Certified on NPHIESGroupDuplicates and time limits
Who usually fixes itBilling
Deadline15 days from the rejection
What it means
For example: A claim waited six weeks for a missing approval and was sent after the limit.
The rejection is about the claim as it was sent, not about whether the care was right.
Why it usually happens
- The claim waited for a missing approval or result.
- Nobody noticed the claim hadn’t been sent.
- A rejected claim was resent after its appeal window had closed.
How to fix this claim
- Check the dates against your contract’s time limit.
- If you sent it in time, appeal with proof of the first sending.
- If not, record why it was late and fix the cause.
Mind the deadline. You have 15 days from the rejection to answer it (CHI Unified Health Insurance Contract, clause 5.4). Your contract with the insurer may set a different window, so check it.
How to stop it next time
Work claims by deadline, oldest first.
This page explains the common causes. Your insurer’s policy and your contract decide each claim.
