Timely Filing Limits of Insurance Companies

within 90 days
You should submit a request for payment of Benefits within 90 days after the date of service.

180 days
Participating providers, 180 days from the date of service. Submission of claims: Participating providers, 180 days from the date of service.

Medicare claims must be filed no later than 12 months (or 1 full calendar year) after the date when the services were provided. If a claim isn’t filed within this time limit, Medicare can’t pay its share.

within 60 days
You must file your appeal within 60 days from the date on the letter you receive. To obtain an aggregate number of the plan’s grievances, appeals and exceptions please contact UnitedHealthcare.

United Health Care (UHC), Optum, and United Behavioral Health (UBH) are all “Optum” companies which handle mental health claims. All of these companies use the same Payer ID to file claims (87726), so they all end up in the same place at the end of the day.

within 120 days
As a Cigna-HealthSpring contracted provider, you have agreed to submit all claims within 120 days of the date of service. CLAIMS SUBMITTED WITH DATES OF SERVICE BEYOND 120 DAYS ARE NOT REIMBURSABLE BY CIGNA- HEALTHSPRING. Print screens are no longer accepted to validate timely filing.

When a claim is submitted to VA or other Community Care third-party administrator (TPA) in error, the provider is required to submit the claim to Optum within 180 days from the denial and must include proof of initial timely filing.

A decision on a request for prior authorization for medical services will typically be made within 72 hours of us receiving the request for urgent cases or 15 days for non-urgent cases.

If you have a complaint, please call us toll-free at 1-877-597-7799 to tell us about your problem. A UnitedHealthcare Community Plan Member Services Advocate can help you file a complaint. Just call 1-877-597-7799. Most of the time, we can help you right away or at the most within a few days.

In general, Medicare claims must be filed to the Medicare claims processing contractor no later than 12 months, or 1 calendar year, from the date the services were furnished. Use the Claims Timely Filing Calculator to determine the timely filing limit for your service. Example: Patient seen on 07/19/2019, file claim by 07/18/2020.

Timely Filing of Claims. All claims must be filed within 12 months of the date services were provided to the patient. The 12 month timely filing limit applies to all claims, including those that must first be filed with a third-party carrier.

Timely filing limits may vary by state, product and employer groups. Situation (assume 180-day timely filing rule) – The time for a claim to fulfill the timely filing rule expired on Feb. 29, 2020. Outcome – The rules to suspend timely filing do not apply. If we receive the claim after Feb. 29, the claim is subject to denial.

Most insurance companies have time limits within which you must submit your claim. The limit usually varies from 90 days to 12 months from the date of the loss or event. Check your policy’s terms and conditions for the time limit for your policy. Provide your insurance agent, broker or company with all supporting documents required by your policy. For example, you may need to provide: an accident report for a car insurance claim