ROI Revenue Optimization & Intelligence
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Every timely filing limit. One reference.

Filing deadlines and appeal windows for 103 commercial and government payers. 10 major payers are free for everyone. The full list is included with any ROI Technical Module license.

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Aetna BCBS Cigna Humana Medicare Medicaid Tricare UnitedHealthcare

Last updated May 4, 2026. Auto-enriched weekly.

Showing 118 payers
Payer Timely Filing Limit Days Appeal Window Source
AARP15 Months from Date of Service450120 days from payment for disputesView policy
Aetna120 Days from DOS120180 calendar days from initial claim decision for reconsiderations/disputesView policy
BCBS (generic baseline)Commonly 180 days from DOS, varies by Blue Plan and product line. See specific plan rows below.180Typically 90-180 days; varies by planView example policy (BCBSIL)
Cigna90 Days for Participating Providers/180 Days for Non-par Providers90180 calendar days from initial payment/denial noticeView policy
Humana180 Days for Physicians or 90 Days for facilities or ancillary providers180Provider claims disputes: 18 months from date of original claim determinationView policy
Medicaid90 days from DOS90Varies by stateView policy
Medicare (Part A/B)1Y or 365 Days from DOS365120 days from receipt of initial determinationView policy
Tricare12 Months from DOS36090 days from date of remittance adviceView policy
UnitedHealthcare Commercial90 days from DOS90Reconsideration within 60 days from remittanceView policy
Wellcare180 Days from DOS18090 calendar days from EOP/claim denial/review decisionView policy
ABC IPA90 days from the date of service90Not publishedLicense a module to view
Accountable Health90 days from the date of service90Not publishedLicense a module to view
ADOC IPA90 days from DOS90365 days from date of the last transactionLicense a module to view
Advantage Care6 Month180Follow provider grievance process in applicable Provider Manual Dispute Resolution chapterLicense a module to view
Advantage Freedom2 Years from DOS73060 days from date of claim denialLicense a module to view
Aetna (HMO)120 days from the date of service120180 calendar days from initial claim decision for disputes/reconsiderationsLicense a module to view
Alliance IPA1 year from DOS365365 days from IPA's action on claimLicense a module to view
AMA2 Years from DOS730Not specifiedLicense a module to view
Ameri health ADM Local 3601 year from DOS36590 days from receipt of claims determinationLicense a module to view
American Life and Health12 Month360Not publishedLicense a module to view
American Progressive1 Year365Not publishedLicense a module to view
Amerigroup90 Days for Participating Providers/12 Months for Non-par Providers360Typically 120 calendar days from EOP date for reconsiderations/medical appealsLicense a module to view
Amerihealth ADM TPA1 Year365Not publishedLicense a module to view
AmeriHealth NJ & DE60 Days60Not specified in sourcesLicense a module to view
Angeles IPA90 days from the date of service9060 days from initial determination HealthSmart MSO ClaimsLicense a module to view
Anthem (Coastwise)3 Years from DOS1095180 days from denial notice for Trustees reviewLicense a module to view
Applecare IPA90 days from DOS90180 days from EOB dateLicense a module to view
Arbazo180 Days180Not publishedLicense a module to view
Asian Community IPA90 days from DOS for contracted and 180 days for non-contracted90Not publishedLicense a module to view
B/C HMO90 days from DOS90180 days from EOP/PCS date for claim disputesLicense a module to view
B/C Medi-cal90 days from DOS90Not publishedLicense a module to view
Bankers Life15 Month form DOS450Not publishedLicense a module to view
BeechStreet90 days from DOS90180 days from the date of the payer’s original payment or explanation of paymentLicense a module to view
Benefit Concepts12 Months from DOS360Not publishedLicense a module to view
Benefit Trust Fund1 year from Medicare EOB365Not publishedLicense a module to view
Blue Advantage HMO180 Days from DOS180Non-participating: 60 days from remit date to appealLicense a module to view
Blue Essential180 Days from DOS180180 days from check date/EOP/PCS date for claim disputesLicense a module to view
Blue Premier180 Days from DOS180180 days from EOP/PCS date for claim disputesLicense a module to view
Bridgestone/Firestone12/31 of the following year of the serviceNone180 days from denial for medical claimsLicense a module to view
Caremore IPA90 days from DOS9090 days from date of denial on EOPLicense a module to view
Champus1 year from DOS365Not specifiedLicense a module to view
Cigna Health Springs (Medicare Plans)120 Days12065 days from original decisionLicense a module to view
Citrus1 year from DOS365365 days from last action dateLicense a module to view
Coventry180 Days from DOS180180 days for reconsiderationsLicense a module to view
Downey IPA60 Days from DOS60Not publishedLicense a module to view
Evercare60 Days from DOS6060 days from date of adverse determinationLicense a module to view
Fire Fighter/Local 101415 Months from DOS450Not publishedLicense a module to view
First Health3 Months from DOS9012 months from DOS or 60 calendar days after payment/denial of timely claim, whichever is laterLicense a module to view
FMH6 Months from DOS180Not publishedLicense a module to view
FRA15 Months from DOS450365 days from IPA action or after time to contest/denyLicense a module to view
GHI- Group health Ins1 year from DOS365Follow provider grievance processLicense a module to view
Global IPA90 days from DOS for contracted and 1 Year for non-contracted365Not publishedLicense a module to view
Great West (AH&L)90 days from DOS90180 calendar days from initial payment/denial noticeLicense a module to view
Healthcare Partners90 days from DOS9060 calendar days from receipt of original EOB for claim reconsiderationsLicense a module to view
Healthnet HMO90 days from DOS90365 days from receipt of RA/EOP for claim disputes/appealsLicense a module to view
Healthnet PPO120 Days from DOS120No specific appeal deadline foundLicense a module to view
Horizon NJ Plus365 Days from DOS36590 days from date of denial or remittance adviceLicense a module to view
ILWU3 Years from DOS1095180 days after denial notice for Trustees reviewLicense a module to view
Karing Physicians90 days from DOS90Not specifiedLicense a module to view
Keystone Health Plan East60 Days from DOS60180 days from denial/EOB for provider billing disputes/appealsLicense a module to view
