Stay on Top of Payer Deadlines
Every payer has its own rules—and that includes different deadlines for filing, making corrections, and submitting appeals. With OneSpot, you won’t need to dig through provider manuals or juggle spreadsheets anymore. We centralize aging information for each payer, helping you stay on track and avoid missed deadlines.
The details you enter on the Payer screen—like filing, correction, and appeal timeframes—are used to automatically calculate claim deadlines in the Aging module. These deadlines are clearly shown on each claim’s detail screen, helping you take action before time runs out.
Configuring Your Payer's Aging Information
1. Filing Deadline: Enter the number of days from the date of service by which a claim must be submitted.
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- How OneSpot uses this: This field powers the Timely Filing filter in the Aging module. Without it, the filter won’t be able to highlight claims that are approaching or past their filing deadlines—making it harder to prioritize urgent work.
2. Corrections Deadline: Enter the number of days from the remittance advice to submit a corrected claim.
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- How OneSpot uses this: When a claim is marked as Denied or Under Appeal, OneSpot automatically calculates the last day to submit a corrected claim. You'll see this deadline right in the claim details, so you can focus on making the necessary corrections before time runs out.
3. Appeals Deadline: Enter the number of days from the remittance advice to file an appeal for a denied service
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- How OneSpot uses this: When you mark a claim as Denied, OneSpot automatically calculates the last day to file an appeal for the claim using this deadline, as well as the date the claim was denied. The calculated appeal deadline appears in the claim’s details, helping you prioritize appeals before time runs out.
4. Expected Payment: Enter the average number of days it typically takes to receive payment from the payer.
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- How OneSpot uses this: OneSpot calculates an Expected Payment Date for each claim by adding the expected payment days to the date of service. This helps you determine when a claim is truly overdue—and when it's time to follow up—based on the payer’s typical turnaround time.
5. Aging Instructions: Enter any payer-specific guidance for handling aged claims. This information is displayed on the Aging > Claim Details screen and helps ensure you have the correct details at your fingertips when following up. Including clear instructions can streamline your follow-up process and reduce delays caused by missing or incorrect information.
This might include details such as:
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- Where to submit appealed claims
- Required resubmission codes
- Steps to initiate a redetermination
- Any other payer-specific instructions
6. When finished, select Save.