Indiana’s Medicaid Managed Care Entities also have a 90-day filing limit. The new 90-day requirement reflects Anthem’s commitment to “simplify processes, improve efficiencies, and better support coordination of care.” The change also aligns Anthem with other commercial payers, including Aetna, Cigna, and United Healthcare, all of whom have 90-day timely filing limits for claims. “One hundred eighty days has been the Anthem Blue Cross and Blue Shield (Anthem) standard since 2007,” the payer explained. ![]() In 2016, when some professional and ancillary provider contracts inadvertently included a 90-day filing limit, Anthem issued a blanket correction, confirming their 180-day filing limit at that time. Beginning October 1, 2019, all claims will be subject to a 90-day filing requirement, and according to the payer, “Anthem will refuse payment if submitted more than 90 days after the date of service.”įor years, Anthem’s timely filing limit has been 180 days. Medicaid, and Child Health Plus (CHPlus): claims must be received within 15 months, post-date-of-service.Commercial products: claims must be received within 18 months, post-date-of-service.Corrected claims must also be submitted within 120 days post-date-of-service unless otherwise specified by the applicable participation agreement.Claims where EmblemHealth is the secondary payer must be received within 120 days from the primary carrier’s EOB voucher date unless otherwise specified by the applicable participation agreement.Claims must be received within 120 days post-date-of-service unless otherwise specified by the applicable participation agreement.Anthem is changing their timely filing limit for professional claims. ![]() #Blue cross blue shield timely filing limit plus Providers who wish to appeal a claim denied for late submission should follow the provider grievance process in the Dispute Resolution chapters for the line of business: Medicare: claims must be received within 365 days, post-date-of-service. ![]() Participating providers: 1 year from date of remittance advice Highmark BCBS of Pennsylvania and West Virginia timely filing limit for filing claim as seconday payer: 365 Days from the Primary payer EOB dateĬarefirst Blue Cross Blue Shield timely filing limit - District of ColumbiaĬarefirst BCBS of District of Columbia limit for filing an initial claim: 365 days from the DOSĬarefirst Blue Cross Blue Shield of District of Columbia timely filing limit for reconsideration: 6 months from the orginal rejection notification notice of payment or electronic remittance adviceįlorida Blue timely filing limit - Floridaįlorida Blue timely filing limit for filing an initial claim: 180 days from the DOS Highmark Blue Cross Blue Shield of Pennsylvania and West Virginia timely filing limit for filing an initial claims: 365 Days from the Date service provided Highmark BCBS timely filing limit - Pennsylvania and West Virginia Highmark BCBS of Delaware timely filing limit for filing the claim as seconday payer: 120 Days from the Primary payer EOB dateīlue Cross Blue Shield timely filing limit - Mississippiīlue Cross Blue Shield of Mississippi timely filing limit for initial claim submission: December 31 of the calendar year following the year in which the service was renderedīCBS of Mississippi timely filing for appeal: 180 days from the date of denial Highmark Blue Cross Blue Shield of Delaware timely filing limit for filing initial claims: 120 Days from the DOS Highmark BCBS timely filing limit - Delaware Premera Blue Cross Blue Shield timely filing limit for Level 2 Appeal: 15 days from the date of Level 1 appeal decisionīlue Cross Blue Shield of Arizona Advantage timely filing limitīCBS of Arizona Advantage timely filing limit for filing an initial claims: 1 year from DOSĪnthem Blue Cross timely filing limit (Commercial and Medicare Advantage plan) Eff: October 1 2019Īnthem Blue Cross timely filing limit for Filing an Initial Claims: 90 Days from the DOS Premera Blue Cross Blue Shield timely filing limit for Level 1 Appeal: 365 from the date that prompted the dispute Premera BCBS of Alaska timely filing limit for filing an initial claims: 365 Days from the DOS Premera BCBS timely filing limit - Alaska Participating practitioners may not bill the patient for services that EmblemHealth has denied because of late submission.Anthem Blue Cross Blue Shield Timely filing limit 2019 - NamesĪnthem BCBS Time Limit for filing Claim or Appeal Reimbursement may be reduced by up to 25% for timely filing claims denials that are overturned upon successful appeal. ![]()
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