Check timely filing alerts

Outcome

Claims at risk of missing the payer's filing deadline are surfaced and actioned before the window expires.

Prerequisites

• claims.read to query.
• Nightly job runner active (see Run batch operations).

Alert levels

The claim service tracks days elapsed vs. payer filing deadlines.

Level	Threshold	Action
WARNING	80% of filing deadline elapsed	Prioritize for submission
ALERT	90% of filing deadline elapsed	Submit immediately
EXPIRED	100% of filing deadline elapsed	May require appeal for late filing

Query alerts

# Get all alerts (filterable by alertLevel, payerId, billingEntityId)
curl "http://localhost:3002/claims/timely-filing?alertLevel=ALERT"

Or in SQL for ad-hoc analysis:

SELECT c.claim_id, c.status_current, c.payer_id,
       MIN(cl.service_date_from) AS earliest_dos,
       CURRENT_DATE - MIN(cl.service_date_from) AS days_elapsed,
       psc.filing_deadline_days,
       ROUND(
         (CURRENT_DATE - MIN(cl.service_date_from))::numeric
           / psc.filing_deadline_days * 100, 1
       ) AS pct_used
  FROM billing.claim c
  JOIN billing.claim_line cl ON c.claim_id = cl.claim_id
  JOIN rcm_master.payer_submission_capability psc
    ON c.payer_id = psc.payer_id AND psc.tx_type = '837P'
 WHERE c.status_current IN ('CREATED', 'BUILT')
 GROUP BY c.claim_id, c.status_current, c.payer_id, psc.filing_deadline_days
HAVING (CURRENT_DATE - MIN(cl.service_date_from))::numeric
         / psc.filing_deadline_days > 0.8
 ORDER BY pct_used DESC;

Validation

Check	Expected
ALERT row count	Trending down
EXPIRED row count	Zero (or all routed to appeal)
Filing window in payer_submission_capability	Matches contract

Troubleshooting

Symptom	Cause	Fix
No alerts but claims should be expiring	payer_submission_capability.filing_deadline_days NULL	Set per Configure a new payer.
Alerts fire incorrectly	Wrong filing window for tx_type	Check tx_type-specific capability rows.
Late-filing appeals stuck	CO-29 handler missing	See Auto-correction operator playbook.

Cross-references

• Configure a new payer for filing-window setup.
• Commercial billing-NPI & filing.

Next

7.3 — Refresh reporting views