Ambetter Timely Filing Limit

Ambetter Timely Filing Limit ListAmbetter Timely Filing Limit of :
1) Initial Claims
2) Reconsideration or Claim disputes/Appeals
3) Coordination of Benefits
Ambetter from Absolute Total Care - South CarolinaInitial Claims:
120 Days from the Date of Service

Reconsideration or Claim Disputes/Appeals:
60 Calender Days from the date of EOP or denial is issued

120 Business Days from the date the Primary EOP is issued.
Ambetter from Arizona Complete Health - ArizonaInitial Claims:
120 Days from the DOS (Participating Providers)
365 Days from the DOS (Non Participating providers)

Reconsideration or Claim Disputes/Appeals:
365 Calender Days from the date of EOP or denial is issued (Participating/Non Participating provider)

COB:
120 Business Days from the date the Primary EOP is issued (Participating Provider).

365 Business Days from the date the Primary EOP is issued (Non Participating Provider).
Ambetter from Arkansas Health & Wellness - ArkansasInitial Claims:
180 Days from the DOS (Participating Providers).
90 Days from the DOS (Non Participating providers).

Reconsideration or Claim Disputes/Appeals:
180 Calender Days from the date of EOP or denial is issued (Participating provider).
90 Calender Days from the date of EOP or denial is issued (Non Participating provider).

COB:
180 Days from the date the Primary EOP is issued (Participating Provider).
90 Days from the date the Primary EOP is issued (Non Participating Provider).
Ambetter from Buckeye Health Plan - OhioInitial Claims:
180 Days from the DOS (Participating Providers).
90 Days from the DOS (Non Participating providers).

Reconsideration or Claim Disputes/Appeals:
180 Calender Days from the date of EOP or denial is issued (Participating provider).
90 Calender Days from the date of EOP or denial is issued (Non Participating provider).

COB:
180 Days from the date the Primary EOP is issued (Participating Provider).
90 Days from the date the Primary EOP is issued (Non Participating Provider).
Ambetter from Coordinated Care - WashingtonInitial Claims:
180 Days from the DOS (Participating Providers).
90 Days from the DOS (Non Participating providers).

Reconsideration or Claim Disputes/Appeals:
24 months from the date of EOP or denial is issued (Participating/Non Participating provider).

COB:
30 months from the date the Primary EOP is issued (Participating/Non Participating Provider).
Ambetter from Home State Health - MissouriInitial Claims:
180 Days from the DOS (Participating Providers).
365 Days from the DOS (Non Participating providers).

Reconsideration or Claim Disputes/Appeals:
180 Days from the date of EOP or denial is issued (Participating/Non Participating provider).

COB:
180 Days from the date the Primary EOP is issued (Participating Provider).

365 Days from the date the Primary EOP is issued (Non Participating Provider).
Ambetter from Illinicare Health - IllinoisInitial Claims:
180 Days from the DOS (Participating Providers).
90 Days from the DOS (Non Participating providers).

Reconsideration or Claim Disputes/Appeals:
180 Days from the date of EOP or denial is issued (Participating provider).
90 Days from the date of EOP or denial is issued (Non Participating provider).

COB:
180 Days from the date the Primary EOP is issued (Participating Provider).
90 Days from the date the Primary EOP is issued (Non Participating Provider).
Ambetter from Magnolia Health - MississippiInitial Claims:
180 Days from the DOS (Participating Providers).
90 Days from the DOS (Non Participating providers).

Reconsideration or Claim Disputes/Appeals:
180 Days from the date of EOP or denial is issued (Participating provider).
90 Days from the date of EOP or denial is issued (Non Participating provider).

COB:
180 Days from the date the Primary EOP is issued (Participating Provider).
90 Days from the date the Primary EOP is issued (Non Participating Provider).
Ambetter from Managed Health Services - IndianaInitial Claims:
180 Days from the DOS (Participating Providers).
90 Days from the DOS (Non Participating providers).

Reconsideration or Claim Disputes/Appeals:
180 Days from the date of EOP or denial is issued (Participating provider).
90 Days from the date of EOP or denial is issued (Non Participating provider).

