Timely Filing Limits: Every Major Payer Deadline You Need to Know
By Nasar Haq | June 29, 2026 | 13 min read | Updated: June 29, 2026
Quick Summary: Medicare gives you 12 months. UnitedHealthcare gives you 90 days. Miss a payer's timely filing deadline by one day and your clean claim becomes a permanent write-off. Here's every major deadline and how to track them.
Every medical claim has an expiration date. Not the date printed on the superbill or the date it appears in your practice management system — but a hard, non-negotiable deadline set by the payer that determines whether your claim will even be considered for payment. Miss that deadline and there is no appeal, no exception, and no recourse. The money is gone.
This is the reality of timely filing limits in medical billing: each payer sets its own deadline, each deadline is different, and most practices don't have a systematic way to track which claims are approaching which payer's cutoff. The result is predictable. Revenue walks out the door not because the claim was wrong, but because it was late.
Medtransic's medical billing team manages timely filing compliance across every major payer for hundreds of practices. What follows is everything we've learned about preventing the most avoidable category of revenue loss in healthcare billing.
- $50K–$150K Annual Write-Offs from Missed Deadlines - Average mid-size practice
- 90 days Tightest Major Payer Deadline - UHC, Cigna, some BCBS plans
- 12 months Medicare Filing Deadline - Calendar year + 12 months from DOS
- 5–8% Claims Lost to Timely Filing - In practices without deadline tracking
What Timely Filing Actually Means
A timely filing limit is the maximum number of days a payer allows between the date of service (or another triggering event) and the date the claim is received by the payer. If the claim arrives after that window closes, the payer will deny it with a timely filing denial — typically using CARC (Claim Adjustment Reason Code) 29: "The time limit for filing has expired." This denial is final. It cannot be billed to the patient. It is a pure write-off.
What makes timely filing especially dangerous is that the deadlines vary dramatically by payer. Medicare gives you 12 months. Medicaid deadlines vary by state — some give you 365 days, others give you 90. UnitedHealthcare's standard commercial plans enforce a 90-day filing limit. Aetna gives 90 days for in-network claims. If your billing team tracks deadlines based on a single rule of thumb like "submit everything within 30 days," they may be hitting Medicare's deadline comfortably while silently losing claims to payers with tighter windows.
- Timely Filing Limit
- The maximum number of days a payer allows for initial claim submission, measured from the date of service (or another triggering event such as date of eligibility determination). Claims submitted after this deadline are denied with no patient liability and no appeal right. Each payer sets its own timely filing limit, and the deadline applies to the date the payer receives the claim — not the date it was sent.
- Clean Claim
- A claim that contains all required data elements, is submitted in the correct format, and has no deficiencies that would cause it to be rejected or returned. Timely filing deadlines apply to when the payer receives a clean claim — a rejected claim that is corrected and resubmitted must still meet the original filing deadline.
Why Claims Expire and What It Costs You
Timely filing write-offs are one of the most expensive problems in medical billing precisely because they are invisible. A denied claim shows up in your denial report. A claim that was never submitted — or was submitted to the wrong payer and never corrected — doesn't show up anywhere. It exists only as a gap between services rendered and claims filed, and most practice management systems don't flag that gap automatically.
Medtransic's intake audits consistently find that mid-size practices (3–7 providers) write off $50,000–$150,000 annually in claims that expired past their timely filing window. The root causes follow a pattern: claims held pending authorization verification that never got submitted, claims denied for eligibility that were never resubmitted after correcting the payer information, secondary claims that were never filed because the primary EOB wasn't posted promptly, and claims that were rejected (not denied) for formatting issues and never resubmitted.
Each of these scenarios has a common thread: the initial claim action happened, but the follow-up action didn't. The filing window quietly closed while the claim sat in a queue, and by the time someone noticed, the deadline had passed. This is why accounts receivable management and timely filing are inseparable — a claim you're not actively tracking is a claim that's silently expiring.
- Claims submitted to the wrong payer — If a patient's coverage changed and the claim went to the old insurer, the denial comes back weeks later. By the time the claim is corrected and sent to the right payer, the filing window may already be closed.
