The Timely Filing Limit is the time duration from service rendered to patients and submitting claims to the insurance companies. For example, if any patient gets services on the 1st of any month then there is a time limit to submit his/her claim to the insurance company for reimbursement. It is 30 days to 1 year and more and depends on insurance companies.
The patient or medical billing agency’s responsibility is to submit his/her claim to insurance within the timely filing limit otherwise claims will be denied due to timely filing exceeded(CO-29).
Timely Filing Limit of Insurance Companies
| Insurance Name | Timely Filing Limit |
|---|---|
| AARP | 15 Months from Date of Service (DOS) |
| ABC IPA | 90 days from the date of service |
| Accountable Health | 90 days from the date of service |
| ADOC IPA | 90 days from DOS |
| Advantage Care | 6 Month |
| Advantage Freedom | 2 Years from DOS |
| Aetna (HMO) | 120 days from the date of service |
| Aetna timely filing | 120 Days from DOS |
| Alliiance IPA | 1 year from DOS |
| AMA | 2 Years from DOS |
| Ameri health ADM Local 360 | 1 Year from DOS |
| American Life and Health | 12 Month |
| American Progressive | 1 Year |
| Amerigroup | 90 Days for Participating Providers/12 Months for Non-par Providers |
| Amerihealth ADM TPA | 1 Year |
| AmeriHealth NJ & DE | 60 Days |
| Angeles IPA | 90 days from the date of service |
| Anthem Health(Coast wise Claims) | 3 Years from DOS |
| Applecare IPA | 90 days from DOS |
| Arbazo | 180 Days |
| Asian Community IPA | 90 days from DOS for contracted and 180 days for non-contracted |
| B/C HMO | 90 days from DOS |
| B/C Medi-cal | 90 days from DOS |
| Bankers Life | 15 Month form DOS |
| BCBS COVERKIDS | 120 Days from DOS |
| BCBS Florida timely filing | 12 Months from DOS |
| BCBS timely filing for Commercial/Federal | 180 Days from Initial Claims or if secondary 60 Days from Primary EOB |
| BeechStreet | 90 Days from DOS |
| Benefit Concepts | 12 Months from DOS |
| Benefit Trust Fund | 1 year from Medicare EOB |
| Blue Advantage HMO | 180 Days from DOS |
| Blue Cross PPO | 1 Year from DOS |
| Blue Essential | 180 Days from DOS |
| Blue Premier | 180 Days from DOS |
| Blue shield High Mark | 60 Days from DOS |
| Blue Shield timely filing | 1 Year from DOS |
| Bridgestone/Firestone | 12/31 of the following year of the service |
| Caremore IPA | 90 days from DOS |
| Champus | 1 Year from DOS |
| Cigna Health Springs (Medicare Plans) | 120 Days |
| Cigna timely filing limit | 90 Days for Participating Providers/180 Days for Non-par Providers |
| Citrus | 1 Year from DOS |
| Coventry | 180 Days from DOS |
| Downey IPA | 60 Days from DOS |
| Evercare | 60 Days from DOS |
| Fire Fighter/Local 1014 | 15 Months from DOS |
| First Health | 3 Months from DOS |
| FMH | 6 Months from DOS |
| FRA | 15 Months from DOS |
| GHI- Group health Ins | 1 Year from DOS |
| Global IPA | 90 days from DOS for contracted and 1 Year for non-contracted |
| Great West (AH&L) | 90 Days from DOS |
| Healthcare Partners | 90 Days from DOS |
| Healthcare Partners | 90 days from DOS |
| Healthnet HMO | 90 Days from DOS |
| Healthnet PPO | 120 Days from DOS |
| Horizon NJ Plus | 365 Days from DOS |
| Humana | 180 Days for Physicians or 90 Days for facilities or ancillary providers |
| Humana | 27 Months from DOS |
| ILWU | 3 Years from DOS |
| Karing Physicians | 90 days from DOS |
| Keystone Health Plan East | 60 Days from DOS |
| Lakewood IPA | 90 days from DOS |
| Local 831 Health | 1 year from DOS |
| Magna Care | 6 Months from DOS |
| Marilyn Electro IND. Benefit Fund | 1 Year from DOS |
| Medicaid | 90 Days from DOS |
| Medicare Timely filing limit | 1Y or 365 Days from DOS |
| Mega Life and Health | 15 Months from DOS |
| Memoria IPA | 90 days from DOS |
| Memorial IPA | 90 Days from DOS |
| Monarch IPA | 90 Days from DOS |
| Motion Picture Ind | 15 Months from DOS |
| Mutual of Omaha | 1 year from DOS |
| NASI | 2 Years from DOS |
| Nationwide Health | 15 Months from DOS |
| Northwest OC IPA | 90 days from DOS |
| Omnicare IPA | 90 Days from DOS |
| One Healthplan | 15 Months from DOS |
| Operating Engineers | 1 Year from DOS |
| Pacificare PPO | 90 Days from DOS |
| Pioneer Medical Group | 60 Days from DOS |
| Polk Community Health Care | 180 Days from DOS |
| Principle Financial | 3 Years from DOS |
| Prospect Medical Group | 90 Days from DOS |
| PUP | 180 Days from DOS |
| Quality Health Plan | 1 Year from DOS |
| Secure Horizons | 90 Days from DOS |
| SMA | 1 year from DOS |
| So. Ca Drug Benefit | 1 year from DOS |
| Sun | 180 Days from DOS |
| Tricare | 12 Months from DOS |
| Troa/mediplus | 2 years from DOS |
| UFCW | 1 year from DOS |
| UHC Community | 120 Days from DOS |
| Unicare | 24 Months from DOS |
| Union Fidelity | 1 Year from DOS |
| United Health Care timely filing limit – UHC COMMERCIAL | 90 Days from DOS |
| United Teacher Associates | 15 Months from DOS |
| Veterans Admin | 90 Days from DOS |
| Vista | 120 Days from DOS |
| Wellcare | 180 Days from DOS |
| Writers Guild Health | 18 Months from DOS |
| Zenith | 1 Year from DOS |
*DOS- Date of Service
