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

https://www.absolutetotalcare
.com/content/dam/centene/a
Absolute Total Care 1 year from date of service bsolute-total-care/pdfs/
Allwell%20Provider%20Manual
%202018%20SC.pdf
http://www.ahcipa.com/index_h
Accountable
90 days from date of service tm_files/Claims%20Submission%
Healthcare IPA 20Instructions.pdf

https://www.adoc.us/provider-
ADOC Medical Group 180 days from the date of service
resources/claims-information/

https://www.aetna.com/health-
Aetna 120 days from date of service care-professionals/disputes-
appeals/provider-appeals.html

https://www.aetnabetterhealth.c
om/pennsylvania/assets/pdf/pro
Aetna Better Health 180 days from date of service
vider/notices/provider-timely-
submission-guide-16-03-21.pdf
https://www.aetnabetterhealth.co
Aetna Better m/pennsylvania/assets/pdf/provi
180 days from date of service
Health Kids der/notices/provider-timely-
submission-guide-16-03-21.pdf

https://provider.amainsure.com
AMA 2 years from date of service
/faq

http://providerresourcecenter.unive
American Progressive 1 year from date of service rsalamerican.com/sharedpdfs/pro
vider/TO_PFFS_TermsConditions.pdf
 Insurance Timely Filing Limit Resource

90 Days for Participating https://providers.amerigroup.com/R

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

https://argusdental.com/wp-
Argus Dental 90 days after the date of service content/uploads/2017/09/Dental-
Provider-Manual-2017.pdf

Arizona Health Care https://www.azahcccs.gov/Plans

Providers/Downloads/IHS-
Cost Containment 12 months from the date of service
TribalManual/IHS-Chap19
System Grievances.pdf

https://baptisthealthplan.com/pdf/
Baptist Health Plan 180 days from the date of service
Timely%20Filing%20of%20Claims.pdf

https://www.floridablue.com/site
s/floridablue.com/files/docs/Pro
BCBS Florida 180 days from the day of service
vider%20Manual%20MASTER%2001
%2002%202019.pdf
https://www.bluecrossnc.com/sites
/default/files/document/attachme
BCBS North Carolina 1 year from the day of service
nt/providers/public/pdfs/BlueBook
_July2016.pdf

https://www2.bcbsri.com/sites/
BCBS Rhode Island 180 days from the day of service default/files/polices/TimelyFiling
Limit.pdf

https://www.beaconhealthoptions
.com/wp-content/uploads/2016
Beacon Health 90 days from the date of service
/11/Beacon-Health-Options-
Provider-Handbook-.pdf
https://www.beechstreet.com/
Beechstreet/ContentReader?
BeechStreet 90 days from the day of service
docName=BEECH_DOC_PRV_
MANUAL

http://www.ccpoabtf.org/Pro
Benefit Trust Fund 1 year from date of Medicare EOB grams/piggyback/piggyback
_claim.html
 Insurance Timely Filing Limit Resource

Blue Advantage https://www.bcbstx.com/provider/

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

https://mediproviders.anthem.
Blue Cross of
12 months from the date of service com/Documents/CACA_MMP_
California RP_ClaimsTimelyFiling.pdf

https://www.bcbstx.com/provider/
Blue Cross PPO 1 year from the date of service
pdf/ppo_secf.pdf

https://www.bcbstx.com/provider/
Blue Essential 180 days from the date of service
pdf/secf_filing_claims.pdf

https://www.va.gov/COMMUNITY
Champus 1 year from the day of service CARE/docs/pubfiles/brochures/
HowToFileACHAMPVAClaim.pdf

https://www.chipa.com/wp-
content/uploads/sites/4/2016/08
CHIPA (Aetna/MHN) 1 year from the day of service
/CHIPA_Provider_Manual_March
2017.pdf
https://www.chipa.com/wp-
content/uploads/sites/4/2016/08
CHIPA (PBH/CHIPA) 90 days from the date of service
/CHIPA_Provider_Manual_March
2017.pdf
https://www.cigna.com/health-
Cigna (out-of-network care-providers/coverage-and-
180 days from the day of service
provider) claims/submit-claims/when-to-
file-claims

https://www.cigna.com/iwov-
Cigna HealthSprings
120 days from the day of service resources/medicare-
(Medicare Plans) 2015/docs/timely-filing-limits.pdf

90 Days for Participating https://www.cigna.com/health-care-

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 https://bit.ly/2UhJEUG

http://3b0c642hkugknal3z1xrpau1-
wpengine.netdna-ssl.com/wp-
Colorado Access 120 days from the date of service
content/uploads/2019/01/Provider-
Manual-Section-6.pdf
http://chcgeorgia.coventryhealth
Coventry Healthcare care.com/web/groups/public/@c
90 days from the date of service
of Georgia vty_regional_chcga/documents/
document/c157683.pdf
https://www.eocco.com/eocco/-/m
Eastern Oregon CCO edia/eocco/pdfs/provider_manual.
120 days from the date of service
(MODA/ODS) pdf?la=en&hash=0384DCFD51350FA
37C6BE112DA85F43D

http://www.elderwoodhealthplan.
Elderwood Health 120 days from the date of service
com/for-providers/

https://www.emblemhealth.com/pro
365 days (in-network),
Emblem Health viders/provider-manual/claims/
18 months (out-of-network)
timely-submission
https://www.evergreenmd.org/m
Evergreen Health aryland-health-insurance-
180 days from the date of service provider-resources/claims-and-
Cooperative
payment-options/

https://www.fideliscare.org/Portals/
0/Providers/ProviderManuals/2018-
Fidelis Care New York 90 days from the date of service 0817-FidelisCare-ProviderManual-
English.pdf