- Secondary claims never filed — When a primary payer adjudicates a claim, the secondary payer's timely filing clock may have been running since the date of service, not the date of primary payment. Delayed EOB posting means delayed secondary submission.
- Rejected claims confused with denied claims — A rejected claim was never processed — it bounced back due to a formatting or data error. Rejections don't stop the timely filing clock. The original deadline still applies.
- Authorization delays — Claims held because prior authorization wasn't obtained or confirmed. The filing deadline doesn't pause while your team resolves the auth issue.
- Staffing gaps and backlogs — Billing staff turnover or vacation creates a backlog. Claims that would normally be filed within a week sit for 30–45 days, eating into the filing window before anyone catches up.
Timely Filing Limits for the Top 15 National Payers
The table below shows the timely filing deadlines for the 15 most common national payers in medical billing. These are the standard deadlines published in each payer's provider manual for in-network participating providers. Out-of-network deadlines may differ. State-specific Medicaid and BCBS plan deadlines may vary from the national standard listed here — always verify against your specific plan's provider manual.
| Payer | Initial Filing Deadline | Corrected Claim Deadline | Appeal Deadline | Notes |
|---|---|---|---|---|
| Medicare (Parts A & B) | 12 months from DOS | 12 months from DOS | 120 days from remittance date | Calendar year deadline: claims for services in 2025 must be filed by 12/31/2026 |
| Medicaid (typical) | 90 days–365 days (varies by state) | Varies by state | 30–90 days from denial | Check your state’s specific deadline; some states allow as few as 90 days |
| UnitedHealthcare (UHC) | 90 days from DOS | 90 days from original remittance | 90 days from denial date | One of the tightest commercial deadlines; strictly enforced |
| Aetna | 90 days from DOS (in-network) | 90 days from remittance | 60 days from denial date | Out-of-network may differ; check plan-specific terms |
| Cigna | 90 days from DOS | 90 days from remittance | 90 days from denial date | Electronic submission strongly recommended to ensure receipt date |
| Blue Cross Blue Shield (BCBS) | 90–365 days (varies by plan) | 60–120 days from remittance | 60–120 days from denial | BCBS is 36 independent companies; deadlines vary significantly by state and plan |
| Humana | 180 days from DOS | 180 days from original remittance | 60 days from denial date | More generous than UHC/Aetna/Cigna but still requires tracking |
| Tricare | 365 days from DOS | 365 days from DOS | 90 days from denial date | Government program; relatively generous initial filing window |
| Medicare Advantage (MA plans) | 12 months from DOS (most plans) | Varies by plan | 60–180 days from denial | MA plans are commercial insurers; verify the specific plan's rules |
| Centene / Ambetter | 90–180 days (varies by state) | 60–90 days from remittance | 60 days from denial date | Marketplace and Medicaid managed care; state-specific rules apply |
| Molina Healthcare | 90–365 days (varies by state) | 60–90 days from remittance | 60 days from denial date | Primarily Medicaid managed care; follows state Medicaid timely filing rules in many states |
| Kaiser Permanente | 90 days from DOS (non-Kaiser providers) | 90 days from remittance | 60 days from denial date | Primarily applies to out-of-network or referral-based claims |
| Health Net | 90 days from DOS | 90 days from remittance | 60 days from denial date | Now part of Centene; filing requirements vary by state |
| Veterans Affairs (VA / CHAMPVA) | 365 days from DOS | 365 days from DOS | 90 days from denial date | Community care claims follow VA-specific submission requirements |
| Workers' Compensation | Varies by state (30–365 days) | Varies by state | Varies by state | State-regulated; some states enforce 30-day filing limits for initial reports |
Date of Service vs. Date of Denial: When the Clock Starts
One of the most common sources of confusion in timely filing is understanding when the clock starts. For initial claims, the answer is usually straightforward: the timely filing clock begins on the date of service (DOS). But for corrected claims, appeals, and secondary submissions, the triggering event can be different — and getting it wrong can cost you the claim.
