The Timely Filing Limit Guide

In medical billing, time is extremely important because when it comes to claim

submissions there is some serious revenue on the line. A timely filing limit is a
constant, lingering due date that healthcare providers need to understand.

Insurance Timely Filing Limit Resource

[Link]
.com/content/dam/centene/a
Absolute Total Care 1 year from date of service bsolute-total-care/pdfs/
Allwell%20Provider%20Manual
%202018%[Link]
[Link]
Accountable
90 days from date of service tm_files/Claims%20Submission%
Healthcare IPA [Link]

[Link]
ADOC Medical Group 180 days from the date of service
resources/claims-information/

[Link]
Aetna 120 days from date of service care-professionals/disputes-
appeals/[Link]

[Link]
om/pennsylvania/assets/pdf/pro
Aetna Better Health 180 days from date of service
vider/notices/provider-timely-
[Link]
[Link]
Aetna Better m/pennsylvania/assets/pdf/provi
180 days from date of service
Health Kids der/notices/provider-timely-
[Link]

[Link]
AMA 2 years from date of service
/faq

[Link]
American Progressive 1 year from date of service [Link]/sharedpdfs/pro
vider/TO_PFFS_TermsConditions.pdf
 Insurance Timely Filing Limit Resource

90 Days for Participating [Link]

Amerigroup Providers or 12 months for Non- eimbursement%20Policy%20Docum
Participating Providers ents/ALL_RP_ClaimsTimelyFiling.pdf

[Link]
Argus Dental 90 days after the date of service content/uploads/2017/09/Dental-
[Link]

Arizona Health Care [Link]

Providers/Downloads/IHS-
Cost Containment 12 months from the date of service
TribalManual/IHS-Chap19
System [Link]

[Link]
Baptist Health Plan 180 days from the date of service
Timely%20Filing%20of%[Link]

[Link]
s/[Link]/files/docs/Pro
BCBS Florida 180 days from the day of service
vider%20Manual%20MASTER%2001
%2002%[Link]
[Link]
/default/files/document/attachme
BCBS North Carolina 1 year from the day of service
nt/providers/public/pdfs/BlueBook
_July2016.pdf

[Link]
BCBS Rhode Island 180 days from the day of service default/files/polices/TimelyFiling
[Link]

[Link]
.com/wp-content/uploads/2016
Beacon Health 90 days from the date of service
/11/Beacon-Health-Options-
[Link]
[Link]
Beechstreet/ContentReader?
BeechStreet 90 days from the day of service
docName=BEECH_DOC_PRV_
MANUAL

[Link]
Benefit Trust Fund 1 year from date of Medicare EOB grams/piggyback/piggyback
_claim.html
 Insurance Timely Filing Limit Resource

Blue Advantage [Link]

180 days from date of service
HMO pdf/secf_filing_claims.pdf

[Link]
Blue Cross of
12 months from the date of service com/Documents/CACA_MMP_
California RP_ClaimsTimelyFiling.pdf

[Link]
Blue Cross PPO 1 year from the date of service
pdf/ppo_secf.pdf

[Link]
Blue Essential 180 days from the date of service
pdf/secf_filing_claims.pdf

[Link]
Champus 1 year from the day of service CARE/docs/pubfiles/brochures/
[Link]

[Link]
content/uploads/sites/4/2016/08
CHIPA (Aetna/MHN) 1 year from the day of service
/CHIPA_Provider_Manual_March
[Link]
[Link]
content/uploads/sites/4/2016/08
CHIPA (PBH/CHIPA) 90 days from the date of service
/CHIPA_Provider_Manual_March
[Link]
[Link]
Cigna (out-of-network care-providers/coverage-and-
180 days from the day of service
provider) claims/submit-claims/when-to-
file-claims

[Link]
Cigna HealthSprings
120 days from the day of service resources/medicare-
(Medicare Plans) 2015/docs/[Link]

90 Days for Participating [Link]

Cigna timely filing
Providers or 180 Days for Non- providers/coverage-and-claims
(Commercial Plans) Participating Providers /submit-claims/when-to-file-claims
 Insurance Timely Filing Limit Resource

Clover Health 90 days from the date of service [Link]

[Link]
[Link]/wp-
Colorado Access 120 days from the date of service
content/uploads/2019/01/Provider-
[Link]
[Link]
Coventry Healthcare [Link]/web/groups/public/@c
90 days from the date of service
of Georgia vty_regional_chcga/documents/
document/[Link]
[Link]
Eastern Oregon CCO edia/eocco/pdfs/provider_manual.
120 days from the date of service
(MODA/ODS) pdf?la=en&hash=0384DCFD51350FA
37C6BE112DA85F43D

