The Timely Filing Limit Guide - Part 2

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.advanticabenefits.c
Advantica Benefits 90 days from the date of service om/Pdfs/AdvanticaBenefits/ADV
_Vision_Provider_Manual.pdf

http://www.affinityplan.org/upload
edFiles/Affinityv3/Providers/Publica
Affinity Health Plan 90 days from date of service
tions_and_Training/Files/Provider_
Manual.pdf

https://www.affinitymd.com/pro
Affinity Medical Group 90 days from the date of service
viders/submitting-a-claim/

AgeRight
12 months from the date of service https://bit.ly/2Wo9new
Advantage

AgeWell New York 180 days from date of service https://bit.ly/2WqkkfG

Alaska Electrical https://www.aetf.com/documents

1 year from the date of service
Health Welfare Fund /Retiree%20HW%20SPD%2001.17.pdf

https://www.allcarehealth.com/
AllCare PEBB 12 months from the date of service media/1414/2017pebb-member-
handbook.pdf

https://myeeportal.com/conifer/all
Allegian Choice 1 year from the date of service egian/SiteAssets/Allegian/Allegian
_Provider%20Manual_Claims.pdf
 Insurance Timely Filing Limit Resource

https://www.alliantplans.com/
Alliant Health
180 days from the date of service wp-content/uploads/AHP-
Plans of Georgia Provider-Manual.pdf

December 31 of the year after

Altius https://bit.ly/2Ylfbax
the year of the service

https://ambetter.buckeyehealth
Ambetter (All 180 days for participants, 90 plan.com/content/dam/centene
States/Plans) days for non-participants /Buckeye/Ambetter/PDFs/OH-
2019-ProviderManual.pdf

https://www.apwuhp.com/resour
American Postal 1 year from the date the
ces/cptdownload/1115/Conversion
Workers Union expense was incurred
_Plan_Brochure_2014.pdf

https://providers.amerigroup.com/
Amerigroup -
180 days from the date of service Public%20Documents/ClaimsTimely
Washington Filing_Reimbursement_ExhibitA.pdf

Atrio Health Plans 90 days from the date of service https://bit.ly/2UZBxw4

December 31 of the year after the
AultCare
year of the service
https://www.opm.gov/healthcare-
insurance/healthcare/plan-
information/plan-
codes/2016/brochures/73-699i.pdf

https://www.averahealthplans.com
Avera Health Plans 1 year from the date of service /app/files/public/57545/Provider-
Manual.pdf

https://www.avmed.org/docume
nts/23406/48532/PhysicianRefere
AvMed 180 days from the date of service
nceGuide.pdf/69447395-a52d-
460f-a96f-0886dcad41aa

Bluechoice Health
365 days from the date of service https://bit.ly/2uyGSPb
Plan of SC Medicaid
 Insurance Timely Filing Limit
Boston Medical Center
150 days from the date of service
Health Plan Inc
Brown and Toland
6 months from the date of service
Medical Group
365 days from the date of
Buckeye/Centene
service or hospital discharge
California Health 6 months following the
and Wellness month of service
Capital BlueCross 180 days from the date of service
365 days from the date of
Caresource
service or discharge
Cenpatico 90 days from the date of service
Central States Joint
1 year after the charges have
Board Health and
been incurred
Welfare Fund
120 days from the date of
Centurion service (contracted) or 365
days (non-contracted)
90 days from the date of
Choice Medical Group service (contracted) or 180
days (non-contracted)
Resource
https://www.bmchp.org/~/media/
823768f88a1645c68910fc106d25e
656.pdf
https://www.brownandtoland.com/
sites/default/files/BTMG_PDRMecha
nism_Commercial_08282018_0.pdf
https://www.buckeyehealthplan.
com/content/dam/centene/Buc
keye/medicaid/pdfs/Provider%2
0Manual-Medicaid.pdf
https://www.cahealthwellness.com
/content/dam/centene/cahealthw
ellness/pdfs/CHW_2016_Provider_
Manual_09-16-2016.pdf
https://bit.ly/2JFJk12
https://www.caresource.com/doc
uments/ohioprovidermanual/
https://www.cenpatico.com/provid
ers/ma/provider-tools/faqs.html
http://csjbunion.org/Portals/2/Cent
ral%20States%20HW%20SPD%20%20
2015%201-1-16.pdf
https://www.centurionmanagedcar
e.com/content/dam/centene/cent
urionmanagedcare/pdfs/Centurion
-of-FL-Provider-Manual-062817.pdf
https://www.choicemg.com/wp-
content/uploads/2018/08/APC-
AB1455-CPNCMG-Notification.pdf
 Insurance Timely Filing Limit Resource