Lakewood IPA90 days from DOS90Not publishedLicense a module to view
Local 831 Health1 year from DOS365Not publishedLicense a module to view
Magna Care6 Months from DOS18060 days from date of payment or denial of original claimLicense a module to view
Mail Handlers Benefit Plan Timely Filing LimitSee policyNone6 months from initial decision for reconsiderationLicense a module to view
Marilyn Electro IND. Benefit Fund1 year from DOS365Not publishedLicense a module to view
Mega Life and Health15 Months from DOS450Not publishedLicense a module to view
Memoria IPA90 days from DOS90365 days from receipt of the Plan’s RALicense a module to view
Memorial IPA90 days from DOS90365 days from receipt of RA or plan actionLicense a module to view
Monarch IPA90 days from DOS90Not publishedLicense a module to view
Motion Picture Ind15 Months from DOS450180 days from receipt of EOB or denial noticeLicense a module to view
Mutual of Omaha1 year from DOS36560 days from initial decisionLicense a module to view
NASI2 Years from DOS730Not specified in policyLicense a module to view
Nationwide Health15 Months from DOS45060 days for payment disputesLicense a module to view
Northwest OC IPA90 days from DOS90Not publishedLicense a module to view
Omnicare IPA90 days from DOS90Not publishedLicense a module to view
One Healthplan15 Months from DOS45065 calendar days from notice of adverse actionLicense a module to view
Operating Engineers1 year from DOS365Typically 180 days after denial noticeLicense a module to view
Pacificare PPO90 days from DOS90Varies by contractLicense a module to view
Pioneer Medical Group60 Days from DOS60Not publishedLicense a module to view
Polk Community Health Care180 Days from DOS180Not specifiedLicense a module to view
Principle Financial3 Years from DOS1095Not publishedLicense a module to view
Prospect Medical Group90 days from DOS90365 days from Prospect's action for provider disputesLicense a module to view
PUP180 Days from DOS180Not specified in policy documentsLicense a module to view
Quality Health Plan1 year from DOS365Not publishedLicense a module to view
Secure Horizons90 days from DOS9060-180 days from remittance/denial dateLicense a module to view
SMA1 year from DOS365Not publishedLicense a module to view
So. Ca Drug Benefit1 year from DOS36560 days from denialLicense a module to view
Sun180 Days from DOS180Submit adjustments/appeals within 90 days of denialLicense a module to view
Troa/mediplus2 Years from DOS730Not publishedLicense a module to view
UFCW1 year from DOS365180 calendar days from adverse determination noticeLicense a module to view
UHC Community120 Days from DOS120Varies by stateLicense a module to view
Unicare24 Months from DOS720ReconsiderationLicense a module to view
Union Fidelity1 year from DOS365Not publishedLicense a module to view
United Teacher Associates15 Months from DOS450Not publishedLicense a module to view
Veterans Admin90 days from DOS9090 days from process date for denied claimsLicense a module to view
Vista120 Days from DOS120Not specifiedLicense a module to view
Writers Guild Health18 Months from DOS540180 days from receipt of denialLicense a module to view
Zenith1 year from DOS365Not publishedLicense a module to view
BCBS FEP (Federal Employee Program)365 days from DOS for non-PPO claims; PPO providers follow plan contract365Member: 1 year from claim payment denial; Provider: per local Plan timely filingView policy
Anthem Blue Cross (CA, IN, KY, ME, MO, NV, NH, OH, VA, WI, GA, CO, CT)90 days from DOS for participating providers (post Oct 2019); 12 months for non-par90180 days from initial claim decision for reconsiderationLicense a module to view
Anthem BCBS Indiana Medicaid90 days for par providers; 180 days for non-par90Per state Medicaid timely filing rulesLicense a module to view
Highmark BCBS Pennsylvania / West Virginia (Commercial)365 days from last DOS unless contract specifies365Per provider contract; secondary submissions follow primary EOB dateLicense a module to view
Highmark BCBS Delaware180 days from DOS unless member policy provides otherwise180Per provider contractLicense a module to view
Highmark Blue Cross Blue Shield New York365 days from DOS or discharge for original bill type365Corrected claims (bill type ending 7) within 365 days of original claim's last finalizationLicense a module to view
Highmark PA CHIP180 days from DOS or discharge for CHIP enrollees180Per CHIP program timely filing rulesLicense a module to view
BCBS Texas PPO (Commercial)365 days from DOS for PPO claims365Provider claim review process; refer to Claim Review FormLicense a module to view
BCBS Texas HMO180 days from DOS for HMO claims180Provider claim review processLicense a module to view
BCBS Illinois (Commercial PPO / BlueChoice / BlueHPN)180 days from DOS or discharge; secondary claims 180 days from primary EOB180Per BCBSIL provider manualLicense a module to view
BCBS Illinois Medicare Advantage PPO180 days from DOS for Blue Cross Medicare Advantage members180Per BCBSIL Medicare Advantage provider manual (2026)License a module to view
BCBS Alabama (Commercial)Member-submitted: 24 months from DOS; provider claims per network contract (typically 365 days)730Per provider contract; refer to Claims Payment PolicyLicense a module to view
BCBS Alabama Blue Advantage (Medicare)15 months from DOS for Blue Advantage Medicare claims450Standard post-service: 60 days; expedited: 72 hoursLicense a module to view
Florida Blue (BCBS Florida)365 days from DOS per provider manual365Per Florida Blue payment policiesLicense a module to view
CareFirst BCBS (MD, DC, Northern VA)180 days from DOS per CareFirst provider manual180Per CareFirst provider manualLicense a module to view
BCBS North Carolina365 days for par and non-par providers (effective 7/1/2023)36590 calendar days for disputes/reconsiderations (effective 5/1/2025)License a module to view
Horizon BCBS New Jersey (Commercial)365 days from DOS for commercial claims (Horizon BCBSNJ)365Inquiries: 18 months from decision; provider inquiry no time limit unless tied to specific claimLicense a module to view
Horizon NJ Health (Medicaid)180 days from DOS; corrected claims 365 days from DOS180COB: 60 days from primary EOB or 180 days from DOS, whichever is laterLicense a module to view
Premera Blue Cross (WA)365 calendar days from DOS; preferred submission within 60 days365Level II appeals: 30 calendar days from Level I decisionLicense a module to view
Premera Blue Cross Medicare Advantage12 months from DOS for Premera Blue Cross Medicare Advantage360Per CMS appeal timelines (60 days standard, 72 hours expedited)License a module to view

