Updated a list of timely filing limits of different insurance companies below Timely Filing Limits of Insurance CompaniesĭOS- Date of Service 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 HealthSprings (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. In the USA there are a lot of insurance companies and their timely filing limit is different as per their profile. We also have to ask the claim received date for confirmation as well.ģrd 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 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.ġst 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. In some case, claim was billed within time but stuck in our system or rejected by the system. 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. How to handle timely filing denial claims? 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). It is 30 days to 1 year and more and depends on 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. The timely filing limit is the time duration from service rendered to patients and submitting claims to the insurance companies. What is the timely filing limit in medical billing?
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