When Disaster Strikes, Ask for a Claims Filing Extension

You know Texas weather. In 2015, floods, blizzards, tornadoes, and windstorms plagued the state. Some physician practices experienced severe damage, and they had to scramble to get back on their feet. Under Texas prompt payment laws, you may be able get an extension of the 95-day claims filing deadline if you believe you will not be able to meet it for some claims because of a catastrophic event, like a tornado. 

But you must act quickly after the disaster. You must notify the Texas Department of Insurance (TDI) of your inability to meet claims filing deadlines by letter within five days after the catastrophic event.

Let TDI know your practice address, contact information, and the names of the physicians in the practice. Mail the letter to Life/Health and HMO Intake Team, Texas Department of Insurance, PO Box 149104, Mail Code 106-1E, Austin, TX 78714-9104.

Once your practice has returned to normal business operations, you'll need to notify TDI of this fact within 10 business days of resuming normal operations via a notarized letter certifying:  

  1. The specific nature and date of the catastrophic event that caused you to be unable to meet the timely filing deadlines, and
  2. The length of time the catastrophic event caused an interruption in your claims submission or processing activities. 

The deadlines are delayed by the period you certify under bullet No. 2 above.  

You might consider drafting both letters in advance so that you'd just have to fill in the specifics and print them out if a time comes when you need to use them.

Action, May 2, 2016

Last Updated On

June 23, 2016

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