COB:
180 Days from the date the Primary EOP is issued (Participating Provider).
90 Days from the date the Primary EOP is issued (Non Participating Provider).
Ambetter from NH Health Families - New HampshireInitial Claims:
180 Days from the DOS (Participating Providers).
90 Days from the DOS (Non Participating providers).

Reconsideration or Claim Disputes/Appeals:
180 Days from the date of EOP or denial is issued (Participating provider).
90 Days from the date of EOP or denial is issued (Non Participating provider).

COB:
180 Days from the date the Primary EOP is issued (Participating Provider).
90 Days from the date the Primary EOP is issued (Non Participating Provider).
Ambetter from PA Health & Wellness - PennsylvaniaInitial Claims:
180 Days from the DOS (Participating Providers).
90 Days from the DOS (Non Participating providers).

Reconsideration or Claim Disputes/Appeals:
180 Days from the date of EOP or denial is issued (Participating provider).
90 Days from the date of EOP or denial is issued (Non Participating provider).

COB:
180 Days from the date the Primary EOP is issued (Participating Provider).
90 Days from the date the Primary EOP is issued (Non Participating Provider).
Ambetter from Peach State Health Plan - GeorgiaInitial Claims:
180 Days from the DOS (Participating Providers).
90 Days from the DOS (Non Participating providers).

Reconsideration or Claim Disputes/Appeals:
180 Days from the date of EOP or denial is issued (Participating provider).
90 Days from the date of EOP or denial is issued (Non Participating provider).

COB:
180 Days from the date the Primary EOP is issued (Participating Provider).
90 Days from the date the Primary EOP is issued (Non Participating Provider).
Ambetter from Silversummit Healthplan - NevadaInitial Claims:
180 Days from the DOS (Participating Providers).
90 Days from the DOS (Non Participating providers).

Reconsideration or Claim Disputes/Appeals:
180 Days from the date of EOP or denial is issued (Participating provider).
90 Days from the date of EOP or denial is issued (Non Participating provider).

COB:
180 Days from the date the Primary EOP is issued (Participating Provider).
90 Days from the date the Primary EOP is issued (Non Participating Provider).
Ambetter from Sunflower Health Plan - KansasInitial Claims:
180 Days from the DOS (Participating Providers).
90 Days from the DOS (Non Participating providers).

Reconsideration or Claim Disputes/Appeals:
180 Days from the date of EOP or denial is issued (Participating provider).
90 Days from the date of EOP or denial is issued (Non Participating provider).

COB:
180 Days from the date the Primary EOP is issued (Participating Provider).
90 Days from the date the Primary EOP is issued (Non Participating Provider).
Ambetter from Sunshine Health - FloridaInitial Claims:
180 Days from the DOS (Participating Providers/Non Participating providers).

Reconsideration or Claim Disputes/Appeals:
90 Days from the date of EOP or denial is issued (Participating/Non Participating provider).

COB:
90 Days from the date the Primary EOP is issued (Participating/Non Participating Provider).
Ambetter from Superior HealthPlan - TexasInitial Claims:
95 Days from the DOS (Participating Providers/Non Participating providers).

Reconsideration or Claim Disputes/Appeals:
120 Days from the date of EOP or denial is issued (Participating/Non Participating provider).

COB:
95 Days from the date the Primary EOP is issued (Participating/Non Participating Provider).
Ambetter of North Carolina IncInitial Claims:
180 Days from the DOS (Participating Providers).
90 Days from the DOS (Non Participating providers).

Reconsideration or Claim Disputes/Appeals:
180 Days from the date of EOP or denial is issued (Participating provider).
90 Days from the date of EOP or denial is issued (Non Participating provider).

COB:
180 Days from the date the Primary EOP is issued (Participating Provider).
90 Days from the date the Primary EOP is issued (Non Participating Provider).
Ambetter of TennesseeInitial Claims:
90 Days from the DOS (Participating Providers/Non Participating providers).

Reconsideration or Claim Disputes/Appeals:
180 Days from the date of EOP or denial is issued (Participating provider).
90 Days from the date of EOP or denial is issued (Non Participating provider).

COB:
90 Days from the date the Primary EOP is issued (Participating/Non Participating Provider).

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