As a healthcare provider, one of the worst things you can face is payment denials. Every year, hospitals and even small clinics incur billions of dollars in losses just because of denials. The denials become increasingly frustrating when caused by negligence and untimely claim submission.
According to a report by Glenwood Systems, almost 7% of all denials are caused by delayed claim submissions. CO 29 denial code remains a big concern, as it can directly impact a healthcare provider’s cash flow and reimbursement rates.
But what are CO 29 denials, and how can you prevent them? That is what we are going to discuss in this blog. We will provide a detailed CO 29 denial code description, prevention strategies, and how to resolve it if you are hit with one. So, let’s start.
CO 29 Denial Code Description
Denial code CO 29 is one of the most common claim rejection codes in medical billing. The insurance company denies a claim with CO 29 when the healthcare provider submits a claim after the deadline.
Every insurance payer has its own time limits. So, it can vary from payer to payer. If we look at the data, the time limit can range from as low as 30 days to a maximum of 2 years. However, one common thing among all insurance payers is that they start their time limit from the day a service is performed.
For example, suppose a medical practice treats a patient on January 1. The insurance payer requires claims to be submitted within 90 days. Now, if the billing department of the hospital submits the claim after April 15 (which is after the deadline), the insurer will deny the claim with the denial code 29.
The hospital will lose the reimbursement and grapple with reduced cash flow.
What Causes the CO 29 Denial Code?
Now that we know what denial code CO 29 is, let’s briefly discuss some of the most common reasons that trigger it.
Delayed Claim Submission
As discussed above, the first and most basic cause of CO 29 denials is the late submission of claims. So, it becomes the duty of medical billers to resolve all issues beforehand and always submit the claim before the deadline.
Lack of Prior Authorization
Not all medical procedures are the same. There are some medical procedures for which the insurance company requires pre-authorization. If you submit a claim without authorization for a procedure requiring it, your claim might get rejected.
You will not get a denial code 29 for this. However, this will waste time, and if you cannot resolve all the issues and submit the claim before the deadline, your claim will be rejected with a denial CO 29.
Miscommunication
Did you know that miscommunication is one of the causes of delayed submissions?
Miscommunication can be of several types. The most common type that confuses billers is getting mixed up with the deadlines of different insurance payers.
All insurance companies mention their claim submission time limit in the contracts. However, healthcare providers sometimes miss this detail, leading to late claim submissions.
So, it is essential for billers to track the deadlines of all the insurance companies they have a contract with.
Uncontrollable Factors
Delayed payments can also be caused by factors that you or the insurance company cannot control.
For example, natural disasters or system outages can lead to submission delays, which in turn trigger a CO 29 denial code. This was a common occurrence during COVID-19 for a lot of hospitals.
How To Prevent Denial Code CO 29?
The best approach to handling CO 29 denials is prevention. Here’s what you can do to prevent the denials.
Track Insurance Deadlines
The most salient step in preventing CO 29 denials is to set up a structured document to track the deadlines of all insurance companies. Creating a quick cheat sheet is a good idea if your billers rely more on manual work.
On the contrary, it is always better to implement automated denial management systems in your organization. These systems can help automate deadline tracking and alert billing teams about upcoming deadlines.
Automate Claim Submission and Monitoring
If you want to keep your organization safe from long-term denial losses, we advise investing in an Electronic Health Record (EHR) system or Revenue Cycle Management (RCM) software.
This software will ensure that claims are submitted electronically and on time.
Review Contracts and Policies
It is essential that you train your employees and that your billers thoroughly review the contracts and policies of different insurance payers.
Also, make sure that all medical records, procedure codes, and supporting documents are complete before submission. You can enforce it by conducting routine and sudden audits.
Keep in Contact with the Insurer
Stay in touch with the payers to clear up any confusion. Keep open communication with insurance companies through the appropriate channels to avoid CO 29 claim denials. If you ever face an emergency, let the insurance payer know beforehand. In most cases, they will give you an extension on the deadline.
How to Resolve Denial Code CO 29?
Let’s look at some steps that you can take to resolve a denial code CO 29.
Verify Submission Dates
First, it is necessary to check whether you submitted the claim late or if the insurance company made a mistake. So, check the service date and the claim submission date. If you believe the claim was filed within the allowed time frame, gather supporting evidence such as:
- Electronic Data Interchange (EDI) acceptance reports
- Payer acknowledgment reports
- Mail tracking records (for paper claims)
File an Appeal (If Applicable)
File an appeal if the claim was denied incorrectly or due to extenuating circumstances (e.g., a system outage). Include:
- A formal appeal letter explaining the reason for the delay.
- Documentation proving timely submission.
- Any payer-specific forms required for reconsideration.
Submit Secondary Insurance Documentation
Sometimes, the primary insurer approves your payment, but the secondary insurer issues a CO 29 denial. To resolve this conflict, include an Explanation of Benefits (EOB) from the primary insurer as proof of timely filing.
Final Thoughts
CO 29 denial code significantly affects healthcare providers’ revenue cycles. It is essential to prevent and tackle it strategically. By implementing the prevention and resolution steps mentioned in this blog, you can hope to reduce your chance of denials successfully.
Many healthcare providers now prefer outsourcing denial management services to specialized billing companies like NeuraBill. It helps them avoid all the fuss and save a lot of money. So, contact our expert billing consultants at NeuraBill to get professional billing and denial management services.
