Timely Filing & Appeal Deadline Calculator

What are you calculating?

Date of service

Payer filing limit

Typical limits — your executed contract always controls. Use Custom for your exact number.

Custom limit (days)Example: 95

Common Timely Filing Limits (Verify Your Contract)

Payer type	Typical limit	Clock starts
Medicare	12 months (365 days)	Date of service
Medicaid	90–365 days (state-dependent)	Date of service, some states vary
Commercial PPO/HMO	90–180 days (some up to 365)	Date of service
UnitedHealthcare	90 days (typical)	Date of service
Cigna	90 days (typical)	Date of service
Aetna	120 days (typical)	Date of service
Humana	90 days (varies by plan type)	Date of service
BCBS plans	Plan-specific — commonly 180, ranges 90–365	Date of service
Anthem	90 days (varies by plan/state)	Date of service
Kaiser Permanente	90 days (typical)	Date of service
Ambetter (Centene)	120 days (typical)	Date of service
Molina Healthcare	90 days (varies by state/plan)	Date of service
WellCare	180 days (typical)	Date of service
TRICARE	365 days	Date of service
Secondary claims	Usually 60–180 days	Primary payer's EOB/remittance date, not DOS
Corrected claims / appeals	Often 90–180 days	Remittance date of the original denial

Treat this table as commonly cited defaults, not guarantees — the specific number in your executed contract or the payer's provider manual is the only answer that counts, and it can differ meaningfully from these industry-typical ranges.

Worked Example

A commercial claim with a 90-day filing limit and a date of service of April 1: the deadline is June 30 (90 days later). If today is June 20, that's 10 days remaining — inside the "urgent" window this calculator flags in red. If the claim hasn't been submitted by June 20, it needs to go out today, with same-day confirmation of clearinghouse acceptance, because a rejection on June 29 leaves no time to fix and resubmit before the wall.

The operational rule that makes this calculator boring: bill within 48–72 hours of the visit and work clearinghouse rejections daily — a rejected claim was never received, and the clock never stopped. If a deadline has already passed, our CO-29 guide and our longer timely filing limits guide cover the exceptions and appeal wording that still recover these claims.

Building a Deadline Tracking System That Actually Works

Practices that never lose a claim to timely filing all run some version of the same workflow, regardless of PM system:

Tag every claim with its filing deadline at charge entry — not after a denial, when it's too late to act on the information.

Run a weekly report filtered to claims inside 30 days of deadline — this catches slow-moving claims while there's still time to fix a rejection and resubmit.

Escalate anything inside 15 days to same-day action — no claim should sit in a queue once it's this close to the wall.

Archive clearinghouse acceptance reports systematically — they're the single most valuable document in a timely filing dispute, and searching for one after a denial wastes days you may not have.

None of this requires expensive software — a shared spreadsheet with a deadline column and a standing weekly review catches the vast majority of at-risk claims. The failure mode isn't a lack of tools; it's a lack of a standing process that runs whether or not anyone remembers to check. Practices that build this habit once rarely revisit it — the review becomes routine, and the deadline stops being a source of surprise denials.

Already denied? The appeal clock is a different clock — it runs from the remit date, not the date of service. Our appeal deadline calculator works that one out.

Post-operative claim denied as included in the surgical package? The global period calculator shows the window and the modifier that makes it separately payable.

The Appeal Clock Is a Different Clock

This is the most expensive misunderstanding in denial work, so it is worth stating plainly: your filing window runs from the date of service, but your appeal window runs from the date of the remittance advice. Two separate clocks measuring two separate things. Switch the calculator above to appeal mode and it counts from the remit instead.

The consequence catches people out constantly. A claim filed on day 5 and denied on day 80 has not used up 80 days of its appeal window — that window had not started. Equally, a claim that sat unworked for four months after denial may be past appeal even though the original filing was comfortably on time. Filing on time and appealing on time are unrelated achievements.

Typical Appeal Windows by Payer

Payer	Product	Typical appeal window
Medicare	Redetermination (level 1)	120 days from the initial determination
Cigna	First-level appeal	180 days from the remit
Humana	Commercial	60–180 days from the remit
Humana	Medicare Advantage	60 days from the remit
Aetna	Commercial reconsideration	60–180 days from the remit
UnitedHealthcare	Commercial	12 months typical
BCBS	Varies by local plan	180 days common

Appeal mode defaults to the shorter end of a published range. Where a payer states 60 to 180 days, the calculator uses 60. The two errors are not symmetrical: filing an appeal earlier than required costs nothing, while filing one day late loses the money outright. Use Custom for the exact window in your executed contract.

Appeal, Corrected Claim or Reconsideration — Pick the Right Route

Choosing wrong is a common way to miss a deadline, because a misrouted submission is usually returned unactioned rather than adjudicated — and the clock keeps running while it travels.

