Timely filing rules are the deadlines set by insurance payers for when a healthcare provider must submit a patient claim after the date of service. 

If you miss that window—even by a day—your claim could be automatically denied, resulting in lost reimbursement and extra work to appeal or write off the charges.​ Different payers have their own timelines, ranging from as short as 90 days to as long as a year, so knowing each rule is crucial for keeping your practice’s revenue cycle healthy. 

When providers track and understand timely filing requirements for every payer they work with, they protect their income, avoid costly denials, and keep billing on track.​ This article will break down what timely filing means, compare the filing windows for major payers, and provide practical tips to keep your claims paid and your revenue flowing.

What is Timely Filing in Medical Billing?

“Timely filing” in medical billing means the specific window of time a provider has to submit a claim to an insurance company after delivering services to a patient. 

Each payer sets its own deadline—commonly ranging from 90 days up to one year from the date of service (or other reference points)—and if you miss it, the claim is almost always automatically denied, regardless of the reason or validity of the service.​

Timely filing rules don’t just apply to initial claims. They also cover situations like:

• Corrected or resubmitted claims (often with different deadlines).
• Secondary or coordination-of-benefits (COB) claims, where the countdown may begin from the date of the primary payer’s explanation of benefits (EOB), not the original service date.​

Keeping track of these deadlines is crucial, because missing even one can mean lost revenue and extra administrative work—not to mention the risk of having to write off valuable services already provided.

Timely Filing Rules for Major Payers

Understanding the specific, timely filing deadlines of major payers is essential to avoid claim denials and lost revenue. 

Here are key rules from some of the largest payers:

Aetna

Many Aetna plans require that initial claims be submitted within 180 days (about 6 months) from the date of service. For some non-participating providers, this window has been reduced to 12 months starting from January 2022.​

UnitedHealthcare (UHC)

For participating providers on many community and Medicaid plans, claims must be submitted within 90 calendar days from the date of service. Non-contracted providers generally have 180 days to file. Corrected or resubmitted claims often have extended deadlines, such as 365 days from the original claim processing date.​

Cigna

Cigna typically expects claims to be filed within 90 days from the date of service for participating providers. For out-of-network providers, this deadline may extend to 180 days, depending on specific plan terms.​

Blue Cross Blue Shield (BCBS) Plans

BCBS plans vary widely by state. For example, some states allow 1 year or more to submit claims, while others have shorter limits like 90 to 180 days. Providers need to check the specific BCBS plan rules based on the state and contract.​

Summary Table 

Knowing these deadlines and double-checking plan-specific contracts ensures you submit claims on time, getting paid faster, and reducing denials.

Things That Impact the Deadlines

While the timely filing rules set firm deadlines, several important variables and exceptions can affect how those deadlines apply in real-world billing:

Provider contracts and participation agreements: 

These may override generic payer rules with stricter or sometimes more lenient filing deadlines. Always check your specific contract terms, as they take priority.​

In-network vs. out-of-network: 

Typically, out-of-network providers get longer filing windows than in-network providers. For example, UnitedHealthcare allows 90 days for in-network claims but 180 days for non-contracted providers.​

Secondary or Coordination-of-Benefits (COB) claims: 

For these claims, deadlines usually start from the date of the primary payer’s Explanation of Benefits (EOB), not the original date of service. This extra step means tracking when you receive the primary EOB is critical to avoid missing deadlines.​

Timely Filing State regulations: 

Some states set minimum or maximum filing limits that may extend or reduce payer-set deadlines. Medicaid claims, in particular, vary widely across states.​

Corrected or resubmitted claims: 

Many payers allow a different, often longer, deadline for claim corrections or resubmissions. UnitedHealthcare, for instance, accepts corrected claims within 365 days after the original claim was processed.​

Exceptions due to extenuating circumstances: 

Some payers, notably Medicare, recognize limited exceptions such as administrative errors, retroactive eligibility changes, or disenrollment from Medicare Advantage plans. These exceptions may extend filing deadlines temporarily but require documented proof.​

Knowing how these variables interact with your payers’ rules helps you plan accurate submission timelines and manage appeals effectively if denials occur. 

Best Practices for Providers

To avoid costly denials due to late claim filing, providers should:

• Maintain a clear, up-to-date tracker of each payer’s timely filing deadlines.
• Submit claims as soon after the date of service as possible to stay comfortably within deadlines.
• Verify each patient’s insurance eligibility before services to prevent surprises.
• Stay informed by regularly reviewing payer contracts and policy updates for any changes in deadlines or exceptions.
• Automate reminders and workflows in billing systems to catch approaching deadlines before it’s too late.

These simple steps help keep claims timely, reduce denials, and protect your practice’s revenue. But if you don’t have time to do all of this, then you should consider hiring a medical billing service.

Why You Should Consider a Medical Billing Partner?

At MedAce Healthcare, we take care of all the tricky parts of submitting your insurance claims, so you don’t have to worry about them. When you work with us, you can hand over the busy and time-sensitive job of keeping up with each insurance company’s rules and deadlines.

We know the ins and outs of different insurers’ filing timelines, exceptions, and how to appeal claims if needed. This helps keep your payments coming and reduces the chances of your claims being denied.

Think of us as your billing partner who’s here to make sure you get paid for your hard work—while you focus on what you do best: caring for your patients. Choosing MedAce Healthcare means better cash flow, less time spent on billing headaches, and confidence that your practice’s billing is in expert hands.