When the Timely Filing Clock Starts
Date of Service (DOS) as Start Date
- Used for initial claim submissions to all payers
- Medicare: 12 months from the DOS
- Most commercial payers: 90–365 days from the DOS
- The clock starts regardless of when you become aware of the patient's coverage
- Authorization delays do not pause or extend the DOS-based deadline
- If a claim is rejected (not denied), the original DOS-based deadline still applies
Date of Denial / Remittance as Start Date
- Used for corrected claim resubmissions after a denial
- Used for appeal submissions following a claim denial
- Used for secondary payer submissions after primary adjudication (some payers)
- The clock starts on the date shown on the EOB or ERA, not the date you received it
- Typically 60–120 days from the denial or remittance date
- If primary EOB posting is delayed, the secondary filing window may be shorter than expected
The critical trap here is with secondary payers. Some secondary payers start the timely filing clock from the date of service, not from the date the primary payer adjudicated the claim. If Medicare is primary and takes 30 days to pay, and the secondary payer has a 90-day timely filing limit from the DOS, you only have 60 days from receiving the Medicare EOB to submit the secondary claim. If posting the primary payment takes another 2–3 weeks internally, your effective window for secondary submission is less than 40 days.
Other secondary payers — and this is where it gets important — start the clock from the date of the primary payer's remittance advice. This gives you a fresh window. But you won't know which rule applies unless you check the specific payer's provider manual or contract. Making assumptions here is the fastest way to lose secondary claims to timely filing.
- Corrected Claim
- A claim resubmitted to a payer with corrections after the original claim was denied or paid incorrectly. Corrected claims are submitted using frequency code 7 (replacement) or 8 (void/cancel) on the CMS-1500 or 837P. The timely filing deadline for a corrected claim is typically measured from the date of the original remittance advice — not from the original date of service. However, the original claim must have been filed within the initial timely filing deadline for the corrected claim to be accepted.
Corrected Claims and Appeal Deadlines
Understanding the distinction between initial filing, corrected claim submission, and formal appeals is critical because each has its own deadline and each follows different rules. Filing a corrected claim when you should have filed an appeal — or vice versa — can waste the window you needed.
- Initial filing deadline. This is the window for submitting the original claim. It's measured from the date of service and is the deadline most people think of when they hear "timely filing." If you miss this, the claim is dead — no corrected claim or appeal will save it.
- Corrected claim deadline. After a claim is denied or paid incorrectly, you can resubmit a corrected version (frequency code 7). This deadline is typically measured from the date of the remittance advice. Most payers allow 60–120 days. The corrected claim must reference the original claim number.
- Appeal deadline. If a claim is denied and you believe the denial is incorrect, you file a formal appeal. Appeal deadlines are measured from the date of the denial notice and typically range from 60–180 days. Appeals require supporting documentation — clinical notes, authorization records, or coding rationale.
- Reconsideration deadline. Some payers offer a reconsideration process that's faster and less formal than a full appeal. Medicare's redetermination (first-level appeal) has a 120-day deadline from the remittance date. Commercial payers may offer reconsideration windows of 30–90 days.
The relationship between these deadlines matters. A corrected claim is not an appeal — it's a new claim submission with corrected data. An appeal is a formal dispute of the payer's adjudication decision. Some billing teams submit corrected claims when they should be filing appeals, which means the denial reason isn't addressed and the claim gets denied again — this time potentially past the appeal window. Medtransic's denial management process categorizes every denial by the correct resolution path before any action is taken, specifically to prevent this kind of deadline waste.
| When to Submit a Corrected Claim | When to File an Appeal |
|---|---|
| The original claim had incorrect patient demographics | The payer denied a correctly coded claim |
| A coding error was made on the original submission | Medical necessity was questioned but documentation supports the service |
| The wrong procedure or diagnosis code was used | Authorization was obtained but the payer claims it wasn't |
| Modifier was missing or incorrect | The payer applied the wrong fee schedule or contract rate |
| Claim was submitted to the wrong payer ID | Coordination of benefits was applied incorrectly |
State-Specific Timely Filing Rules
Federal payers like Medicare and Tricare have uniform national timely filing rules, but state-regulated programs — Medicaid, workers' compensation, and state-mandated commercial insurance rules — vary significantly by state. Some states impose prompt-payment laws that require insurers to pay clean claims within a set number of days, and these laws can indirectly affect timely filing by setting standards for what constitutes a "received" claim.
