Fixed by regulation
Medicare Advantage plans are not bound by Medicare’s 12-month limit. Practices routinely assume they are and lose claims. MA plans set their filing limits by contract, and they are frequently far shorter.
Typical commercial ranges
Directional only, confirm each from your own contract.The three windows to record
Each payer has three deadlines, and they differ:
Record all three per payer when you sign the contract.
Proving you filed on time
Clearinghouse acceptance reports are the standard evidence. A 277CA showing payer acceptance on a specific date, or a clearinghouse transmission report, is what wins a CARC 29 appeal. A screenshot of your PM system showing “submitted” is not evidence — it proves you pressed a button, not that the payer received anything. Retain acceptance reports for at least the longest appeal window across your payer mix.The exceptions
Each has a documentation requirement. Assemble it with the appeal.
The guardrails that get write-offs to zero
1
Enter charges within one business day
The clock starts at the date of service.
2
Work rejections same-day
The most common cause of a timely-filing loss is a claim stuck in a rejection loop. A 277CA rejection means nothing was filed as far as the payer is concerned, while your system shows it as “submitted.” A rejected claim sitting for two months has consumed two months of a 90-day window.
3
Run a weekly no-acceptance report
Every claim submitted more than three days ago with no 277CA acceptance. This catches claims lost between your system and the payer, the failure nothing else surfaces.
4
Track held claims against their limits
Claims held during credentialing, awaiting authorization, or pending COB need an aging report with the deadline attached.
5
Set an internal deadline inside the contractual one
If the limit is 90 days, escalate anything unfiled at 45. The buffer absorbs the rejection loop.
6
Alert on approaching deadlines
Weekly, by payer.
7
Track timely-filing write-offs as a metric, targeting zero
Any non-zero number gets a root cause and a process change.
The grid template
Verify annually and on every contract renewal or amendment — unilateral amendment clauses mean a limit can change without your signature.
Sources
- Medicare timely filing: Social Security Act § 1842(b)(3)(B); 42 C.F.R. § 424.44. See CMS, Medicare Claims Processing Manual, ch. 1. Confirm current rules and any exception provisions with CMS.