First Health https://hf.org/health_plans/pr

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

https://hf.org/health_plans/pr
First Health (Medicare
1 year from date of Medicare EOB oviders/forms/provider_timely
Advantage) _filing_guidelines_hfhp.pdf
 Insurance Timely Filing Limit Resource

https://www.cenpatico.com/conte
Florida Cenpatico
180 days from the date of service nt/dam/centene/cenpatico/pdfs/F
Behavioral Health LFL_ALL_FAQ_122613_ENG.pdf

https://www.myfhca.com/fhca/pro
Florida Hospital
1 year from the date of service viders/forms/provider_timely_filing
Care Advantage _guidelines_fhca.pdf

https://www.parkviewmc.com/app/
Great-West
180 days from the date of service files/public/2377/PHC-Cigna-
Healthcare Great-West-2017.pdf

Group Health https://ghcscw.com/SiteCollection

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 https://www.harmonyhpi.com/WCA

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

https://www.harvardpilgrim.org/pls/
Harvard Pilgrim
90 days from the date of service portal/url/item/8662B3FFC98D495C
Health Care 85BE7CA04E809A68

https://www.healthpartnersplans.co
Healthcare Partners 180 days from the date of service m/media/100260464/hpp-provider-
manual-2018.pdf

https://www.healthnet.com/provco
Health Net 180 days from the date of service
m/pdf/40171.pdf

https://www.healthnet.com/portal/pr
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

https://www.healthplex.com/doc/fn/
HealthPlex Inc 365 days from the date of service
transparency_in_coverage
 Insurance Timely Filing Limit Resource

https://healthteamadvantage.com/
Health Team
180 days after the date of service wp-content/uploads/HTA-PROVIDER-
Advantage MANUAL-070118.pdf

365 days from date of service
Highmark
(PA and WV), 120 days (DE)
https://content.highmarkprc.com/Fil
es/EducationManuals/HFM/hfm-
chapter9-1.pdf

https://www.horizonnjhealth.com/sec
Horizon Healthcare
180 days from the date of service urecms-documents/459/Billing%20
Dental Services NJ Guide%20August%202017.pdf

https://www.horizonnjhealth.com/
Horizon NJ Plus 180 days from the date of service for-providers/resources/claims-
information

https://www.choicemg.com/wp-
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)
01.01.2018-for-website.pdf

https://www.cgsmedicare.com/hhh
Household Merch Nni 12 months from the date of service /education/materials/timely_claim
_filing_req.html

https://www.hsahealthplan.com/wp-
HSA Health Plan 12 months from the date of service content/uploads/2017/12/MasterPolic
ySmall-9-7-15.pdf

180 Days for Physicians or 90 Days
Humana
for facilities or ancillary providers
https://www.humana.com/provider/
support/claims/electronic-
submission

https://www.illinicare.com/newsroo
IlliniCare Health 180 days from the date of service
m/timely-filing-policy-update.html

http://www.imcare.org/DocumentC
IMCare 90 days from the date of service enter/View/4295/2019-Member-
Handbook-PDF
 Insurance Timely Filing Limit Resource

http://imperialhealthholdings.com/
Imperial Health wp-content/uploads/2012/07/IHP-
90 days from the date of service Provider-Manual_2017-update-
Holdings
121817.pdf
https://www.hopkinsmedicine.org/joh
John Hopkins ns_hopkins_healthcare/downloads/r
180 days after the date of service
Healthcare esources_guidelines/amd_provider_
manual.pdf

https://wa-provider.kaiserpermanen
Kaiser Permanente 12 months after the date of service te.org/provider-manual/billing-
claims/claims/claims-timely

https://www.kaloshealth.org/wp-
Kalos Health 90 days after the date of service content/uploads/2018/10/KHGP_
provider-manual_final-1.pdf

https://www.lacare.org/providers/
L.A. Care 180 days from the date of service
claims-edi/submitting-claim

LaSalle IPA http://www.nmm.cc/nmm/en/LSMA

90 days from the date of service
(contracted) %20AB1455%20Sample.pdf

LaSalle IPA (non- http://www.nmm.cc/nmm/en/LSMA%

180 days from the date of service
contracted) 20AB1455%20Sample.pdf

https://libertyadvantageplan.com/w
Liberty
12 months from the date of service p-content/uploads/documents/
Advantage LLC. LIBERTY_Provider-Manual.pdf

