General Medical Billing

Claim Timely Filing Limits:

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Sl.No
Payer		TFLCorrected Claim Filing LimitAppeal Filing Limit
1AETNA120 DAYS FROM DOS180 DAYS FROM DOD180 DAYS FROM DOD
2Ambetter Magnolia90 days from DOS45 days from denial date45 days from denial date
3Ambetter Magnolia OON365 days from DOS180 days from initial denial date45days from initial denial
4Amerigroup90 days from DOS60 calendar days from denial date60 calendar days from denial date
5AMERIGROUP COMMUNITY CARE- MD120 DAYS FROM DOS90 calendar days from initial denial date30 DAYS FROM DOD
6ANTHEM MEDICAID IN90 DAYS FROM DOS60 DAYS FROM DOD60 DAYS FROM DOD
7BCBS EMPIRE NY180 days from DOS or Discharge date/ If secondary 60 days from Primary eob1 YEAR FROM DODMed Ness denials in written form 180 days from denial/ Appeals 60 days from orginial denial
8BCBS IN180 days from DOS or Discharge date/ If secondary 60 days from Primary eob1 YEAR FROM DODMed Ness denials in written form 180 days from denial/ Appeals 60 days from orginial denial
9BCBS LA1 YEAR FROM DOS1 YEAR FROM DOD180 DAYS FROM DOD
10BCBS MA180 days from DOS or Discharge date/ If secondary 60 days from Primary eob1 YEAR FROM DODMed Ness denials in written form 180 days from denial/ Appeals 60 days from orginial denial
11BCBS MI1 YEAR FROM DOS1 YEAR FROM DOD30 business days from DOD
12BCBS MS180 days from DOS or Discharge date/ If secondary 60 days from Primary eob1 YEAR FROM DODMed Ness denials in written form 180 days from denial/ Appeals 60 days from orginial denial
13BCBS OF FL180 days from DOS or Discharge date/ If secondary 60 days from Primary eob1 YEAR FROM DODMed Ness denials in written form 180 days from denial/ Appeals 60 days from orginial denial
14BCBS OF NEW HAMPSHIRE180 days from DOS or Discharge date/ If secondary 60 days from Primary eob1 YEAR FROM DODMed Ness denials in written form 180 days from denial/ Appeals 60 days from orginial denial
15BCBS PA180 days from DOS or Discharge date/ If secondary 60 days from Primary eob1 YEAR FROM DODMed Ness denials in written form 180 days from denial/ Appeals 60 days from orginial denial
16BCBS TN180 days from DOS1 YEAR FROM DOD30 DAYS FROM DOD
17Beacon60 Days from the dos60 days from the date of Initial Dnd60 days from the date of Initial Dnd
18CARESOURCUE1 YEAR FROM DOS365 DAYS FROM DOD365 DAYS FROM DOD
19CGS MEDICARE OH1 YEAR FROM DOS180 days from DOD120 DAYS FROM DOD
20Cigna90 days from DOS180 days from Initial EOB date180 days from Initial EOB date
21Community First180 days from dos–120 days from dod
22Coventry90 days from DOS90 days from DOD180 days from DOD
23COVENTRY HEALTH CARE120 DAYS FROM DOS90 days from dod180 days from DOD
24Ever care180 days from DOS1 Year from DOD45 days from denial date
25Greatwest1 YEAR FROM DOS180 days from Initial EOB date60 days from DOD
26HEALTH FIRST180 days from DOS180 days from DOS60 days from DOD
27HEALTH FIRST NY90 days from DOS180 days from DOS45 days from denial date
28Health Net180 days from DOS365 days from date of service365 days from DOD
29Healthsprings120 days from DOS/ Secondary is 120 days from Primary eob date180 days from the date of denial or payment180 days from the date of denial or payment
30HMO Blue Value Plus90 days from dos180 days from Initial EOB date180 days from Initial EOB date
31Humana180 days from DOS365 days from DOS60 calendar days from denial date
32INDEPENDANCE BCBS180 days from DOS or Discharge date/ If secondary 60 days from Primary eob1 YEAR FROM DODMed Ness denials in written form 180 days from denial/ Appeals 60 days from orginial denial
33Magnolia90 days from DOS45 days from denial date45 days from denial date
34MBHP90 dys from the Dos90 days from the Initial date of Dnd180 days from the Dos
35MEDICAID FL1 YEAR from DOS, IF MEDICAR PRIMARY WILL 3 YEARS from DOS2 years from date of service90 DAYS FROM DOD
36Medicaid IN365 days from DOS365 days from denial date.180 days from denial date
37MEDICAID MISSIPI1 YEAR from DOS , For secondary medicaid TFL IS 180 Days from DOS2 years from date of serviceNO APPEAL LIMIT
38Medicare365 days from DOS365 days from DOS120 days from denial date
39Medicare / BCBS MEDICARE
ADVANTAGE-Medicare TN		1 YEAR FROM DOS2 YEARS FROM DOD2 YEARS FROM DOD
40PASS PORT HEALTH PLAN180 days from DOS180 days from DOS2 YEARS FROM DOD
41Polk Healthcare (Community Healthplan)180 days from DOS1 year from DOD24 months from DOD
42PSYCHCARE180 DAYS FROM DOS30 DAYS FROM DOD180 days from DOD
43Quality Health Plan180 days from DOS60 days from DOD60 days from DOD
44Rail Road Medicare365 days from DOS365 days from DOS120 days from intial denial date
45SecureHorizons90 days from DOS365 days from date of service or 60 days from date of initial denial [whichever is later]45 days from denial date
46SELECT HEALTHNETWORK180 days from DOS180 days from DOS90 DAYS FROM DOD
47Staywell180 days from DOS180 days from DOS1 YEAR FROM DOD
48Superior Health95 days from DOS120 days from dod120 days from dod
49THERAMATRIX1 YEAR FROM DOS1 YEAR FROM DOS90 DAYS FROM DOD
50UHC90 days from DOS365 DAYS FROM DOD90-days from denial date
51UHC Community Plan120 days from date of service1 Year from DOD1 Year from DOD
52Value option90 days from DOS60 days from DOD60 days from DOD
53WINDSOR MEDICARETFL IS 180 DAYS from DOS180 days from DOD90 DAYS FROM DOD
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