Every payer has a deadline for initial claim submission and a separate deadline for appeals. Miss either one and the money is gone permanently, regardless of whether the claim was valid. Medicare gives you 12 months. Most commercial payers give 90-365 days. Some give as few as 60. This page has every major payer's filing and appeal deadlines in one table. Bookmark it.
Bookmark this page. You'll need it the next time a claim gets denied for CO-29 (timely filing) and you need to know if you still have time to appeal.
Timely filing limits are the hard deadlines payers set for submitting claims and filing appeals. They're non-negotiable. A perfectly valid, properly coded, medically necessary claim becomes permanently unpayable the moment it crosses the filing deadline. No appeal. No exception. No recovery.
The problem: every payer sets their own deadlines, and those deadlines vary by claim type (initial submission vs. corrected claim vs. appeal vs. reconsideration). Most billing teams know their top 3-4 payers' deadlines from memory and guess on the rest. That guessing costs practices thousands per year in claims that expire silently.
This is the deadline for submitting the original claim after the date of service. If you miss this deadline, the claim cannot be submitted at all.
| Payer | Filing Limit | Measured From | Key Notes |
|---|---|---|---|
| Medicare (Part B) | 12 months | Date of service | Calendar year deadline: services in 2026 must be filed by 12/31/2027. No extensions. CMS requires electronic submission for all providers with 10+ FTEs. |
| Medicare Advantage | Varies by plan | Date of service | Each MA plan sets its own deadline, typically 6-12 months. Check the specific plan. Do not assume Medicare Part B rules apply.Common MA plans: UHC Medicare Advantage = 365 days. Humana MA = 365 days. Aetna MA = 180 days. |
| Medicaid | Varies by state | Date of service | Ranges from 90 days to 365 days depending on state. Hawaii Medicaid: 180 days. California Medi-Cal: 180 days. Texas: 95 days. New York: 90 days. Florida: 365 days. |
| UnitedHealthcare | 90 days | Date of service | One of the shortest commercial deadlines. In-network providers: 90 days. Out-of-network: 90 days. Some employer group plans may differ. Always verify with the specific plan. |
| Aetna | 90 days | Date of service | In-network: 90 days. Out-of-network: check plan. Corrected claims: 90 days from denial date. Aetna is strict on enforcement. |
| BCBS (Anthem) | 180 days | Date of service | Anthem BCBS plans: 180 days. Other BCBS plans vary by state licensee. BCBS of Illinois: 365 days. BCBS of Texas: 95 days. Always check the specific BCBS plan. |
| Cigna | 180 days | Date of service | In-network: 180 days standard. Some Cigna plans extend to 365 days. Out-of-network may differ. Verify with the plan document. |
| Humana | 180 days | Date of service | Commercial plans: 180 days. Humana Medicare Advantage: 365 days. Humana Military (Tricare East): follows Tricare rules. |
| Tricare | 365 days | Date of service | One of the most generous deadlines. Participating providers: 365 days. Non-participating: patient must file within 365 days of service or 365 days of being notified of authorization. |
| Tricare for Life | 365 days | Date of service or Medicare EOB date | If Medicare is primary, file within 365 days of Medicare's EOB date. Always file Medicare first. |
| Workers' Compensation | Varies by state | Date of service | Hawaii: 24 months from DOS or 12 months from date injury is reported. California: 180 days. Most states: 6-24 months. Workers' comp deadlines are generally longer than commercial but vary widely. |
| OWCP (Federal) | 12 months | Date of service | Federal workers' comp. 12 months from date of service. Submissions through OWCP's EDI gateway or CMS-1500 paper. |
| Centene / Ambetter | 90-180 days | Date of service | Varies by state Medicaid managed care contract. Ambetter marketplace plans typically 90-120 days. Verify per plan. |
| Molina Healthcare | 90-180 days | Date of service | Medicaid managed care timely filing follows state Medicaid rules. Marketplace plans: typically 180 days. |
| VA / Community Care | 180 days | Date of service | VA Community Care claims: 180 days. Must submit through VA's portal or Optum VA CCN. Authorization number required on claim. |
The 90-day payers are the killers. UnitedHealthcare and Aetna both enforce 90-day filing limits. If your practice submits claims weekly instead of daily and a batch fails silently, you can lose 2-3 weeks before anyone notices. For a practice billing $15,000/week to UHC, a 3-week submission gap that isn't caught until day 91 means $45,000 in permanently lost revenue. Denial management systems with automated claim aging alerts prevent this.
When a claim is denied, you have a separate deadline to file an appeal. This deadline is measured from the date on the Explanation of Benefits (EOB) or Electronic Remittance Advice (ERA), not from the date of service.