CHRISTUS Health
120 days from the date of service https://bit.ly/2U4netW
New Mexico HIX

CHRISTUS Health Plan

95 days from the date of service https://bit.ly/2FC1WuJ
TX HIX

http://www.ccsi.care/wp-
Coastal Care
6 months from the date of service content/uploads/2018/03/WELLCAR
Services Inc E-PROVIDER-TRAINING-TOOL.pdf

90 days from the date of

Commonwealth
service (contracted) or 12 https://bit.ly/2HFCuqj
Care Alliance months (non-contracted)

https://www.cfhp.com/images/uplo
Community First
95 days from the date of service ads/STAR_Provider_Manual_rev_08
Health Plan 15_NRL1.pdf

https://www.chpw.org/resources/Pr
Community
365 days from the date of service oviders/programs_guidelines/Provi
HealthPlan of WA der_Manual_2018_update_june.pdf

https://www.connecticare.com/pro
ConnectiCare 180 days from the date of service vider/commercial/providermanual
/Admin/Filing.aspx

Coordinated Care
180 days from the date of service https://bit.ly/2HZb6mm
Washington

http://www.countycare.com/
CountyCare 180 days from the date of service
providers/reference

Dell Children's
95 days from the date of service https://bit.ly/2FCK5nw
Health Plan
 Insurance Timely Filing Limit Resource

http://driscollhealthplan.com/wp/w
p-content/uploads/2018/08/DHP-
Driscoll Health Plan 95 days from the date of service
Provider-Manual-Revised-12-
2017.pdf?ts=1537920000110

Gates Corp Dba Gates

12 months from the date of service https://bit.ly/2Ueiq4c
Rubber Co

Gateway Health
https://www.gatewayhealthplan.co
Plan Medicare 180 days from the date of service
m/Portals/0/MedicareManual.pdf
Assured
https://www.myoptumhealthphysi
calhealth.com/documents/plansu
GEHA 90 days from the date of service
mmaries/UHC%20GEHA%20FAQ-
DCLACPTOTSLP_FAQ2017.pdf
https://www.geisinger.org/-/media/
Geisinger OneGeisinger/Files/PDFs/GHP-
180 days from the date of service
Health Plan Family/For-Providers/GHP-Family-
Provider-Manual.pdf?la=en

https://www.goldcoasthealthplan.
Gold Coast 6 months from the date of service org/media/30389/gchp-
providermanual_dec15-v7.pdf

Great Plains
Medicare Advantage 12 months from the date of service https://bit.ly/2TBj07M
Nebraska

GuildNet 120 days from the date of service https://bit.ly/2HScTKc

https://www.midwesthealthplan.
30 days from the date of service
HAP Midwest com/Docs/Providers/Midwest%2
for capitated services, 180 days
Health Plan 0Provider%20Manual%20January
for non-capitated
%202019.pdf

Healthfirst of
180 days from the date of service https://bit.ly/2I4JcWs
New York
 Insurance Timely Filing Limit Resource

https://www.opm.gov/healthcare-
Healthplus of December 31 of the year after the insurance/healthcare/plan-
Michigan year of the service information/plan-
codes/2015/brochures/73-648.pdf

