A specialty practice finding CO-29 timely filing denials months after its biller left

This is an illustrative scenario: a composite of a situation that practices commonly face. It is not a Soft Home Global client and not any real practice, and it claims no result. The resolution steps come from our CO-29 guide, so the two never disagree.

The practice

A small specialty practice whose only biller left.

What they were seeing

The practice's biller resigned and claims sat unsubmitted and unworked for weeks. When a replacement started, CO-29 denials — the time limit for filing has expired — were already arriving.

What was actually going wrong

Timely filing limits run from the date of service and differ by payer. A claim that was never submitted, or submitted and rejected at the clearinghouse without anyone noticing, can pass the limit without a single denial arriving to warn anyone.

How it is resolved

1. Check whether you can prove timely submission: a clearinghouse acceptance report with a date inside the window will overturn many of these.
2. If the delay was caused by the payer, for example an eligibility or COB error on their side, appeal with the evidence and cite it.
3. If it was filed to the wrong payer first, many contracts allow the clock to run from the primary’s remittance date — check the contract, not the general rule.
4. Where it is genuinely late and unprovable, write it off and move on rather than spending forty dollars of labour on it.

How to stop it coming back

Every CO-29 is a claim that was already worked once and then abandoned. An aged AR queue that nobody calls on generates these steadily and silently.

Questions