Timely Filing Appeal Letter (with Proof of Timely Submission)

Use this when a claim was filed on time but denied as late, or aged out in COB. It only wins with proof — a clearinghouse acceptance report, payer acknowledgment, or the primary EOB date. Never send it without the trail.

What makes it win

• Attach hard proof of timely submission: clearinghouse acceptance/acknowledgment report showing the original send date and payer acceptance
• For COB, cite the primary payer's EOB date, which resets the filing clock for the secondary claim
• Invoke the payer-specific exception you fall under (payer error, retroactive eligibility, provider vs payer fault)
• Reference the original claim number and original submission date, not just the resubmission

The template

Replace the [BRACKETED] fields with your details. This is the manual version of the appeal Volari files for you automatically.

[PRACTICE LETTERHEAD]
[DATE]

[PAYER NAME] — Appeals Department
[PAYER APPEALS ADDRESS]

RE: Appeal of Timely Filing Denial (CARC 29)
Patient: [PATIENT NAME]   Member ID: [MEMBER ID]
Claim #: [CLAIM NUMBER]   Date(s) of Service: [DOS]
Original Submission Date: [ORIGINAL SUBMIT DATE]

To the Appeals Department:

We are appealing the timely filing denial for the above claim. This claim was submitted within [PAYER]'s [NUMBER]-day filing window and we have enclosed proof of timely submission.

The claim was originally transmitted on [ORIGINAL SUBMIT DATE] and accepted by [CLEARINGHOUSE NAME] on [ACCEPTANCE DATE]. The enclosed clearinghouse acceptance report (trace/batch #[TRACE NUMBER]) confirms the claim was received into the payer processing stream on that date — within the filing limit for a [DOS] date of service.

[IF COB: This claim was pending coordination of benefits. The primary payer's EOB is dated [PRIMARY EOB DATE], which establishes the filing clock for this secondary submission per [PAYER]'s COB filing policy.]

Because timely submission is documented, the CARC 29 denial does not apply. We request the claim be reopened and adjudicated on its merits.

Enclosed: clearinghouse acceptance report, [PAYER ACKNOWLEDGMENT / PRIMARY EOB].

Sincerely,
[BILLING MANAGER NAME], [TITLE]
[PRACTICE NAME] — NPI [NPI]   TIN [TIN]

Common questions

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