Timely Filing Limits by Major Payer

Why Timely Filing Matters

Every payer sets a deadline — called the timely filing limit — for how long after the date of service you have to submit a clean claim. Missing this deadline results in a CARC 29 denial ("timely filing limit exceeded") that is usually unappealable unless you have documented proof of prior timely submission. A missed timely filing limit is a permanent write-off.

Timely Filing Limits by Major Payer

Payer	Timely Filing Limit	Notes
Aetna	180 days from DOS	Commercial; Medicaid managed care may vary by state
Anthem / BCBS	90–365 days	Varies widely by state plan — check the specific Anthem plan's provider manual
Blue Cross Blue Shield (national)	90–365 days	Each BCBS plan is independent; verify per state
Cigna	180 days from DOS	Standard commercial; some behavioral health carve-outs may differ
Humana	180 days from DOS	Commercial and some Medicare Advantage
United Healthcare (UHC)	90–365 days	Varies by product; UHC Oxford, UHC Choice, etc. check provider agreements
Magellan Health	180 days	Behavioral health carve-out for many commercial plans
Optum / UBH	180 days	Behavioral health carve-out; often manages ABA separately
Medicaid (most states)	12 months (365 days)	State Medicaid programs typically allow 12 months; a few states allow 24 months
Medicare	12 months (365 days)	ABA not broadly covered; applies for applicable Medicare Advantage ABA benefits
Tricare	365 days from DOS	Military/CHAMPVA; confirm per regional contractor

Note: These are general guidelines. Always verify the exact timely filing limit in your specific provider contract or the payer's current provider manual — limits can change annually.

Secondary Claims Timely Filing

Secondary claim timely filing typically runs from the date of the primary EOB/ERA, NOT the original date of service. Most payers allow 90–180 days from the primary payer's explanation of benefits date to submit the secondary claim.

How to Protect Your Practice

• Submit within 30 days: Even if the limit is 180 days, submit quickly to allow time for corrections and resubmissions
• Track clearinghouse acceptance: Save the 999 acknowledgment or batch acceptance report — this is your proof of timely submission
• Set billing alerts: Flag any unpaid claim older than 45 days for follow-up before the limit approaches
• Document appeal exceptions: If a timely filing denial occurs but you have proof of prior submission, file an appeal immediately with the clearinghouse acceptance report attached
• Use Onvelas claim age tracking: The AR Follow-Up queue in Billing automatically flags claims by age so none slip past their timely filing window

When a Timely Filing Appeal Works

A CARC 29 denial is appealable — but only if you have documented proof that the original submission was within the timely filing window. Acceptable proof includes:

• Clearinghouse acceptance timestamp (batch ID + date)
• Payer's acknowledgment of receipt (277CA transaction)
• Fax confirmation with timestamp
• Certified mail receipt (for paper submissions)

Without one of these, the denial is final. This is why clearinghouse acceptance confirmation must be archived for every claim.