[Link]
Elderwood Health 120 days from the date of service
com/for-providers/

[Link]
365 days (in-network),
Emblem Health viders/provider-manual/claims/
18 months (out-of-network)
timely-submission
[Link]
Evergreen Health aryland-health-insurance-
180 days from the date of service provider-resources/claims-and-
Cooperative
payment-options/

[Link]
0/Providers/ProviderManuals/2018-
Fidelis Care New York 90 days from the date of service 0817-FidelisCare-ProviderManual-
[Link]

First Health [Link]

(Commercial, 6 months from the date of service oviders/forms/provider_timely
Individual, PPO) _filing_guidelines_hfhp.pdf

[Link]
First Health (Medicare
1 year from date of Medicare EOB oviders/forms/provider_timely
Advantage) _filing_guidelines_hfhp.pdf
 Insurance Timely Filing Limit Resource

[Link]
Florida Cenpatico
180 days from the date of service nt/dam/centene/cenpatico/pdfs/F
Behavioral Health LFL_ALL_FAQ_122613_ENG.pdf

[Link]
Florida Hospital
1 year from the date of service viders/forms/provider_timely_filing
Care Advantage _guidelines_fhca.pdf

[Link]
Great-West
180 days from the date of service files/public/2377/PHC-Cigna-
Healthcare [Link]

Group Health [Link]

by December 31 of the year after
Cooperative of South Documents/2018_Federal_Employe
the year you received the service
Central Wisconsin e_Brochure.pdf

180 days (outpatient service) or [Link]

Harmony Health Plan
90 days (primary insurance ssets/illinois/assets/illinois_medicai
(Wellcare of Florida) payment date), whichever is later d_provider_manual_11_2012.pdf

[Link]
Harvard Pilgrim
90 days from the date of service portal/url/item/8662B3FFC98D495C
Health Care 85BE7CA04E809A68

[Link]
Healthcare Partners 180 days from the date of service m/media/100260464/hpp-provider-
[Link]

[Link]
Health Net 180 days from the date of service
m/pdf/[Link]

[Link]
HealthNet ovider/content/iwc/provider/unprot
365 days from the date of service
(Non-PPO) ected/working_with_HN/book/non_c
ontracting_provider_policies.action

[Link]
HealthPlex Inc 365 days from the date of service
transparency_in_coverage
 Insurance Timely Filing Limit Resource

[Link]
Health Team
180 days after the date of service wp-content/uploads/HTA-PROVIDER-
Advantage [Link]

[Link]
365 days from date of service
Highmark es/EducationManuals/HFM/hfm-
(PA and WV), 120 days (DE)
[Link]

[Link]
Horizon Healthcare
180 days from the date of service urecms-documents/459/Billing%20
Dental Services NJ Guide%20August%[Link]

[Link]
Horizon NJ Plus 180 days from the date of service for-providers/resources/claims-
information

[Link]
90 days from the date of service
Horizon Valley content/uploads/2018/08/APC-
(contracted providers), 180 days
Medical Group AB1455-HVMG-Notification-
(non-contracted providers)
[Link]

[Link]
Household Merch Nni 12 months from the date of service /education/materials/timely_claim
_filing_req.html

[Link]
HSA Health Plan 12 months from the date of service content/uploads/2017/12/MasterPolic
[Link]

[Link]
180 Days for Physicians or 90 Days
Humana support/claims/electronic-
for facilities or ancillary providers
submission

[Link]
IlliniCare Health 180 days from the date of service
m/[Link]

[Link]
IMCare 90 days from the date of service enter/View/4295/2019-Member-
Handbook-PDF
 Insurance Timely Filing Limit Resource

[Link]
Imperial Health wp-content/uploads/2012/07/IHP-
90 days from the date of service Provider-Manual_2017-update-
Holdings
[Link]
[Link]
John Hopkins ns_hopkins_healthcare/downloads/r
180 days after the date of service
Healthcare esources_guidelines/amd_provider_
[Link]

[Link]
Kaiser Permanente 12 months after the date of service [Link]/provider-manual/billing-
claims/claims/claims-timely

[Link]
Kalos Health 90 days after the date of service content/uploads/2018/10/KHGP_
provider-manual_final-[Link]

[Link]
L.A. Care 180 days from the date of service
claims-edi/submitting-claim

LaSalle IPA [Link]

90 days from the date of service
(contracted) %20AB1455%[Link]