| Allied Benefit Systems Appeal Limit | An appeal must be submitted to the Plan Administrator within 180 days from the date of denial. Contact # 1-866-444-EBSA (3272). |
| Mail Handlers Benefit Plan Timely Filing Limit | The claim must submit by December 31 of the year after the year patient received the service unless timely filing was prevented by administrative operations of the Government or legal incapacity. Once we pay benefits, there is a three-year limitation on the re-issuance of uncashed checks. Claim Address- MHBP Medical Claims PO Box 8402 London, KY 40742 |
The timely filing limit of all the above insurance companies is updated from reliable resources of information. Try to keep all information in the latest update and will update as per receive any new information. If there is any discrepancy please let us know through the contact form.
AmeriHealth Caritas New Hampshire Claim Filing Guidlines
AmeriHealth Caritas New Hampshire, referred to as the Plan when applicable, is obligated under its contract and in compliance with both New Hampshire and federal regulations to collect specific data related to the services provided to its members. Providers must strictly adhere to all billing requirements to promptly process claims.
Under 42 C.F.R. §438.602(b), healthcare providers seeking to join the AmeriHealth Caritas New Hampshire network must undergo screening and enrollment as Medicaid providers through the relevant New Hampshire agency. They are also required to undergo periodic re-enrollment. This requirement applies to providers within and outside the state who do not participate in the network.
Furthermore, it’s essential to note that claims for all services rendered to Plan members must be submitted by the provider who performed the services.
For Paper Claims
AmeriHealth Caritas New Hampshire
Attn: Claims Processing Department, P.O. Box 7387 London, KY 40742-7387
For EDI/Electronic Claims
Use Payer ID for AmeriHealth Caritas New Hampshire: 87716.
Claim Timely Filing
Original claims submitted to the Plan within 120 calendar days from the date of services (DOS) were
rendered or the date of discharge for inpatient hospital admissions.
- Claims with Explanation of Benefits (EOB) from primary insurance must be submitted within 60 days of the date of the primary insurance EOB.
Corrected Claim Instructions
Re-submission of previous denied claim with corrections and requests for adjustment must be
submitted within 365 calendar days from the date of services (DOS) were rendered or compensable item swere provided.
What is the Timely Filing Limit (TFL) in Medical Billing?
The Timely Filing Limit in medical billing refers to the timeframe healthcare providers must submit claims to insurance companies for reimbursement. It represents the maximum period allowed for the submission of claims from the date of service (DOS) or the date of discharge (DOD).
Insurance companies set timely filing limits to ensure that claims are submitted on time and to maintain efficient processing of healthcare claims. Please submit claims within the specified time frame to avoid claim denials, and the provider is responsible for the cost of the services rendered.
The specific timely filing limit can vary depending on the insurance company, type of insurance plan, and state regulations. Generally, timely filing limits range from 90 days to one year from the date of service. However, it’s essential to note that different insurance companies and plans may have specific TFL , so healthcare providers must review the guidelines each payer provides.
How to Handle Timely Filing Denial Claims?
When receiving timely filing denials in that case we have to first review the claim and patient account to check when we billed the claim that it was billed within time or after timely filing. In some case, claim was billed within time but stuck in our system or rejected by the system.
In the second scenario, claim was billed after timely filing and in 3rd scenario, the claim was billed on time but wrongly denied so we discuss all the possible ways to handle timely filing denial.
1st and 2nd Condition- If the claim was not received by the insurance company within the time we have to call insurance and ask the appeal limit of the insurance company and the correct address to resubmit the claim with an appeal if they need some medical documents we can send that with appeal also. We also have to ask the claim received date for confirmation as well.
3rd Condition- If a claim is denied by the insurance company wrongly in that case we have to call to insurance and request for reprocessing the claim because the claim was sent on time.
In the USA there are a lot of insurance companies and their timely filing limit is different as per their profile. Updated a list of timely filing limits of different insurance companies below
Healthcare providers should familiarize themselves with each insurance company’s specific filing limits to ensure claims are submitted within the designated time frame.
Insurance Timely Filing PDFs
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