| Payer | First-Level Appeal | Second-Level Appeal | Key Notes |
|---|---|---|---|
| Medicare (Part B) | 120 days | 180 days | Redetermination (Level 1): 120 days from MSN/ERA. Reconsideration (Level 2): 180 days from redetermination decision. ALJ hearing (Level 3): 60 days. Medicare appeals have 5 levels total. Most are resolved at Level 1 or 2. |
| UnitedHealthcare | 90 days | 60 days | Reconsideration: 90 days from denial. Formal appeal: 60 days from reconsideration decision. External review available for clinical denials after internal appeals exhausted. |
| Aetna | 90 days | 60 days | Pre-service appeals: must be filed before the service is rendered. Post-service appeals: 90 days from denial date. Expedited appeals available for urgent clinical situations. |
| BCBS (Anthem) | 180 days | 60 days | First appeal: 180 days from denial (Anthem). Other BCBS plans vary. Second appeal: 60 days from first appeal decision. State insurance commissioner complaint available as external appeal. |
| Cigna | 180 days | 60 days | Post-service appeal: 180 days from denial. Pre-service urgent appeal: 72-hour turnaround required from Cigna. Voluntary second appeal available before external review. |
| Humana | 180 days | 60 days | Standard appeal: 180 days from denial date. Expedited appeal for active treatment: 72 hours. Peer-to-peer review available for clinical denials. |
| Tricare | 90 days | 60 days | Reconsideration: 90 days from initial determination. Formal review: 60 days from reconsideration. Independent external review available as third level. |
| Workers' Comp | Varies by state | Varies by state | Workers' comp disputes are adjudicated through state workers' comp boards, not the payer's internal appeal process. Deadlines and procedures are state-specific. Hawaii: dispute within 60 days via DLIR. |
When a claim is rejected (not denied) for a data error and needs to be corrected and resubmitted, the timely filing clock works differently than for original claims.
Critical distinction: A rejected claim was never processed by the payer (data error, wrong payer ID, missing fields). A denied claim was processed and adjudicated but payment was refused. Rejected claims are resubmitted as corrected claims. Denied claims are appealed. The deadlines and processes are different.
Medicare: Corrected claims must be filed within the original 12-month timely filing limit from the date of service. The rejection doesn't reset the clock.
Most commercial payers: Corrected claims typically must be filed within 60-90 days of the rejection date OR within the original filing deadline, whichever is later. Some payers (UHC, Aetna) measure from the rejection date, which can give you additional time if the original claim was filed near the deadline.
The safe rule: Resubmit corrected claims within 30 days of the rejection. Don't test the deadline. A clearinghouse rejection on day 85 of a 90-day filing window leaves you 5 days to identify the error, fix it, and resubmit. That's not enough margin.
When a patient has multiple insurance plans, the secondary payer's timely filing clock usually starts from the date the primary payer's EOB was issued, not from the date of service. This is critical because waiting for the primary payer to process can consume months.
| Scenario | Filing Deadline | Measured From |
|---|---|---|
| Secondary after Medicare | Varies (typically 90-180 days) | Medicare EOB/ERA date |
| Coordination of Benefits delay | Original deadline + extension | Many payers extend the deadline when COB is documented |
| Retroactive eligibility change | Typically 90 days | Date the eligibility change was communicated |
COB tip: If a claim is denied by the secondary payer for timely filing but the delay was caused by waiting for the primary EOB, appeal with a copy of the primary EOB showing the date it was issued. Most payers have a COB exception to their timely filing policy. The appeal must reference the specific COB exception and include the primary EOB as evidence.
Most payers have exceptions to their timely filing limits for specific situations. If you missed a deadline, check whether any of these apply before writing off the claim:
Retroactive eligibility. If the patient's eligibility was determined retroactively (e.g., Medicaid retroactive coverage, retroactive employer enrollment), the filing deadline typically starts from the date the eligibility was confirmed, not the date of service.
Coordination of benefits. When the delay in filing was caused by waiting for another payer to process first, most payers extend the deadline. Documentation of the primary payer's processing timeline is required.
Payer system errors. If the payer's system was down, their portal was inaccessible, or their EDI gateway rejected claims due to a system issue on their end, the filing deadline may be extended. Document the error with screenshots, clearinghouse rejection reports, and dates.
Retroactive provider enrollment. If a credentialing gap caused the original denial and retroactive enrollment was subsequently approved, claims from the gap period can be submitted even if the original filing deadline has passed. The new deadline typically starts from the effective date of the retroactive enrollment.
Natural disasters and declared emergencies. CMS and some commercial payers extend filing deadlines during declared disasters. This applied during COVID and after major hurricanes. Check CMS and payer bulletins for active deadline extensions.
The practices that lose money to timely filing aren't the ones who don't know the deadlines. They're the ones who don't have a system that catches claims approaching deadlines before they expire.
Submit claims within 48 hours of the encounter. Not weekly. Not when the biller "gets to it." Within 48 hours. This gives you maximum runway for rejections, corrections, and resubmissions. A claim submitted on day 1 has 89 days of buffer with a 90-day payer. A claim submitted on day 60 has 30 days, which is barely enough time to handle one rejection cycle.
Run a weekly aging alert at 60% of each payer's deadline. If UHC's deadline is 90 days, flag every UHC claim that's 54+ days old and unpaid. That gives you 36 days to follow up, resubmit, or escalate. If you wait until day 80 to notice, you have 10 days and no room for error.
Track clearinghouse rejections daily. A claim that fails at the clearinghouse never reaches the payer. The timely filing clock is still ticking. If your clearinghouse rejection report sits unreviewed for 2 weeks, you've lost 2 weeks of filing runway on those claims. Daily clearinghouse review is the single most important habit for preventing timely filing losses.
Keep proof of every submission. If a payer denies a claim for timely filing but you filed on time, you need the clearinghouse transmission report showing the date and confirmation number. Without proof of timely submission, your appeal will fail. Most clearinghouses retain transmission records for 12-24 months. Download and save them.
Our denial management system tracks every claim against its payer-specific filing deadline and alerts you before claims approach expiration. No more money dying silently in the system.
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