HealthShare CCO 120 days from the date of service https://bit.ly/2FPeCyr

Hennepin Health 180 days from the date of service https://bit.ly/2HX9mez

HMC HealthWorks https://www.hmchealthworks.com/

aka Health 365 days from the date of service wp-content/uploads/2017/08/HMC-
Management Co HealthWorks-Provider-Manual.pdf

15 months from the date of service

HMO Louisiana Inc https://bit.ly/2Un88Pb
or 12 months for OGB members

https://www.homestatehealth.com/
Home State Health content/dam/centene/home-state-
180 days from the date of service
Plan Missouri health/pdfs/MO-
AllwellPrvderManual2018.pdf

https://www.cenpatico.com/cont
Illinois Cenpatico
180 days from the date of service ent/dam/centene/cenpatico/pdfs
Behavioral Health /IL-Provider-Manual-5.31.16.pdf

Independent Care https://www.icarehealthplan.org/

120 days from the date of service
Health Plan Download.aspx?ResourceId=296

Independent http://hccil.org/acrobatfiles/tw/
180 days from the date of service
Living Systems tw1672humanails.pdf

http://www.novitas-
solutions.com/cs/idcplg?
Indian Health
1 year from the date of service IdcService=GET_FILE&RevisionSelec
Services tionMethod=LatestReleased&dDoc
Name=00005806&allowInterrupt=1
 Insurance Timely Filing Limit Resource

https://www.ecommunity.com/sites/
Indiana ProHealth
365 days from the date of service default/files/uploads/2016-
Network 09/ProHealth-Provider-Manual.pdf

https://s3.amazonaws.com/iuhealth
Indiana University 365 days from the date of service plans/page-content/2018-Provider-
Health Plan for out-of-network providers Manual-3.4.2018.pdf?
mtime=20180304172808

Ingham Health http://www.ihpmi.org/ihp_claim

365 days from the date of service
Plan Corp SubGuidelines

https://www.imglobal.com/docs/
International
90 days from the date of service library/forms-library/claims-
Medical Group procedure-overview.pdf

Kaiser Foundation
by December 31 of the year after
Health Plan Inc. - the year of the date of service
https://bit.ly/2TPZZPj
Hawaii Region

Kaiser Foundation
by December 31 of the year after
Health Plan of the year of the date of service
https://bit.ly/2uGi6N6
Northern CA Region

Kaiser Foundation by December 31 of the year after

https://bit.ly/2JZaYWO
Health Plan of the Mid- the year of the date of service
Atlantic States Inc.
https://providers.kaiserpermanente
Kaiser Foundation
.org/info_assets/cpp_knw/Section_
Health Plan of the 365 days from the date of service
5_Billing_and_Payment_FINAL_2018
Northwest 0308.pdf

http://www.kernlegacyhp.com/
Kern Legacy
180 days from the date of service Documents/summary_plan_de
Health Plan scription_2016.pdf

https://www.keystonefirstpa.com/
Keystone First 180 days from the date of service pdf/provider/claims-
billing/claims-filing.pdf
 Insurance Timely Filing Limit Resource

Keystone First http://www.keystonefirstchc.com/p

Community 180 days from the date of service df/providers/training/provider-
HealthChoices training-for-medical-providers.pdf

https://www.keystonefirstvipchoice.
Keystone First VIP
365 days from the date of service com/assets/pdf/provider/training/
Choice claims.pdf

Lancaster General
Health Group - 365 days from the date of service https://bit.ly/2I5nZvw
Preferred Health Care

https://www.libertydentalplan.co
Liberty Dental Plan 180 days from the date of service m/Resources/Documents/ma_Pro
vider_Reference_Guide_WNY.pdf

https://www.lhany.com/sites/d
Liberty Health
180 days from the date of service efault/files/pdf/ProviderManual
Advantage 2015.pdf

LifeWise Health
12 months from the date of service https://www.lifewiseor.com/
Plan of Oregon provider/market-exit/

