was sent to insurance or it is rejected if it was sent electronically.
2. If Claim was sent via mail check whether the address is correct or not.
3. There could be multiple rejection scenario that is because software is not updated with the details.
4. If you are assured that everything is correct and still there is no claim on file, then follow up with the insurance regarding coverage and also make sure to check if the patient is eligible on the date of service over payor’s portal before calling to payer.
5. Always remember if you correct edit of rejection and found that timely filing crossed for billing you can ask the insurance if the claim can be submitted along with the proof of timely filing.
6. You can attach snip of rejected claim to insurance along with claim form as a proof.

No claim on file

1. Could you please check Whether the Patient is eligible for the date of service.May I have policy effective and termed date?
2. May I have claim mailing address, Payer ID and Fax#?
3.  Can we fax the claim along with proof of timely filing
4. May I have the claim’s mailing address?
5. May I have the Timely filing limit to resubmit?
6. Call reference number.

Important points:

• Always try to resubmit claim either by fax or payer id as it takes less time to deliver claim to insurance which means insurance can take action promptly, since sending a claim via mail takes a longer time.
• Always update correct information in host to avoid future rejection.
• If there is denial of co-29 timely filing exhaust, then always send an appeal with POTF.
• If there is no POTF then claim can be written off only if there is no other active insurance card available.
• If the member id has been changed for the patient, then rep can provide the details and please submit it as fresh claim or corrected claim as per insurance guideline or as per process update.

Also read: MOST FREQUENTLY ASKED QUESTIONS