LaSalle IPA (non- [Link]

180 days from the date of service
contracted) 20AB1455%[Link]

[Link]
Liberty
12 months from the date of service p-content/uploads/documents/
Advantage LLC. LIBERTY_Provider-[Link]

Louisiana Health
180 days from the date of service [Link]
Connections

[Link]
Magellan
365 days from the date of service [Link]/media/1464/c-h1015rev5-
Complete Care [Link]
 Insurance Timely Filing Limit Resource

Magnolia Health
90 days from the date of service [Link]
Plan

[Link]
MARCH Vision 180 days from the date of service /docs/ks_providerreferenceguide.
pdf

[Link]
Maryland [Link]/content/dam/centene/m
180 days from the date of service
Physicians Care aryland/pdfs/Claims_Submission_
[Link]

Medica 180 days from the date of service [Link]

[Link]
Medical Mutual 12 months from the date of service m/tools_and_resources/manua
ls/provider/[Link]

[Link]
Medicare 12 months from the date of service [Link]

[Link]
ssets/pdf/MCP%20Provider%20Docu
Mercy Care
1 year from the date of service ments/Mercy-Care-Advantage-
Advantage MCA-Provider-Manual-January-
[Link]

[Link]
Operating Engineers 1 year from date of service
isite137/eremitimages/137/[Link]

Oxford Health Plans - [Link]

180 days (CT), 180 days (NJ),
Nonparticipating licy/filing_deadlines_for_claims_
120 (NY)
[Link]
Providers
[Link]
Oxford Health Plans - 90 days (CT), 180 days (NJ),
licy/filing_deadlines_for_claims_
Participating Providers 120 (NY)
[Link]
 Insurance Timely Filing Limit Resource

[Link]
Paramount com/documents/provider/advanta
365 days after the date of service
Advantage [Link]

[Link]
Passport content/uploads/2018/08/2018-
180 days from the date of service Passport-Advantage-Provider-
Advantage
Manual_FINAL.pdf

[Link]
Passport Health
180 days from the date of service content/uploads/2017/01/Section15_
Plan Prov_Bill.pdf

Positive [Link]
90 days from the date of service
Healthcare ida/php/for-providers/claims/

[Link]
SelectHealth 12 months from the date of service /selecthealth/providermanual/Pag
es/[Link]

[Link]
Signature
12 months after the date of service m/wp-content/uploads/documents
Advantage /SA_Provider-[Link]

Simply Health - [Link]

Nonparticipating 365 days after the date of service com/docs/FLFL_SMH_ProviderManu
Providers [Link]

[Link]
Simply Health - com/docs/FLFL_SMH_ProviderManu
6 months after the date of service
Participating Providers [Link]

[Link]
Sunshine Health 180 days from the date of service ntent/dam/centene/Sunshine/Advan
tage/PDFs/[Link]

Tricare 12 months from the date of service [Link]

 Insurance Timely Filing Limit Resource

Tricare for Life 1 year from the date of service [Link]

[Link]
Tufts Health Plan 90 days from the day of service ents/providers/provider-
manuals/comm-provider-manual

[Link]
UCare 12 months after the date of service files/bulletin_2018_dec6_nursingh
[Link]

[Link]
Ultimate Health 90 days from the date of service UHP_ProviderManual.pdf
Plans

[Link]
oapplication/plansbenefits/medical/
Unicare 180 days from date of service
notertiary/pw_e244065.pdf?
refer=chpproviderunicare&state=WV

[Link]
United Healthcare 90 days from date of service
allscripts-ebook-december-2015

University of 365 days from date of service, 180

[Link]
days when Medicare is primary
Utah Health providers/pdf/provider_manual.pdf
insurance

[Link]
UPMC Health Plan 90 days from the date of service docs/providers/2017_ProviderManu
al_H.pdf

Vantage Medical [Link]

90 days from the date of service
Group com/Documents/[Link]

[Link]
Wellcare 180 days from the day of service /.../na_care_provider_manual_eng
_03_2017.ashx
 Insurance Timely Filing Limit Resource

[Link]
WABASH Memorial content/uploads/2017/01/Wabash-
15 months from the date of service
Hospital Association Member-Handbook-Medicare-
[Link]

[Link]
Yale University
1 year from the date of service default/files/member_coverage
Health Plan _booklet_june_2017.pdf

DISCLAIMER: This Timely Filing Limit Guide was created on March 5, 2019. This is meant to be
used as a reference. For the actual timely filing limit, you are responsible for contacting the
insurance company to confirm. Etactics is not responsible for any timely filing denials.