Timely Filing Limit of All Major Insurances – 2025 Update

Timely filing limit refers to the maximum time period an insurance company allows its policyholders, healthcare providers, and medical billing companies to submit claims after a healthcare service has been rendered. Understanding these time frames can save you from unnecessary claims denials and losses.

The time limit starts from the date of service when the medical procedure was performed and ends on the date the insurance company receives the claim. The purpose of a timely filing limit is to ensure that insurance claims are processed and paid in a timely manner.

What is the Timely Filing Limit of Insurance Companies?

Different insurance companies enforce various time frames for timely filings, so it’s important to verify the specifics with the insurance company involved. Typically, the timely filing limit ranges from 90 days to 180 days. However, it’s critical to note that the Medicare timely filing limit is 365 days.

Below is a summary of the timely filing limits of all major insurance companies in the United States.

Timely Filing Limit of Major Insurance Companies in US

Insurance Name	Timely Filing Limit
AARP	15 months from the date of service
Aetna	120 days from date of service
Aetna Appeals	60 days from previous decision
Aetna Better Health	180 days
Aetna Better Health Appeals	60 days from previous decision
Aetna Denied Claims	180 days from denial
Aetna Reconsiderations	180 days
AMA	2 years from date of service
Ambetter for Non Participating Providers	365 days from date of service
Ambetter for Participating Providers	120 days from date of service
Ambetter for Reconsideration or Appeals	365 days
American Life & Health	1 year from date of service
Amerigroup for Non Participating Providers	365 days
Amerigroup for Participating Providers	180 days
Anthem Health Coastwise Claims	3 years from date of service
Bankers Life	15 months from date of service
Benefit Concepts	12 months from date of service
Benefit Trust Fund	1 year from date of Medicare EOB
Blue Cross PPO	1 year from date of service
Blue Shield	1 year from date of service
Bridgestone/Firestone	12/31 of the following year of service
Champus	1 year from date of service
Cigna for Non Participating Provider	180 days from the date of service
Cigna for Participating Providers	90 days from the date of service
Coventry	180 days from the date of service
Fire Fighters /Local 1014	15 months from the date of service
FMH	6 months from the date of service
FRA	15 months from the date of service
GHI for In Network Claims	1 year from the date of service
GHI for Out of Network Claims	18 months from the date of service
GHI Secondary	365 days from the primary EOB date
Great West/AH&L/	90 days from date of service
Healthfirst	1 year from the date of service
Healthnet Access	6 months from date of service
HealthNet PPO	120 days from date of service
HIP Primary Insurance	120 days from date of service
HIP Secondary Payer	120 days from date of service
Humana Commercial Claims	90 days from the date of service
Humana Medicare Claims	1 year from the date of service
ILWU	3 years from the date of service
Kaiser Permanente	90 days from the date of service
Keystone First Initial Claims	180 days from the date of service
Keystone First Resubmissions & Corrected Claims	365 days from the date of service
Local 831 Health	1 year from the date of service
Medicare Appeals	120 days from original determination
Medicare Initial Claims	12 months from date of service
Mega Life & Health	15 months from the date of service
Molina Healthcare Initial claims	1 Calendar year from the date of service
Molina Healthcare Secondary	180 Calendar days from Primary EOB processing date
Motion Picture Ind.	15 months from the date of service
Mutual of Omaha	1 year from the date of service
Nationwide Health	15 months from the date of service
One Healthplan	15 months from the date of service
Operating Engineers	1 year from date of service
Pacificare (PPO)	90 days from the date of service
Principal Financial	3 years from the date of service
Prospect Medical Group (PMG)	90 days from the date of service
SMA	1 year from the date of service
So. Ca Drug Benefit	1 year from the date of service
Tricare East	1 year from the date of service
Tricare West	1 year from the date of service
Troa/Mediplus	2 years from the date of service
UHC Community	120 days from date of service
United Healthcare Appeals	12 months from original claim determination
United Healthcare Non Participating Providers	180 days from the date of service
United Healthcare Participating Providers	90 days from the date of service
United Healthcare Secondary	90 days from Primary EOB processing date
Wellcare Medicare	180 days from the date of service

Notice: New Timely Filing Limit Requirement for Aetna

Effective May 1, 2023, the Aetna Texas timely filing limit will change to align with the Texas requirement of 95 days. All claims must be sent within 95 days of the date of service(s).

What if claim isn’t sent within the timely filing limit?

Failing to submit a claim within the timely filing limit may result in the claim being denied with a denial code CO 29. It is imperative to be aware of the deadline and submit claims promptly to avoid unnecessary losses.

How to avoid timely filing limit exhaustion?

To avoid denial due to the timely filing limit, always submit claims within the stipulated time frame by the insurance company. If electronic submission is available, utilize it and regularly monitor for any rejections. It’s also a best practice to have your accounts receivable team follow up on claims within 15 days of submission.

What is Aetna’s timely filing limit for claims?

Aetna’s timely filing limit is typically 90 days from the date of service, though variations may exist based on specific plans or contracts. Therefore, verifying the individual contract details is crucial.

Final Remarks about Timely Filing Limit

This article outlines all you need to know about the timely filing limits with major insurance providers in the United States. If you have further questions or require assistance, please feel free to reach out to us at support@texmed.us.