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.