Every timely filing limit. One reference.
Filing deadlines and appeal windows for 118 commercial and government payers. 11 entries are free for everyone, including the 10 largest national payers and a generic BCBS baseline. The remaining 107 are included with any ROI Automation Suite license.
Last updated September 1, 2026. Reviewed and revised whenever a payer publishes a change.
| Payer | Timely Filing Limit | Days | Appeal Window | Source |
|---|---|---|---|---|
| AARP | 15 Months from Date of Service | 450 | 120 days from payment for disputes | View policy |
| Aetna | 120 Days from DOS | 120 | 180 calendar days from initial claim decision for reconsiderations/disputes | View policy |
| BCBS (generic baseline) | Commonly 180 days from DOS, varies by Blue Plan and product line. See specific plan rows below. | 180 | Typically 90-180 days; varies by plan | View example policy (BCBSIL) |
| Cigna | 90 Days for Participating Providers/180 Days for Non-par Providers | 90 | 180 calendar days from initial payment/denial notice | View policy |
| Humana | 180 Days for Physicians or 90 Days for facilities or ancillary providers | 180 | Provider claims disputes: 18 months from date of original claim determination | View policy |
| Medicaid | 90 days from DOS | 90 | Varies by state | View policy |
| Medicare (Part A/B) | 1Y or 365 Days from DOS | 365 | 120 days from receipt of initial determination | View policy |
| Tricare | 12 Months from DOS | 360 | 90 days from date of remittance advice | View policy |
| UnitedHealthcare Commercial | 90 days from DOS | 90 | Reconsideration within 60 days from remittance | View policy |
| Wellcare | 180 Days from DOS | 180 | 90 calendar days from EOP/claim denial/review decision | View policy |
| ABC IPA | 🔒 | 🔒 | 🔒 | License a module to view |
| Accountable Health | 🔒 | 🔒 | 🔒 | License a module to view |
| ADOC IPA | 🔒 | 🔒 | 🔒 | License a module to view |
| Advantage Care | 🔒 | 🔒 | 🔒 | License a module to view |
| Advantage Freedom | 🔒 | 🔒 | 🔒 | License a module to view |
| Aetna (HMO) | 🔒 | 🔒 | 🔒 | License a module to view |
| Alliance IPA | 🔒 | 🔒 | 🔒 | License a module to view |
| AMA | 🔒 | 🔒 | 🔒 | License a module to view |
| Ameri health ADM Local 360 | 🔒 | 🔒 | 🔒 | License a module to view |
| American Life and Health | 🔒 | 🔒 | 🔒 | License a module to view |
| American Progressive | 🔒 | 🔒 | 🔒 | License a module to view |
| Amerigroup | 🔒 | 🔒 | 🔒 | License a module to view |
| Amerihealth ADM TPA | 🔒 | 🔒 | 🔒 | License a module to view |
| AmeriHealth NJ & DE | 🔒 | 🔒 | 🔒 | License a module to view |
| Angeles IPA | 🔒 | 🔒 | 🔒 | License a module to view |
| Anthem (Coastwise) | 🔒 | 🔒 | 🔒 | License a module to view |
| Applecare IPA | 🔒 | 🔒 | 🔒 | License a module to view |
| Arbazo | 🔒 | 🔒 | 🔒 | License a module to view |
| Asian Community IPA | 🔒 | 🔒 | 🔒 | License a module to view |
| B/C HMO | 🔒 | 🔒 | 🔒 | License a module to view |
