Each Care Management Agency (CMA) determines its own schedule for completing billing support questionnaires for Children’s Health Home members and Adult Health Home enrolled members. The date on which a billing support questionnaire is completed determines when a claim is submitted by Foothold Care Management for the member-month. (Please consult the “Claim Submission” section for details about the claim submission schedule.) Although FCM can accommodate late submissions and retroactive modifications to billing support data, claim submission and eventual payment remittance may be delayed.
It is important to note that each payer has a different set of rules for how many days a claim can be submitted from the date of service. A billing support questionnaire that is not completed in a timely manner may result in a denied claim.
See article "Payers Timely Filing Rules" for the rules for each of the payers.