There are many different reasons why this might happen. Each clinic does things differently. Inspire Physical Therapy now has a designated biller so things are changing for us and will result in more timely filing.
Most plans allow up to a year to resubmit claims and have a time requirement (each plan is different) to submit the first claim by. At Inspire, we aim to send each claim within a week (give or take) of your service date.
Once submitted, there are many reasons why claims can be missed. Issues with the clearinghouse getting the claim to the plan, EMR (Electronic Medical Record) system failures, clerical errors, etc. We run reports monthly and quarterly to search for such issues. Currently, most insurance companies are very behind. This is mainly due to the spike in resubmissions from COVID and the increased hospitalizations with RSV, flu, etc. For example, Blue Card (who handles all non-Regence claims) states that they are at a 30-45 business day window before they even review a denied claim that has been asked to be resubmitted.
With all this being said, you can feel good knowing that you do not have to worry about all those little details because Allie has your back!
We appreciate your patience, especially as older claims are getting processed.
If you ever have a question about your bill, please feel free to email Allie at allie@inspireptforkids.com
