INSURANCE TIMELY FILING LIMITS

PPO Insurance Time Limit

Insurance Name Time Limit

AARP 15 months from the date of service
Aetna 120 days from date of service
American Life & Health 1 Year from Date of Service
AMA 2 Years from Date of Service
Anthem Health (Coastwise Claims) 3 Years from Date of Service
Bankers Life 15 months from date of service
Benefit Concepts 12 months from date of service
Blue Cross (PPO) 1 year from date of service
Blue Shield 1 year from date of service
Bridgestone/Firestone 12/31 of the following year of service
Champus 1 year from date of service
Cigna 90 dates from the date of service
Fire Fighters /Local 1014 15 months from the date of service
GHI 1 year from the date of service
Great West/AH&L/ 90 dates from date of service
HealthNet (PPO) 120 dates from date of service
Humana 15 months from the date of service
ILWU 3 years from the date of service
Local 831 Health 1 year from the date of service
Mega Life & Health 15 months from the date of service
Motion Picture Ind. 15 months from the date of service
Mutual of Omaha 1 year from the date of service
Nationwide Health 15 months from the date of service
One Healthplan 15 months from the date of service
Operating Engineers 1 year from date of service
Pacificare (PPO) 90 days from the date of service
Benefit Trust Fund 1 year from date of Medicare EOB
Principal Financial 3 years from the date of service
SMA 1 year from the date of service
So. Ca Drug Benefit 1 year from the date of service
FRA 15 months from the date of service
FMH 6 months from the date of service
Troa/Mediplus 2 years from the date of service

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 INSURANCE TIMELY FILING LIMITS

Insurance Name Time Limit

UFCW 1 year from the date of service
Union Fidelity 1 year from date of service
United Healthcare 90 days from date of service
United Teachers Associates 15 months from date of service
Writers Guild Health 18 months from date of service
Zenith 1 year from the date of service

HMO Insurance Time Limit

Insurance Name Time Limit

Aetna (HMO) 120 days from the date of service
Angeles IPA 90 days from the date of service
ABC IPA 90 days from the date of service
Accountable Health 90 days from the date of service
ADOC IPA 90 days from the date of service
Alliance IPA 1 year from date of service
Alamitos IPA 90 days from date of service
Applecare IPA 90 days from date of service
Asian Community IPA 90 days from date of service (contracted)
180 days for non contracted providers
B/C Medi-Cal 90 days from date of service
B/C HMO 90 days from date of service
Caremore IPA 90 days from date of service
Downey IPA 60 days from date of service
Global IPA 90 days from date of service (Contracted)
1 year if not contracted
HealthNet (HMO) 90 days from date of service
Healthcare Partners 90 days from date of service
Karing Physicians 90 days from date of service
Lakewood IPA 90 days from date of service
Memorial IPA 90 days from date of service
Monarch IPA 90 days from date of service
Northwest OC IPA 90 days from date of service
Omnicare IPA 90 days from date of service

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 INSURANCE TIMELY FILING LIMITS

Insurance Name Time Limit

Pacificare (HMO)
Pacific Heath Care IPA
Pioneer Medical Group
Prospect Medical Group
Regal(contracted)
St. Francis IPA
TALBERT
Torrance IPA
90 days from date of service
90 days from date of service
60 days from date of service
90 days from date of service
90 days from date of service (contracted)
60 days from date of service
90 days from date of service
60 days from date of service

Medicare & Medi-Cal Insurance Time Limit

Insurance Name Time Limit

Medi-Cal 1 year from the date of service
 7-9 month = 75% of allowed amount
 10-12 month = 50% of allowed amount
Medicare 12 months from date of service

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