| B/C Medi-cal | 🔒 | 🔒 | 🔒 | License a module to view |
| Bankers Life | 🔒 | 🔒 | 🔒 | License a module to view |
| BeechStreet | 🔒 | 🔒 | 🔒 | License a module to view |
| Benefit Concepts | 🔒 | 🔒 | 🔒 | License a module to view |
| Benefit Trust Fund | 🔒 | 🔒 | 🔒 | License a module to view |
| Blue Advantage HMO | 🔒 | 🔒 | 🔒 | License a module to view |
| Blue Essential | 🔒 | 🔒 | 🔒 | License a module to view |
| Blue Premier | 🔒 | 🔒 | 🔒 | License a module to view |
| Bridgestone/Firestone | 🔒 | 🔒 | 🔒 | License a module to view |
| Caremore IPA | 🔒 | 🔒 | 🔒 | License a module to view |
| Champus | 🔒 | 🔒 | 🔒 | License a module to view |
| Cigna Health Springs (Medicare Plans) | 🔒 | 🔒 | 🔒 | License a module to view |
| Citrus | 🔒 | 🔒 | 🔒 | License a module to view |
| Coventry | 🔒 | 🔒 | 🔒 | License a module to view |
| Downey IPA | 🔒 | 🔒 | 🔒 | License a module to view |
| Evercare | 🔒 | 🔒 | 🔒 | License a module to view |
| Fire Fighter/Local 1014 | 🔒 | 🔒 | 🔒 | License a module to view |
| First Health | 🔒 | 🔒 | 🔒 | License a module to view |
| FMH | 🔒 | 🔒 | 🔒 | License a module to view |
| FRA | 🔒 | 🔒 | 🔒 | License a module to view |
| GHI- Group health Ins | 🔒 | 🔒 | 🔒 | License a module to view |
| Global IPA | 🔒 | 🔒 | 🔒 | License a module to view |
| Great West (AH&L) | 🔒 | 🔒 | 🔒 | License a module to view |
| Healthcare Partners | 🔒 | 🔒 | 🔒 | License a module to view |
| Healthnet HMO | 🔒 | 🔒 | 🔒 | License a module to view |
| Healthnet PPO | 🔒 | 🔒 | 🔒 | License a module to view |
| Horizon NJ Plus | 🔒 | 🔒 | 🔒 | License a module to view |
| ILWU | 🔒 | 🔒 | 🔒 | License a module to view |
| Karing Physicians | 🔒 | 🔒 | 🔒 | License a module to view |
| Keystone Health Plan East | 🔒 | 🔒 | 🔒 | License a module to view |
| Lakewood IPA | 🔒 | 🔒 | 🔒 | License a module to view |
| Local 831 Health | 🔒 | 🔒 | 🔒 | License a module to view |
| Magna Care | 🔒 | 🔒 | 🔒 | License a module to view |
| Mail Handlers Benefit Plan Timely Filing Limit | 🔒 | 🔒 | 🔒 | License a module to view |
| Marilyn Electro IND. Benefit Fund | 🔒 | 🔒 | 🔒 | License a module to view |
| Mega Life and Health | 🔒 | 🔒 | 🔒 | License a module to view |
| Memoria IPA | 🔒 | 🔒 | 🔒 | License a module to view |
| Memorial IPA | 🔒 | 🔒 | 🔒 | License a module to view |
| Monarch IPA | 🔒 | 🔒 | 🔒 | License a module to view |
| Motion Picture Ind | 🔒 | 🔒 | 🔒 | License a module to view |
| Mutual of Omaha | 🔒 | 🔒 | 🔒 | License a module to view |
| NASI | 🔒 | 🔒 | 🔒 | License a module to view |
| Nationwide Health | 🔒 | 🔒 | 🔒 | License a module to view |
| Northwest OC IPA | 🔒 | 🔒 | 🔒 | License a module to view |
| Omnicare IPA | 🔒 | 🔒 | 🔒 | License a module to view |
| One Healthplan | 🔒 | 🔒 | 🔒 | License a module to view |
| Operating Engineers | 🔒 | 🔒 | 🔒 | License a module to view |
| Pacificare PPO | 🔒 | 🔒 | 🔒 | License a module to view |
| Pioneer Medical Group | 🔒 | 🔒 | 🔒 | License a module to view |