Medicaid timely filing limits are the most variable. California Medi-Cal allows 6 months (180 days) from the date of service. New York Medicaid allows 90 days. Texas Medicaid allows 95 days for clean claims and 365 days for non-clean claims. Florida Medicaid allows 12 months. These differences mean a practice operating in multiple states — or seeing patients with out-of-state Medicaid coverage — must track state-specific Medicaid deadlines independently.
Medtransic maintains a comprehensive state billing laws database that includes timely filing rules for every state's Medicaid program, prompt-payment regulations, and commercial insurance filing requirements. For practices operating across state lines, this is a critical resource for preventing state-specific timely filing losses.
Payer-Specific Traps That Cause Write-Offs
Beyond the published deadlines, each payer has operational quirks that can catch billing teams off guard. These aren't policy violations by the payer — they're features of how each payer processes claims that create timely filing risk if you don't know about them.
- UnitedHealthcare's 90-day wall. UHC enforces its 90-day deadline rigidly. There is no grace period, no exception for "mailed but not received," and no extension for authorization delays. Electronic submission with real-time confirmation is the only way to ensure the claim was received within the window. If you mail a claim on day 85 and it arrives on day 92, it will be denied for timely filing.
- BCBS plan variation. Blue Cross Blue Shield is not one company — it's 36 independent licensees. BCBS of Illinois may have a 365-day filing limit while BCBS of Texas enforces 90 days. Your team must look up the specific BCBS plan, not assume a single BCBS deadline applies across all patients.
- Aetna's out-of-network distinction. Aetna's 90-day filing limit applies to in-network providers. Out-of-network deadlines can be different (and often shorter for certain plan types). If a patient's Aetna plan routes to an out-of-network benefit, the filing rules change.
- Medicaid retro-eligibility. When a Medicaid patient's eligibility is determined retroactively, the timely filing clock may start from the date of eligibility determination rather than the date of service. This can create a situation where the original claim was filed to the wrong payer, the eligibility determination comes back months later, and the practice now has a compressed window to file the Medicaid claim.
- Medicare Advantage mismatch. Medicare Advantage plans are run by commercial insurers but cover Medicare-eligible patients. The timely filing rules follow the commercial insurer's policies, not traditional Medicare's 12-month window. A practice that assumes "Medicare patient = 12-month deadline" for an MA patient may be operating against a 90-day commercial deadline.
- Workers' compensation state variation. Workers' comp timely filing is governed by state law, not the insurer. Some states require initial reports within 10–30 days of the injury, with separate deadlines for billing submission. Missing the reporting deadline can void the billing deadline entirely.
What Happens When You Miss a Deadline
Understanding the consequences of a missed timely filing deadline is important because the impact is final and the options are extremely limited. Unlike a coding denial or an authorization denial, a timely filing denial has almost no recovery path.
- The claim is denied with CARC 29. The payer issues a denial using Claim Adjustment Reason Code 29 ("The time limit for filing has expired") or a similar proprietary code. The denial notice will show the allowed amount as $0.
- The balance cannot be billed to the patient. Per your provider agreement with the payer, timely filing failures are the provider's responsibility. You cannot send the patient a bill for the denied amount. Doing so violates your contract and may violate state balance-billing laws.
- The claim becomes a write-off. The charge is written off as a contractual adjustment. It appears in your financial reports as lost revenue — not as a denial to be worked, but as money that will never be collected.
- Appeal options are nearly nonexistent. Most payers will not overturn a timely filing denial unless you can prove the claim was submitted on time (with electronic confirmation or certified mail receipt) or that the delay was caused by the payer's own system error. "We didn't know the deadline" or "our staff was short-handed" are not valid appeal arguments.
- The only exception: proof of timely submission. If you have documentation proving the claim was received by the payer within the filing window — such as an electronic submission confirmation, a clearinghouse receipt with timestamp, or a certified mail return receipt — you may be able to overturn the denial. This is why electronic submission with confirmation tracking is non-negotiable for every claim.