Louisiana Health
180 days from the date of service https://bit.ly/2SHi3dJ
Connections

https://www.magellancompletecare
Magellan
365 days from the date of service offl.com/media/1464/c-h1015rev5-
Complete Care mcc-fl-provider-handbook-2018.pdf
 Insurance Timely Filing Limit Resource

Magnolia Health
90 days from the date of service https://bit.ly/2Hcg2Ed
Plan

https://www.marchvisioncare.com
MARCH Vision 180 days from the date of service /docs/ks_providerreferenceguide.
pdf

https://www.marylandphysiciansc
Maryland are.com/content/dam/centene/m
180 days from the date of service
Physicians Care aryland/pdfs/Claims_Submission_
Guide.pdf

Medica 180 days from the date of service https://bit.ly/2IPPLhu

https://provider.medmutual.co
Medical Mutual 12 months from the date of service m/tools_and_resources/manua
ls/provider/providermanual.pdf

https://cgsmedicare.com/articles/
Medicare 12 months from the date of service cope18411.html

https://www.mercycareplan.com/a
ssets/pdf/MCP%20Provider%20Docu
Mercy Care
1 year from the date of service ments/Mercy-Care-Advantage-
Advantage MCA-Provider-Manual-January-
2018-FinalUA.pdf

https://ecommerce.issisystems.com/
Operating Engineers 1 year from date of service
isite137/eremitimages/137/spd1109.pdf

Oxford Health Plans - https://www.oxhp.com/secure/po

180 days (CT), 180 days (NJ),
Nonparticipating licy/filing_deadlines_for_claims_
120 (NY)
submissions.pdf
Providers
https://www.oxhp.com/secure/po
Oxford Health Plans - 90 days (CT), 180 days (NJ),
licy/filing_deadlines_for_claims_
Participating Providers 120 (NY)
submissions.pdf
 Insurance Timely Filing Limit Resource

https://www.paramounthealthcare.
Paramount com/documents/provider/advanta
365 days after the date of service
Advantage ge-provider-manual.pdf

http://passportadvantage.com/wp-
Passport content/uploads/2018/08/2018-
180 days from the date of service Passport-Advantage-Provider-
Advantage
Manual_FINAL.pdf

http://passporthealthplan.com/wp-
Passport Health
180 days from the date of service content/uploads/2017/01/Section15_
Plan Prov_Bill.pdf

Positive https://positivehealthcare.net/flor
90 days from the date of service
Healthcare ida/php/for-providers/claims/

https://intermountainphysician.org
SelectHealth 12 months from the date of service /selecthealth/providermanual/Pag
es/Claims-Filing-Deadlines.aspx

https://signatureadvantageplan.co
Signature
12 months after the date of service m/wp-content/uploads/documents
Advantage /SA_Provider-Manual.pdf

Simply Health - https://www.simplyhealthcareplans.

Nonparticipating 365 days after the date of service com/docs/FLFL_SMH_ProviderManu
Providers al.pdf

https://www.simplyhealthcareplans.
Simply Health - com/docs/FLFL_SMH_ProviderManu
6 months after the date of service
Participating Providers al.pdf

https://www.sunshinehealth.com/co
Sunshine Health 180 days from the date of service ntent/dam/centene/Sunshine/Advan
tage/PDFs/PRO-MCR-FL-Manual.pdf

Tricare 12 months from the date of service https://bit.ly/2VuaE34

 Insurance Timely Filing Limit Resource

Tricare for Life 1 year from the date of service https://bit.ly/2VuaE34

https://tuftshealthplan.com/docum
Tufts Health Plan 90 days from the day of service ents/providers/provider-
manuals/comm-provider-manual

https://docs.ucare.org/filer_public/
UCare 12 months after the date of service files/bulletin_2018_dec6_nursingh
omeliability.pdf

https://chooseultimate.com/Library/
Ultimate Health 90 days from the date of service UHP_ProviderManual.pdf
Plans

https://www.unicare.com/provider/n
oapplication/plansbenefits/medical/
Unicare 180 days from date of service
notertiary/pw_e244065.pdf?
refer=chpproviderunicare&state=WV

http://dc.cn.ubm-us.com/i/629493-
United Healthcare 90 days from date of service
allscripts-ebook-december-2015

University of 365 days from date of service, 180

https://uhealthplan.utah.edu/for-
days when Medicare is primary
Utah Health providers/pdf/provider_manual.pdf
insurance

https://www.upmchealthplan.com/
UPMC Health Plan 90 days from the date of service docs/providers/2017_ProviderManu
al_H.pdf

Vantage Medical https://www.vantagemedicalgroup.

90 days from the date of service
Group com/Documents/VMGAB1455.pdf

https://www.wellcare.com/~/media
Wellcare 180 days from the day of service /.../na_care_provider_manual_eng
_03_2017.ashx
 Insurance Timely Filing Limit Resource

http://wabashcannonball.org/wp-
WABASH Memorial content/uploads/2017/01/Wabash-
15 months from the date of service
Hospital Association Member-Handbook-Medicare-
2017.pdf

https://yalehealth.yale.edu/sites/
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.