Timely filing limit refers to the maximum time period an insurance company allows its policyholders, healthcare providers and medical billing companies to submit claims after a healthcare service has been rendered.
The time limit starts from the date of service, when the medical procedure was performed, and ends on the date when the insurance company receives the claim. The purpose of a timely filing limit is to ensure that insurance claims are processed and paid in a timely manner.
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What is the Timely Filing Limit of Insurance Companies?
Different insurance companies have different time frames for timely filing, so it is important to check with the specific insurance company. The timely filing limit varies by insurance company and typically ranges from 90 to 180 days. However, Medicare timely filing limit is 365 days.
Below, I have shared the timely filing limit of all the major insurance Companies in United States.
Timely Filing Limit of Major Insurance Companies in US
| Insurance Name | Insurance Timely Filing Limit |
|---|---|
| AARP | 15 months from the date of service |
| Aetna | 120 days from date of service |
| Aetna Appeals | 60 days from previous decision |
| Aetna Better Health | 180 Days |
| Aetna Better Health Appeals | 60 days from previous decision |
| Aetna Denied Claims | 180 Days from denial |
| Aetna Reconsiderations | 180 days |
| AMA | 2 Years from Date of Service |
| Ambetter for Non Participating providers | 365 Days from date of service |
| Ambetter for participating providers | 120 days from date of service |
| Ambetter for Reconsideration or Appeals | 365 Days |
| American Life & Health | 1 Year from Date of Service |
| Amerigroup for Non Participating Providers | 365 Days |
| Amerigroup for Participating Providers | 180 Days |
| 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 |
| Benefit Trust Fund | 1 year from date of Medicare EOB |
| 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 for Non Participating Provider | 180 days from the date of service |
| Cigna for Participating Providers | 90 days from the date of service |
| Coventry | 180 days from the date of service |
| Fire Fighters /Local 1014 | 15 months from the date of service |
| FMH | 6 months from the date of service |
| FRA | 15 months from the date of service |
| GHI for In Network Claims | 1 year from the date of service |
| GHI for Out of Network Claims | 18 months from the date of service |
| GHI Secondary | 365 Days from the primary EOB date |
| Great West/AH&L/ | 90 dates from date of service |
| Healthfirst | 1 year from the date of service |
| Healthnet Access | 6 months from date of service |
| HealthNet PPO | 120 days from date of service |
| HIP Primary Insurance | 120 days from date of service |
| HIP Secondary Payer | 120 days from date of service |
| Humana Commercial Claims | 90 Days from the date of service |
| Humana Medicare Claims | 1 year from the date of service |
| ILWU | 3 years from the date of service |
| Kaiser Permanente | 90 days from the date of service |
| Keystone First Initial Claims | 180 days from the date of service |
| Keystone First Resubmissions & Corrected Claims | 365 days from the date of service |
| Local 831 Health | 1 year from the date of service |
| Medicare Appeals | 120 days from original determination |
| Medicare Initial Claims | 12 months |
| Mega Life & Health | 15 months from the date of service |
| Molina Healthcare Initial claims | 1 Calender year from the date of service |
| Molina Healthcare Secondary | 180 Calender days from Primary EOB processing date |
| 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 |
| Principal Financial | 3 years from the date of service |
| Prospect Medical Group (PMG) | 90 days from the date of service |
| SMA | 1 year from the date of service |
| So. Ca Drug Benefit | 1 year from the date of service |
| Tricare East | 1 year from the date of service |
| Tricare West | 1 year from the date of service |
| Troa/Mediplus | 2 years from the date of service |
| UHC Community | 120 days from date of service |
| Unitedhealthcare Appeals | 12 months from original claim determination |
| Unitedhealthcare Non Participating Providers | 180 days from the date of service |
| Unitedhealthcare Participating Providers | 90 days from the date of service |
| Unitedhealthcare Secondary | 90 days from Primary EOB processing date |
| Wellcare Medicare | 180 days from the date of service |
Notice: New Timely Filing Limit Requirement for Aetna
Effective May 1, 2023, the Aetna Texas timely filing limit will change to align with the Texas requirement of 95 days. All claims must be sent within 95 days of the date of service(s).
What if claim isn’t sent within the timely filing limit?
Failing to submit a claim within the timely filing limit may result in the claim being denied with a denial code CO 29, so it is important to be aware of the deadline and submit the claim promptly.
How to avoid from claim timely filing limit exhausted?
To avoid timely filing limit denial, submit claims within the timely filing limit of insurance company. If insurance company allows electronic submission then submit claims electronically and keep an eye on rejections. Also ask your accounts receivable team to follow up on claims within 15 days of claim submission.
What is Aetna timely filing limit for claims?
Aetna’s timely filing limit for claims is typically 90 days from the date of service. However, this can vary based on the specific plan, contract, or state. So it’s advisable to check the details of the individual policy or contract for the exact time frame.
Final Remarks about Timely Filing Limit
In this article, I have mentioned everything you need to know about timely filing limit along with the timely filing limit of all major insurances in United States. In case, you’re looking for some additional information, feel free to contact us or comment below.
Hi, I’m Kim Keck! Born in Texas, USA. I have completed my Bachelor of Business Administration in Healthcare Management from University of Texas. Right after completing my degree in 2011, I started my job career as an Accounts Receivable in a medical billing company.
Now, with more than 15 years of experience as a medical biller and revenue cycle manager, I am on a mission to serve the medical billing industry with my vast knowledge and years of expertise.