Route	Use it when	Clock runs from
Corrected claim	You got something wrong — wrong code, missing modifier, wrong place of service	The remit, under the correction window
Reconsideration	You want a second look using documentation you already have	The remit
Formal appeal	You disagree with a coverage or medical-necessity decision	The remit, or the reconsideration outcome

A useful test: if the documentation already supports what you billed and only the claim was wrong, that is a correction. If the documentation supports the service and the payer still says no, that is an appeal. CO-236 and CO-97 are frequently corrections; CO-50 medical-necessity denials are usually genuine appeals.

Medicare's Five Appeal Levels

Medicare fee-for-service runs a formal five-level structure defined in regulation, with fixed deadlines and a dollar threshold before the higher levels open. None of it is negotiable — the windows are identical for every provider.

Level	Decided by	Deadline to file
1. Redetermination	The MAC	120 days from the initial determination
2. Reconsideration	Qualified Independent Contractor	180 days from the redetermination
3. ALJ hearing	Administrative Law Judge	60 days — minimum amount in controversy applies
4. Appeals Council	Departmental Appeals Board	60 days
5. Federal district court	Federal court	60 days — higher threshold applies

Level 1 is where almost everything is won or lost. The redetermination is your best chance to submit supporting documentation and the cheapest stage to fight at. Appeals reaching an ALJ take a long time, and for most single professional claims the amount in controversy will not justify it.

What to Include So the Appeal Is Not Returned

The evidence the reason code asks for. Medical necessity needs the clinical note and the coverage criteria. Bundling needs the operative report showing the services were genuinely distinct. Eligibility needs proof of coverage on the date of service.

The claim identifiers. Claim number, member ID, dates of service and billed codes. Appeals get closed for being unmatchable more often than for being wrong.

A specific argument, not a general objection. Name the policy, the criterion met, and the page of documentation that proves it. Our appeal letter generator structures this.

Proof of submission. A dated clearinghouse acceptance report or certified-mail receipt — what wins a "we never received it" dispute months later, and it costs nothing at the time.

Frequently Asked Questions

When does the timely filing clock actually start?

For primary claims, on the date of service (discharge date for inpatient stays). For secondary claims, most payers count from the primary payer's EOB/remittance date. Corrected claims usually must still land within the original window — a denial does not restart the clock.

What counts as 'filed' — sent or received?

Received (or accepted). A claim sitting in your PM system or rejected at the clearinghouse was never received by the payer. Keep acceptance reports — they're your proof if a payer later claims non-receipt, and they win CO-29 appeals.

The deadline passed. Is the claim dead?

Not always. Proof of earlier timely submission, payer-caused delays (COB corrections, retroactive eligibility), and good-faith filing with the wrong payer all support exceptions at most plans. What's never allowed: billing the patient for a timely-filing write-off.

Where do I find the exact filing limit for a specific payer?

Your executed provider agreement's claims submission section, or the payer's published provider manual. Filing limits are contract terms, not universal rules, so a generic benchmark table is a starting point for estimation, not a substitute for the actual contract language.

Does resubmitting a corrected claim reset the timely filing clock?

No, at most payers. Corrected claims generally must still land inside the original filing window measured from the date of service — they don't get their own fresh countdown. Appeals of a denial do run on separate deadlines, typically 90-180 days from the remittance.

How far in advance should I track an approaching deadline?

Set alerts at 30 and 15 days remaining, not just at the deadline itself. That gives enough runway to fix a clearinghouse rejection and resubmit before the window closes — waiting until the final days leaves no room to recover from a bounced claim.

When does the appeal clock start - date of service or date of denial?

The date of the remittance advice, not the date of service. The initial filing window runs from the date of service, but the appeal window runs from the remit. A claim filed on day 5 and denied on day 80 has not used up 80 days of its appeal window - that window had not started yet.

What is the Medicare appeal deadline?

Level one, redetermination by the MAC, is due within 120 days of the initial determination. Level two, reconsideration by a Qualified Independent Contractor, is 180 days from the redetermination. Levels three through five each allow 60 days, with minimum amount-in-controversy thresholds applying from the Administrative Law Judge stage onward.

Can I use this as an insurance claim deadline calculator?

Yes. Timely filing is the insurance claim deadline - the last date a payer will accept a first-time claim for a given date of service. Enter the date of service and the payer, and the tool returns that deadline. Switch the mode selector to appeal and it returns the appeal deadline from the remittance date instead.

Is there a timely filing calendar for 2026?

A fixed calendar cannot work, because every payer counts from the date of service and every contract carries its own window - 90 days, 180 days, 365 days or a negotiated figure. A calculator is the correct form: it applies your payer's window to your specific date of service and returns the 2026 deadline for that claim rather than a generic chart.

Common Timely Filing Limits (Verify Your Contract)

Worked Example

Building a Deadline Tracking System That Actually Works

More Free Billing Tools & Guides

CO-29: Timely Filing Expired

Timely Filing Limits Guide

Appeal Letter Generator