Process for 180-Day and 365-Day Timely Filing Edits: Exception and Special Handling Requests

ODP Announcement 21-046 is intended to instruct providers on how to proceed when a claim denial is received for Error Status Codes (ESC) 545 and 512. The short descriptions for these ESCs are “Claim Past Filing Limit” and “Claim Past 365 Day Filing Limit.” Providers should utilize the Bureau of Financial Management and Program Support 180-Day Timely Filing Exception/Special Handling Request Form when requesting payment for these claims. Please note: the release of this communication will obsolete Informational Memo 037-17.

Additionally, Medical Assistance (MA) Regulation 55 Pa. Code § 1101.68(b)(1) established criteria for submitting invoices for services rendered to MA recipients. Please view the regulation here.