A Practical Filing Deadline Tracking Workflow
Preventing timely filing losses requires a systematic approach. Individual vigilance is not enough — when a billing team manages hundreds or thousands of claims across dozens of payers, deadlines will be missed unless there's a process that makes them visible before they expire. The following workflow is what Medtransic uses across our client practices, adapted for in-house billing teams.
- Submit every claim within 3–5 business days of the date of service. This is the single most important step. Regardless of which payer the claim goes to, submitting within the first week gives you the maximum runway against every deadline. Build this into your daily billing workflow — charges entered today should be scrubbed and submitted today or the next business day.
- Use electronic submission with confirmation tracking for every claim. Never mail a claim without also submitting electronically. Your clearinghouse should provide a submission confirmation with a timestamp for every claim. Save these confirmations — they are your proof of timely filing if a payer issues a CARC 29 denial.
- Build a payer-specific deadline matrix. Create a reference document listing every payer in your mix with their initial filing deadline, corrected claim deadline, appeal deadline, and any notes about plan-specific variations. Update it annually or whenever you receive notice of a deadline change.
- Run a weekly "approaching deadline" report. Pull a report every Monday of all unpaid claims aged 60+ days and segment them by payer. For payers with 90-day deadlines, any claim at 60 days is 30 days from permanent write-off. Escalate these claims immediately — call the payer, verify claim receipt, and document the status.
- Track rejected claims separately from denied claims. A rejected claim was never processed. The timely filing clock is still running. Build a daily workflow for reviewing rejections, correcting the data error, and resubmitting on the same day. No rejection should sit unresolved for more than 48 hours.
- Automate secondary claim submission. Configure your practice management system to automatically generate secondary claims when primary EOBs are posted. If secondary submission depends on manual action, delays are inevitable. For practices using AR management workflows, this automation is critical.
- Conduct monthly timely filing audits. At the end of each month, review all claims denied for timely filing (CARC 29 or equivalent). Calculate the total dollar amount written off. Track the trend over time. Identify which payers and which internal workflow gaps generated the losses. This audit turns timely filing from an invisible problem into a visible, measurable metric.
| Signs Your Deadline Tracking Is Working | Signs It Isn't |
|---|---|
| Zero or near-zero CARC 29 denials per month | CARC 29 denials appearing monthly in your write-off report |
| All claims submitted within 5 business days of DOS | Claims sitting in "pending" status for 30+ days before submission |
| Weekly aging reports reviewed with payer-specific deadlines noted | No payer-specific deadline matrix exists for your billing team |
| Rejected claims resolved within 48 hours | Rejected claims discovered weeks after the initial rejection |
| Secondary claims auto-generated on primary EOB posting | Secondary claims filed manually — or not filed at all |
How Medtransic Prevents Timely Filing Write-Offs
Medtransic manages timely filing as a core function of our medical billing services, not as an afterthought. Every claim we manage is tracked against its payer-specific deadline from the moment it's submitted, and our workflow is designed to ensure no claim approaches a filing window without intervention.
Our claims submission target is same-day or next-business-day filing for every charge entered. Claims are submitted electronically through certified clearinghouses with real-time confirmation tracking, so we have timestamped proof of submission for every claim. Our payer deadline matrix covers every payer across every state our clients operate in — including plan-specific variations for BCBS, Medicaid managed care, and Medicare Advantage plans.
Our AR management team runs automated aging alerts at 45, 60, and 75 days for payers with 90-day deadlines, and at proportional intervals for payers with longer windows. Claims that hit the 60-day mark on a 90-day payer are escalated to senior billing specialists for direct payer follow-up. The result: across our client base, timely filing write-offs represent less than 0.5% of total charges — compared to the 5–8% average we find in practices managing billing in-house without a tracking system.
For practices that have been losing revenue to timely filing issues, Medtransic's onboarding process includes a retroactive review of all claims approaching their deadlines. We've recovered tens of thousands of dollars for new clients simply by identifying claims in the 60–80 day window and getting them filed or followed up before the deadline hit. If your practice suspects timely filing is an issue — or if you've never measured it — that's exactly where we start.
