Timely Filing Limit of Insurance Companies in Medical Billing (2021)

What is timely filing limit in medical billing?

Timely filing limit is the time duration from service rendered to patients and submitting claims to the insurance companies. For example, if any patient getting 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 to submit his/her claim to insurance within the timely filing limit otherwise claims will be denied due to timely filing exceeded(CO-29).

How to handle timely filing denial claims?

When received 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 second scenario claim was billed after timely filing and in 3rd scenario 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 claim denied by insurance company wrongly in that case we have to call to insurance and request for reprocessing the claim because claim sent on time.

In USA there are a lots of insurance companies and there timely filing limit is different as per their profile. Updated a list of timely filing limit of different insurance companies below

Timely Filing Limits of Insurance Companies

List is in alphabetical order

Insurance Company NameTimely Filing Limit
AARP15 Month from Date of Service (DOS)
Advantage Care6 Month
Advantage Freedom2 Years from DOS
Aetna timely filing120 Days from DOS
Ameri health ADM Local 3601 Year from DOS
American Life and Health12 Month
American Progressive1 Year
Amerigroup90 Days for Participating Providers/12 Months for Non-par Providers
Amerihealth ADM TPA1 Year
AmeriHealth NJ & DE60 Days
AMA2 Years from DOS
Anthem Health(Coast wise Claims)3 Years from DOS
Arbazo180 Days
Bankers Life15 Month form DOS
BCBS timely filing for Commercial/Federal180 Days from Initial Claims or if its secondary 60 Days from Primary EOB
Benefit Concepts12 Month from DOS
BCBS Florida timely filing12 Month from DOS
BeechStreet90 Days from DOS
Benefit Trust Fund1 year from Medicare EOB
Blue Advantage HMO180 Days from DOS
Blue Cross PPO1 Year from DOS
Blue Essential180 Days from DOS
Blue Premier180 Days from DOS
Blue Shield timely filing1 Year from DOS
Blue shield High Mark60 Days from DOS
Bridgestone/Firestone12/31 of the following year of the service
Cigna timely filing limit90 Days for Participating Providers/180 Days for Non-par Providers
Cigna HealthSprings (Medicare Plans)120 Days
Champus1 Year from DOS
Citrus1 Year from DOS
Coventry180 Days from DOS
Evercare60 Days from DOS
First Health3 Month from DOS
Fire Fighter/Local 101415 Month from DOS
FRA15 Month from DOS
FMH6 Month from DOS
GHI- Group health Ins1 Year from DOS
Great West (AH&L)90 Days from DOS
Healthcare Partners90 Days from DOS
Healthnet HMO90 Days from DOS
Healthnet PPO120 Days from DOS
Horizon NJ Plus365 Days from DOS
Humana180 Days for Physicians or 90 Days for facilities or ancillary providers
Humana27 Month from DOS
ILWU3 Years from DOS
Keystone Health Plan East60 Days from DOS
Local 831 Health1 year from DOS
Magna Care6 Month from DOS
Motion Picture Ind15 Month from DOS
Marilyn Electro IND. Benefit Fund1 Year from DOS
Medicaid95 Days from DOS
Medicare timely filing limit1 Year from DOS
Mega Life and Health15 Month from DOS
Memorial IPA90 Days from DOS
Monarch IPA90 Days from DOS
Mutual of Omaha1 year from DOS
Nationwide Health15 Month from DOS
NASI2 Years from DOS
Omnicare IPA90 Days from DOS
One Healthplan15 Month from DOS
Operating Engineers1 Year from DOS
Pacificare PPO90 Days from DOS
Pioneer Medical Group60 Days from DOS
Polk Community Health Care180 Days from DOS
Prospect Medical Group90 Days from DOS
Principle Financial3 Years from DOS
PUP180 Days from DOS
Quality Health Plan1 Year from DOS
SMA1 year from DOS
So. Ca Drug Benefit1 year from DOS
Secure Hoizons90 Days from DOS
Sun180 Days from DOS
Tricare12 Month from DOS
Troa/mediplus2 year from DOS
UFCW1 year from DOS
UHC Community120 Days from DOS
Union Fidelity1 Year from DOS
Unicare24 Month from DOS
United Health Care timely filing limit – UHC COMMERCIAL90 Days from DOS
United Teacher Associates15 Month from DOS
Veterans Admin90 Days from DOS
Vista120 Days from DOS
Wellcare180 Days from DOS
Writers Guild Health18 Month from DOS
Zenith1 Year from DOS
Allied Benefit Systems Appeal LimitAn 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 Timly Filing LimitThe 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 

Timely filing limit of all above insurance companies is updated from reliable resources of information. Try to keep all information is latest update and will update as per received any new information. If there is any discrepancy please let us know through contact form.

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