May 23, 2019
Timely Filing Reduction

Applicable to: Mercy Care Complete Care, Mercy Care RBHA, Mercy Care Long Term Care, Division of Developmental Disabilities and Mercy Care Advantage

We have recently been informed that AHCCCS is reducing its time frame for each contractor to submit encounters from 240 days to 210 days after the end of the month in which a service is rendered, or the effective date of the enrollment with the Contractor, whichever is later. 

As a result of these changes Mercy Care will be reducing its timely filing editing from 180 to 150 days from date of service on the claim for participating providers. This change will allow for internal claims processing time to pay providers and subsequent submission of all provider claims to AHCCCS. 

Our internal analysis shows that annually 98% of total claim volume is submitted to Mercy Care within 90 days of the date of service. Due to this, we do not anticipate any significant impact to providers in changing this edit. We wanted to inform you that the timely filing reduction will be implemented on July 1, 2019 (claim processing date) on a go-forward basis.

This does not apply to Court-Order Evaluations (COE). 

As always, don't hesitate to contact your Mercy Care Provider Relations Representative with any questions or comments. You can find this notice and all other provider notices on our Mercy Care website.

Thanks for all you do!