Sources & References
- Centers for Medicare & Medicaid Services (CMS) — Medicare timely filing rules, claims processing guidelines, and CARC/RARC code definitions
- UnitedHealthcare Provider Portal — UHC timely filing policies, claims submission guidelines, and appeal procedures
- Aetna Provider Manual — In-network and out-of-network timely filing deadlines and corrected claim procedures
- Cigna Provider Resources — Claims filing deadlines, appeal timelines, and electronic submission requirements
- Blue Cross Blue Shield Association — Overview of BCBS licensee network; plan-specific deadlines available through individual state plan provider portals
- Tricare Provider Handbook — Military health program timely filing rules and claims submission requirements
- MGMA (Medical Group Management Association) — Practice management benchmarks including timely filing write-off rates and claims submission velocity data
- Washington Publishing Company — CARC Code List — Official Claim Adjustment Reason Code definitions including CARC 29 (timely filing)
Frequently Asked Questions
What is the timely filing limit for Medicare?
Medicare's timely filing limit is 12 months (365 days) from the date of service. For calendar year purposes, claims for services rendered in 2025 must be filed by December 31, 2026. This applies to Medicare Parts A and B. Medicare Advantage plans, however, are administered by commercial insurers and may have different — often shorter — timely filing deadlines, so always verify the specific MA plan's rules rather than assuming the standard Medicare 12-month window applies.
Can I bill the patient if a claim is denied for timely filing?
No. When a claim is denied for timely filing (CARC 29), the provider must absorb the loss as a write-off. Your provider agreement with the payer explicitly prohibits billing the patient for charges denied due to your failure to submit the claim on time. This is the provider's contractual responsibility, and balance-billing the patient for a timely filing denial violates your contract and may violate state balance-billing laws. The only recovery path is proving the claim was actually submitted on time using electronic confirmation or certified mail documentation.
What is the difference between a rejected claim and a denied claim for timely filing purposes?
A rejected claim was never received or processed by the payer — it bounced back due to a formatting error, invalid data, or transmission failure. A denied claim was received, processed, and adjudicated with a denial decision. The critical difference for timely filing: a rejection does not stop the timely filing clock. The original deadline still applies, and the corrected claim must be resubmitted within the original filing window. A denial, by contrast, opens a new window for corrected claims or appeals, typically measured from the date of the denial notice.
How do I appeal a timely filing denial?
Timely filing denials are extremely difficult to overturn. The only successful appeal argument is proof that the claim was actually submitted within the filing window. This requires documentation such as an electronic submission confirmation with a timestamp from your clearinghouse, a payer acknowledgment (277CA transaction), or a certified mail return receipt. Arguments based on staffing issues, system errors on your end, or lack of awareness of the deadline are not accepted. To prevent this situation, always submit claims electronically with real-time confirmation tracking and save all submission receipts.
Do timely filing limits apply to corrected claims?
Yes, but the deadline is different. Corrected claims (submitted with frequency code 7) have their own timely filing window, typically measured from the date of the original remittance advice rather than the original date of service. Most payers allow 60–120 days from the remittance date to submit a corrected claim. However, a corrected claim is only valid if the original claim was submitted within the initial timely filing deadline. You cannot use a corrected claim submission to circumvent a missed initial filing window.
What is CARC 29?
CARC 29 is Claim Adjustment Reason Code 29, defined as "The time limit for filing has expired." It is the standard denial code payers use when a claim is received after the timely filing deadline has passed. A CARC 29 denial means the claim will not be processed, the allowed amount is $0, and the balance cannot be transferred to the patient. It is effectively a final, non-recoverable denial unless you can prove the claim was submitted on time with documented evidence of receipt.
Stop Losing Revenue to Expired Filing Windows
Medtransic tracks every payer deadline for every claim — with same-day submission, automated aging alerts, and proof-of-filing documentation that eliminates timely filing write-offs. If your practice is losing money to missed deadlines, we'll find it in your first 90-day audit.