Timely Filing

Timely filing is the deadline by which a claim must be submitted to a payer in order to be considered for payment. Missing the deadline results in CARC CO-29 (timely filing) — a permanent denial that is rarely overturnable regardless of the underlying merit of the claim. Each payer publishes its own timely filing window: Medicare allows 365 days from the date of service, UnitedHealthcare 90 days for in-network commercial claims (180 for out-of-network), Aetna 90 days, BCBS varies by state plan from 90 to 365 days, Cigna 90 days, and most Medicaid programs 95-180 days depending on state. Workers' compensation carriers and motor vehicle insurance often have shorter windows (30-90 days). Once the timely filing deadline passes, the right to bill the claim is forfeited — even appeals filed after the original timely filing window cannot resurrect the claim. The fix is process: daily claim submission instead of weekly batches, day-14 status checks on every claim that has not been adjudicated, and a workflow that flags any claim approaching 75% of its timely filing window for immediate action. Practices that submit claims weekly instead of daily systematically lose 1-3% of revenue to CO-29 denials on edge cases — claims that needed corrections, claims missing prior auth that took weeks to resolve, claims tied up in eligibility issues that aged past the deadline before anyone realized.