When thinking about filing timely claims, there are two time frames to keep in mind: The time from when the initial claim was submitted, and the time from when it was denied or resubmitted.
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Aetna Better Health
- Initial Claims: 180 days
- Resubmission: 365 days from date of Explanation of Benefits
- Appeals: 60 days from date of denial
Ambetter
- Participating Providers: 120 days
- Non-Participating Providers: 365 days
- Reconsideration or Appeals: 365 days from the date of explanation of payment
Amerigroup
- Participating Providers: 180 days
- Non-Participating Providers: 365 days
Cigna
- Participating Providers: 90 days
- Non-Participating Providers: 180 days
Georgia Medicaid
- Claims must be billed to Medicaid within three months of the date of the denial/payment
- No more than 12 months from the date of service
Humana
- Limit Providers: 180 days
Louisiana Medicaid
- Straight Medicaid Claims must be filed within 12 months of the date of service
Medicare
- Initial Claims: 12 months
Molina Healthcare
- Initial Claims: one calendar year from the date of service or discharge date
Tricare
- 365 days
UnitedHealthcare
- Participating Providers: 90 days
- Non-Participating Providers: 180 days
WellCare
- 180 days