> ## Documentation Index
> Fetch the complete documentation index at: https://mso.getlemma.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Beat timely filing limits

> Know each contract's limit, prove submission with clearinghouse acceptance reports, use the recognized exceptions, and build guardrails that drive timely-filing write-offs to zero.

**Timely filing** is the deadline by which a claim must reach the payer. Miss it and the claim is generally unpayable, CARC 29, with no clinical or coding defect involved. It is the most avoidable form of revenue loss in healthcare, and it should approach zero.

## Prerequisites

* Each payer's timely filing limit, recorded from the contract
* Clearinghouse acceptance reports retained
* A held-claims report

## Know your limits

Limits vary widely and are set by contract:

| Payer type             | Typical initial filing limit                      |
| ---------------------- | ------------------------------------------------- |
| **Medicare**           | 12 months from the date of service                |
| Medicaid               | State-specific; commonly 90 days to 12 months     |
| Commercial             | **Contract-specific; commonly 90–180 days**       |
| Workers' compensation  | State-specific                                    |
| Secondary / COB claims | Often measured from the primary's remittance date |

**Record every payer's limit in your tracking grid when you sign the contract**, not when you get a CARC 29. Some commercial contracts run 90 days, which is shorter than a credentialing gap and shorter than many appeal cycles.

There are also separate, usually shorter, windows for **corrected claims** and **appeals**. Record all three per payer. See [Timely filing limits by payer](/reference/payers/timely-filing-limits).

## Prove you filed on time

**Clearinghouse acceptance reports are the standard evidence.** A 277CA showing the payer accepted the claim on a specific date, or a clearinghouse report showing successful transmission, is what wins a timely filing appeal. A screenshot of your PM system showing "submitted" is not — it proves you pressed a button, not that the payer received anything.

Retain acceptance reports for at least the longest appeal window across your payers.

## The recognized exceptions

Where the deadline can be extended or excused:

| Exception                          | How it works                                                                                                                                                                            |
| ---------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **Proof of timely submission**     | The claim was filed on time; the payer lost or misprocessed it. Strongest argument.                                                                                                     |
| **Retroactive eligibility**        | Coverage was backdated after the service; the clock generally runs from when eligibility was established                                                                                |
| **Coordination of benefits delay** | The secondary's clock typically runs from the primary's remittance                                                                                                                      |
| **Payer error**                    | The claim was rejected in error and resubmitted promptly                                                                                                                                |
| **Provider enrollment delay**      | Where a retro-effective date was granted; ask how the payer measures filing from it                                                                                                     |
| **Catastrophic circumstances**     | Disaster, systems outage, payers sometimes grant relief. **The 2024 Change Healthcare outage led to widespread accommodations**, which is a precedent worth citing if it happens again. |

Each has a documentation requirement. Assemble it with the appeal.

## The guardrails

Getting timely-filing write-offs to zero is a process problem, not a diligence problem.

<Steps>
  <Step title="Enter charges within one business day">
    The clock starts at the date of service, not at charge entry. Every day of lag is a day of the window consumed.
  </Step>

  <Step title="Work rejections same-day">
    <Warning>
      **The most common cause of a timely-filing loss is a claim stuck in a rejection loop.** A 277CA rejection means the claim was never accepted, so as far as the payer is concerned, nothing was filed. A rejected claim sitting unworked for two months has consumed two months of a 90-day window while appearing "submitted" in your system.
    </Warning>
  </Step>

  <Step title="Run a no-acceptance report weekly">
    Every claim submitted more than three days ago with no 277CA acceptance. This is the report that catches claims lost between your system and the payer, the failure mode nothing else surfaces.
  </Step>

  <Step title="Track held claims against their limits">
    Claims held during credentialing, awaiting authorization, or pending COB resolution need an aging report with the deadline attached. See [Handle credentialing delays](/guides/enrollment/handle-credentialing-delays).
  </Step>

  <Step title="Set an internal deadline well inside the contractual one">
    If the limit is 90 days, escalate anything unfiled at 45. The buffer absorbs the rejection loop.
  </Step>

  <Step title="Alert on approaching deadlines">
    A daily or weekly report of unfiled claims within 30 days of their limit, by payer.
  </Step>

  <Step title="Track timely-filing write-offs as a metric">
    Target zero. Any non-zero number gets a root cause and a process change.
  </Step>
</Steps>

## Appealing a CARC 29

<Steps>
  <Step title="Find the proof">
    Clearinghouse acceptance report, 277CA, or transmission confirmation showing the original submission date.
  </Step>

  <Step title="Write the appeal">
    State the original submission date, attach the acceptance report, cite the contract's filing limit, and show the submission fell within it.
  </Step>

  <Step title="If there was genuinely no timely submission, check for an exception">
    Retroactive eligibility, COB delay, payer error, or a retro-effective enrollment date.
  </Step>

  <Step title="If neither applies, write it off, with a root cause">
    And fix the process that caused it. A timely-filing write-off with no process change will recur.
  </Step>
</Steps>

## Verify it worked

* [ ] Every payer's initial, corrected-claim, and appeal windows recorded
* [ ] Charges entered within one business day
* [ ] Rejections worked same-day
* [ ] Weekly no-acceptance report running
* [ ] Held claims tracked with deadlines
* [ ] Internal deadline set inside the contractual one
* [ ] Approaching-deadline alerts configured
* [ ] Acceptance reports retained for the longest appeal window
* [ ] Timely-filing write-offs tracked, targeting zero

## Common failure modes

| Failure                          | Consequence                               |
| -------------------------------- | ----------------------------------------- |
| Not knowing a payer's limit      | Discovering it via CARC 29                |
| Claim stuck in a rejection loop  | Window consumed while appearing submitted |
| No no-acceptance report          | Lost claims invisible                     |
| Charge entry lag                 | Window consumed before submission         |
| Held claims untracked            | They age out                              |
| No acceptance reports retained   | No proof; appeal fails                    |
| Writing off without a root cause | It happens again                          |


## Related topics

- [Submit clean claims](/guides/billing/submit-clean-claims.md)
- [Work the denial queue](/guides/billing/work-the-denial-queue.md)
- [File appeals](/guides/billing/file-appeals.md)
- [Claim denials, explained](/concepts/payments/claim-denials.md)
- [The life of a claim](/concepts/payments/claim-lifecycle.md)
- [Timely filing limits by payer](/reference/payers/timely-filing-limits.md)
- [CARC codes (Claim Adjustment Reason Codes)](/reference/edi/carc-codes.md)