Unlock all 103 payers

Reach out to us about licensing one or more of our Technical Modules to get exclusive access to the full timely filing reference. Sortable, searchable, weekly-refreshed data with direct policy links and appeal windows for 93 additional payers, included with every active license.

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How this reference is built

Every entry traces back to a published payer policy. We capture the timely filing limit, appeal window, and direct link to the source document. Where a payer publishes different windows for participating versus non-participating providers or for facility versus professional claims, both are noted.

Auto-enrichment

A weekly cron job re-checks each policy URL for changes. When a payer updates their timely filing rule or appeal window, the table is updated and any practice with an active Technical Module license sees the new at-risk math on their next dashboard refresh.

What "Conservative" means in our modules

For payer rollups (BCBS, UHC, Aetna, Humana, Cigna, Medicare, Medicaid, Tricare, Managed Care, Workers Comp, Other), modules that consume this reference (such as A/R Command Engine) use two modes:

  • Conservative: Uses the tightest (shortest) timely filing limit across all matched payers in that rollup. Recommended for at-risk flagging.
  • Average: Uses the mean timely filing days across matched payers. Useful for forecasting.

Why some payers show different limits than you may have seen

Filing limits change. Plans are sold and renamed. State-specific Medicaid managed care can have different rules than the parent payer. We always link back to the source so you can verify against the version of the policy that matters for your contract.

Disclaimer: This reference is informational. Always verify timely filing limits against the contract or policy document for the specific payer plan and provider participation status. State-specific Medicaid and Workers Comp programs can have rules that override the published payer guidance.