| Polk Community Health Care | 🔒 | 🔒 | 🔒 | License a module to view |
| Principle Financial | 🔒 | 🔒 | 🔒 | License a module to view |
| Prospect Medical Group | 🔒 | 🔒 | 🔒 | License a module to view |
| PUP | 🔒 | 🔒 | 🔒 | License a module to view |
| Quality Health Plan | 🔒 | 🔒 | 🔒 | License a module to view |
| Secure Horizons | 🔒 | 🔒 | 🔒 | License a module to view |
| SMA | 🔒 | 🔒 | 🔒 | License a module to view |
| So. Ca Drug Benefit | 🔒 | 🔒 | 🔒 | License a module to view |
| Sun | 🔒 | 🔒 | 🔒 | License a module to view |
| Troa/mediplus | 🔒 | 🔒 | 🔒 | License a module to view |
| UFCW | 🔒 | 🔒 | 🔒 | License a module to view |
| UHC Community | 🔒 | 🔒 | 🔒 | License a module to view |
| Unicare | 🔒 | 🔒 | 🔒 | License a module to view |
| Union Fidelity | 🔒 | 🔒 | 🔒 | License a module to view |
| United Teacher Associates | 🔒 | 🔒 | 🔒 | License a module to view |
| Veterans Admin | 🔒 | 🔒 | 🔒 | License a module to view |
| Vista | 🔒 | 🔒 | 🔒 | License a module to view |
| Writers Guild Health | 🔒 | 🔒 | 🔒 | License a module to view |
| Zenith | 🔒 | 🔒 | 🔒 | License a module to view |
| BCBS FEP (Federal Employee Program) | 365 days from DOS for non-PPO claims; PPO providers follow plan contract | 365 | Member: 1 year from claim payment denial; Provider: per local Plan timely filing | View policy |
| Anthem Blue Cross (CA, IN, KY, ME, MO, NV, NH, OH, VA, WI, GA, CO, CT) | 🔒 | 🔒 | 🔒 | License a module to view |
| Anthem BCBS Indiana Medicaid | 🔒 | 🔒 | 🔒 | License a module to view |
| Highmark BCBS Pennsylvania / West Virginia (Commercial) | 🔒 | 🔒 | 🔒 | License a module to view |
| Highmark BCBS Delaware | 🔒 | 🔒 | 🔒 | License a module to view |
| Highmark Blue Cross Blue Shield New York | 🔒 | 🔒 | 🔒 | License a module to view |
| Highmark PA CHIP | 🔒 | 🔒 | 🔒 | License a module to view |
| BCBS Texas PPO (Commercial) | 🔒 | 🔒 | 🔒 | License a module to view |
| BCBS Texas HMO | 🔒 | 🔒 | 🔒 | License a module to view |
| BCBS Illinois (Commercial PPO / BlueChoice / BlueHPN) | 🔒 | 🔒 | 🔒 | License a module to view |
| BCBS Illinois Medicare Advantage PPO | 🔒 | 🔒 | 🔒 | License a module to view |
| BCBS Alabama (Commercial) | 🔒 | 🔒 | 🔒 | License a module to view |
| BCBS Alabama Blue Advantage (Medicare) | 🔒 | 🔒 | 🔒 | License a module to view |
| Florida Blue (BCBS Florida) | 🔒 | 🔒 | 🔒 | License a module to view |
| CareFirst BCBS (MD, DC, Northern VA) | 🔒 | 🔒 | 🔒 | License a module to view |
| BCBS North Carolina | 🔒 | 🔒 | 🔒 | License a module to view |
| Horizon BCBS New Jersey (Commercial) | 🔒 | 🔒 | 🔒 | License a module to view |
| Horizon NJ Health (Medicaid) | 🔒 | 🔒 | 🔒 | License a module to view |
| Premera Blue Cross (WA) | 🔒 | 🔒 | 🔒 | License a module to view |
| Premera Blue Cross Medicare Advantage | 🔒 | 🔒 | 🔒 | License a module to view |
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 Automation Suite 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.