LifeWorks Advantage 12 months from the date of service https://bit.ly/2JVOs11

http://www.londonhealthusa.com/
London Health
90 days from the date of service documents/FSA/HRA_FSA_Claim_
Administrators Reimbursement_Form.pdf

Longevity Health
12 months from the date of service https://bit.ly/2HRw2N2
Plan of Illinois

http://www.aipinternational.com/
Loomis 12 months from the date of service
pdfs/ICSClaimInstructions.pdf
 Insurance Timely Filing Limit Resource

https://www.mhsindiana.com/cont
90 days from the date of
Managed Health ent/dam/centene/mhsindiana/me
service for contracted, 365 for
Services Indiana dicaid/pdfs/Provider_Manual_2017_
non-contracted
PROOF5.pdf
https://www.mhswi.com/content/d
90 days from the date of
Managed Health am/centene/MHSWI/Providers/PDFs
service for in-Plan providers,
Services Wisconsin /MHS-Health-WI-Provider-Manual-
365 days for out-of-Plan
Final-4.9.16.pdf

McLaren Health Plan 1 year from the date of service https://bit.ly/2uG0kK0

MDWise 90 days from the date of service https://bit.ly/2FRFWMl

Medicare https://medicaid.mmis.arkansas.gov
12 months from the date of service
Arkansas /Provider/Faq/Faq.aspx#timely-filing

https://www.colorado.gov/pacific/
Medicare
365 days from the date of service sites/default/files/General_Provid
Colorado er_Information%20v2_2.pdf

Medicare District of
365 days from the date of service https://bit.ly/2UdyHqU
Columbia

https://www.wellcare.com/~/media
/PDFs/Florida/Provider/Medicaid/20
Medicare Florida 6 months from the date of service
17/fl_caid_provider_manual_eng_
06_2017.ashx

Medicare Hawaii 12 months from the date of service https://bit.ly/2YIvKxi

https://www.idmedicaid.com/Ge
Medicare Idaho 12 months from the date of service neral%20Information/General%20
Billing%20Instructions.pdf
 Insurance Timely Filing Limit Resource

https://www.lamedicaid.com/
provweb1/billing_information
Medicare Louisiana 12 months from the date of service
/timely_filing.htm

MediGold 365 days from the date of service https://bit.ly/2COFBbi

MedPoint
1 year from the date of service https://bit.ly/2UpyCQ5
Management

https://www.medstarprovidernet
MedStar 180 days from the date of service work.org/sites/default/files/attach
ments/Manual_Claims_Select.pdf

http://healthplan.memorialherma
Memorial
nn.org/uploadedFiles/_Library_File
Hermann Health 365 days from the date of service
s/Health_Plan/Providers/QRG_PPO
Network (MHHN) _2017.pdf

Mercy Care Plan 60 days from date of recoupment,

https://bit.ly/2VewQOX
(AHCCCS) 12 months from date of service

https://www.mercymaricopa.org/
Mercy Maricopa assets/pdf/providers/manuals/M
180 days from the date of service
Integrated Care MIC-Provider-Manual-
%20January-2018-FinalUA.pdf

MetroPlus 90 days from the date of service

https://bit.ly/2uFpQPs
Health Plan or discharge

Missouri
12 months from the date of service https://bit.ly/2uFuddk
Medicare Select

https://www.molinahealthcare.com
1 year from date of service
Molina - Ohio /providers/common/medicare/PDF
or discharge
/provider-manual-oh.pdf
 Insurance Timely Filing Limit Resource

180 days from the date of
Molina - Washington
service or discharge
https://www.molinahealthcare.com
/providers/common/medicare/PDF
/provider-manual-wa.pdf

https://medicaid.ohio.gov/Portals/0
365 days from the date of
Ohio Medicaid service or discharge
/Providers/Enrollment%20and%20Su
pport/Provider-Assistance-FAQ.pdf

DISCLAIMER: This Timely Filing Limit Guide was created on April 2, 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.