Timely Filing Limits by Payer
Timely filing limits are the window a payer gives you to submit a claim from the date of service. The single most important thing to know: these are set by your specific contract and plan, not by a universal rule. The ranges below are the commonly published defaults for each payer, but a Medicare Advantage, Medicaid managed-care, or self-funded employer plan under the same brand can be shorter or longer. Always confirm against your contract and the payer's provider manual. When in doubt, the remit and the payer's provider portal are the authority.
| Payer | Initial filing limit (commonly) | Appeal filing limit (commonly) |
|---|---|---|
| UnitedHealthcare | 90 days from DOS for most commercial (varies by plan/contract) | ~12 months from the remittance date (plan-specific) |
| Aetna | 90–120 days from DOS (varies by plan/contract) | ~60–180 days from the denial (plan-specific) |
| Cigna | 90–180 days from DOS (varies by plan/contract) | ~180 days from the denial (plan-specific) |
| BCBS (varies by state/plan) | Varies widely by Blue plan — commonly 90–365 days from DOS | Varies by Blue plan — commonly 180 days from the denial |
| Humana | Commonly 90–180 days from DOS (varies by plan/contract) | ~60–90 days from the denial for Medicare Advantage (plan-specific) |
| Medicare (Part A/B, fee-for-service) | 1 calendar year from the date of service (statutory) | 120 days from the remittance for a redetermination (statutory) |
| Medicaid (state-specific) | Varies by state — commonly 90–365 days from DOS | Varies by state — check the state Medicaid manual |
What to do with this
- Treat the ranges here as a starting point, then pull the exact number from your contract or the payer's provider manual — that is the value you can defend on appeal.
- Medicare fee-for-service is the one hard, statutory number: one year to file, 120 days to request a redetermination.
- Most 'timely filing' denials (CARC 29) are appealable when you have a clearinghouse acceptance report or payer acknowledgment proving the claim was sent inside the window.
- COB claims that bounced between primary and secondary aged out for a reason that resets the clock — the primary EOB date, not the DOS, often controls the secondary's deadline.
Volari reads the filing deadline off each claim's remit and payer, tracks it against the clock, and flags claims that are still inside their appeal window — so timely-filing denials get worked with proof before they age out, instead of being written off as final.
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