Timely Filing Limits by Payer

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Filing Deadline Checker

Enter the date of service and your payer. We will show you the filing deadline and how much time is left.

Date of service Payer

Estimates only. Your provider contract and the payer manual always control. If the deadline has passed, talk to us before writing anything off - partial recovery options sometimes exist.

Payer Reference

General reference ranges verified October 2026. Every contract can override these, so always confirm against your provider agreement.

Payer	Filing window	Notes
Medicare (Part A and B)	12 months (365 days) from date of service	Same window nationwide. Does not extend for weekends or holidays in the usual way contracts do - count the days.
TRICARE	12 months from date of service	Same national standard as Medicare.
UnitedHealthcare	90 days (commercial)	Medicare Advantage and employer plans can run up to 1 year. Commercial 90 days is one of the tightest clocks in the industry.
Aetna	120 days (commercial)	Some plans drop to 90 days. Check the plan, not just the payer name.
Cigna	90 days in-network / 180 days non-par	Your network status changes the clock, not just the rate.
Humana	90 days (commercial) / 1 year (Medicare plans)	Commercial and Medicare books are completely different clocks.
BCBS	180 to 365 days, varies by state and plan	BCBS Community (IL) is 180 days from the date of service. Dispute or redetermination: 60 days from the denial date. Always confirm your state plan.
Medicaid	90 days to 12 months, varies by state	Examples: Texas Medicaid 95 days, Ohio Medicaid 365 days. Your state Medicaid provider manual is the only source that matters.

Late claims deny with claim adjustment reason code CO-29 (timely filing). A CO-29 denial cannot be billed to the patient, so the revenue is gone for good unless the payer accepts a documented exception.

Three Clocks

Original, Corrected and Appeal Windows

Most practices only watch the first clock. All three can kill revenue.

1. Original claim

The window above - from date of service to first submission. Miss it and the claim is dead on arrival.

2. Corrected claim

Your plan paid wrong or denied on an error? The correction has its own clock, often shorter than the original window.

3. Dispute and appeal

Lost the denial fight? The appeal window starts at the denial date, not the service date. BCBS Community (IL) gives 60 days from denial for a dispute or redetermination.

Medicaid Warning

Medicaid Deadlines Change State by State

Medicare gives you 12 months everywhere. Medicaid gives you whatever your state decides - and the spread is enormous.

State example	Filing window
Texas Medicaid	95 days
Ohio Medicaid	365 days

If you bill across state lines, each state Medicaid runs its own clock. One workflow does not fit all - we track per-state filing calendars for every client.

How We Help

How Zaxis Health Stops TF Denials

Timely filing is a process problem, not a knowledge problem. Here is the process we run for every client.

Per-payer filing calendars

Every payer and plan in your mix gets its own deadline rule in our workflow. No claim drifts past its window.

Daily worklist triage

Claims approaching their window get worked first. Urgent filings jump the queue automatically.

AR aging watch

Unworked claims show up in aging reports long before the deadline. We flag the risk, then work it.

Appeal window tracking

Denials enter an appeal clock the day they arrive. We calendar the dispute deadline at first review.

FAQ

Timely Filing Questions

Straight answers on filing deadlines.

What happens if I miss the timely filing deadline?

The claim denies with CO-29, and a timely filing denial cannot be billed to the patient. That revenue is gone unless the payer grants an exception, which is rare. Prevention is the only reliable strategy.

Does my contract override the published limits?

Yes. Every provider contract and payer manual can override general reference ranges. Treat this page as orientation, then confirm against your agreement before acting.

Is Medicare really a full 12 months?

Yes. Medicare Part A and Part B both allow 12 months (365 days) from the date of service for original claims. Corrected claims and appeals run on their own shorter clocks.

What is the difference between the filing clock and the appeal clock?

The filing clock runs from the date of service. The appeal or dispute clock starts at the denial date. Example: BCBS Community (IL) allows 180 days from the service date for the original claim, then 60 days from the denial for a dispute or redetermination.

Why does Medicaid vary so much by state?

Medicaid is state-run, so each state sets its own filing rules. Texas Medicaid is 95 days while Ohio Medicaid is 365 days. Your state Medicaid provider manual is the final word.

Can Zaxis Health recover claims that already missed the deadline?

Sometimes, when a payer grants a documented exception. But most TF denials are final. The real value is in our process: per-payer calendars, daily triage and AR aging watch that keep claims inside the window.

Find Out What Your Practice Is Losing - Free.

Send one billing export. We'll show you the leaks, the stuck AR and the denials worth fighting - before you spend a dollar.

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