Reference · maintained
Timely filing limits, by payer
The single deadline that turns a payable claim into a permanent write-off, gathered in one place. Print it, bookmark it, tape it to the monitor. The software tracks every one of these automatically, but the table is free either way.
Last verified: July 2026
| Payer | Timely filing limit (initial claim) | Clock starts | Corrected claim / appeal window |
|---|---|---|---|
| Medicare (fee-for-service) | 12 months | Date of service | 120 days to request redetermination from the remittance |
| Medicaid (Ohio, fee-for-service) | 365 days | Date of service | Per Ohio Medicaid rules; varies |
| UnitedHealthcare (commercial) | 90 days (contract may differ) | Date of service | Commonly 12 months to appeal |
| UnitedHealthcare (Medicare Advantage) | 90 to 180 days | Date of service | Varies by plan and state |
| Aetna (commercial) | 120 days (common) | Date of service | Commonly 180 days to appeal |
| Aetna (employer / Medicare Advantage) | 180 days to 1 year | Date of service | Varies by plan |
| Cigna (commercial) | 90 to 180 days | Date of service | Commonly 180 days to appeal |
| Humana | 90 days (common) | Date of service | Varies by plan |
| Anthem Blue Cross Blue Shield (Ohio) | Varies widely; commonly 90 to 365 days | Date of service | Set by contract |
| Medical Mutual of Ohio | Commonly 365 days | Date of service | Reference your certificate or contract |
| CareSource (Ohio Medicaid) | 365 days | Date of service, or 90 days from primary EOB, whichever is greater | Appeals 365 days from date of service |
| Buckeye Health Plan (Ohio Medicaid) | 365 days | Date of service | Corrected claims / appeals 180 days from the EOP |
| Molina (Ohio Medicaid) | 365 days (common for OH Medicaid MCOs) | Date of service | Varies by plan |
| Tricare | 1 year | Date of service (or discharge for inpatient) | 90 days to appeal a denial |
| UMR (UnitedHealthcare TPA) | Follows the underlying plan; commonly 90 days | Date of service | Per plan document |
Sources: each payer's provider manual and public claims guidance, verified July 2026 (CMS for Medicare, Ohio Department of Medicaid, and the CareSource, Buckeye Health Plan, and Medical Mutual of Ohio provider manuals). Windows marked "common" vary by contract.
What timely filing actually means
Timely filing is the deadline by which a payer will accept a claim for a service. Submit inside the window and the claim is adjudicated on its merits. Submit one day late and it is denied for timely filing, almost always with reason code CO-29, and in most contracts that balance cannot be billed to the patient. It becomes a write-off, which is to say, money you earned and then gave back for a calendar reason.
The window is set by contract, not by law, which is why the same CPT code for the same patient can have a 90-day deadline with one payer and a 365-day deadline with another. The clock almost always starts on the date of service. For inpatient claims it sometimes starts at discharge. When a patient has secondary coverage, many payers start the secondary clock at the date on the primary payer's explanation of benefits, which is why coordination-of-benefits delays are so dangerous.
How to prove you filed on time
If a claim is denied for timely filing but you actually submitted it inside the window, you can win the appeal, but only with proof. The gold standard is a clearinghouse acceptance report showing the payer received the claim on a specific date. A dated claim in your software is weaker on its own; the acceptance report is what payers accept as evidence. Keep these:
- The clearinghouse acceptance or 277CA report showing the payer accepted the claim, with the date
- Proof of the original submission date from your billing system
- For coordination-of-benefits cases, the primary payer's EOB with its date
- For retroactive eligibility, the payer's own notice of the retroactive date
What to do when you miss it
If the deadline genuinely passed and you have no proof of timely submission, the claim is usually lost. Before you write it off, check three things: whether the delay was caused by the payer, whether the patient had retroactive eligibility (many payers extend the window in that case), and whether your contract has an exceptions clause. If none apply, write it off, then figure out how the claim aged that far without anyone noticing, because that is the fixable part.
Payer-specific questions
The ones people search by name
What is the timely filing limit for Medicare?
12 months, one calendar year, from the date of service. There is no participating versus non-participating distinction for the filing limit itself. Miss it and Medicare denies for timely filing with almost no path to recovery unless the delay was Medicare's fault or the patient had retroactive entitlement.
What is the timely filing limit for UHC?
UnitedHealthcare commercial plans commonly require claims within 90 days of the date of service, but your provider contract sets the actual number, so check it. UnitedHealthcare Medicare Advantage plans commonly run 90 to 180 days depending on the plan and state. UMR, which UnitedHealthcare administers for self-funded employers, follows the individual plan document.
What is the timely filing limit for Aetna?
Aetna commercial plans are commonly 120 days from the date of service. Some employer-sponsored and Medicare Advantage plans stretch to 180 days or a full year. Because Aetna administers a lot of self-funded employer plans, the variance is real, so confirm the window on the specific plan.
What is the timely filing limit for Ohio Medicaid and its plans?
Ohio Medicaid and its managed care plans generally give you 365 days from the date of service for an initial clean claim. CareSource accepts initial claims 365 days from the date of service (or 90 days from the primary EOB, whichever is greater). Buckeye Health Plan gives 365 days for the initial claim but only 180 days from the EOP for corrected claims and appeals, which is the deadline people miss most.
What is the timely filing limit for Cigna and Humana?
Cigna commercial plans commonly run 90 to 180 days from the date of service, with some employer-sponsored plans allowing up to a year. Humana is commonly 90 days from the date of service. Both vary by contract, so treat these as the starting assumption and verify the plan.