Anthem Blue Cross Blue Shield Timely filing limit – BCBS TFL List

Anthem Blue Cross Blue Shield Timely filing limit 2019 - NamesAnthem BCBS Time Limit for filing Claim or Appeal
Premera BCBS timely filing limit - AlaskaPremera BCBS of Alaska timely filing limit for filing an initial claims: 365 Days from the DOS

Premera Blue Cross Blue Shield timely filing limit for Level 1 Appeal: 365 from the date that prompted the dispute

Premera Blue Cross Blue Shield timely filing limit for Level 2 Appeal: 15 days from the date of Level 1 appeal decision
Blue Cross Blue Shield of Arizona Advantage timely filing limitBCBS of Arizona Advantage timely filing limit for filing an initial claims: 1 year from DOS
Anthem Blue Cross timely filing limit (Commercial and Medicare Advantage plan) Eff: October 1 2019Anthem Blue Cross timely filing limit for Filing an Initial Claims: 90 Days from the DOS
Highmark BCBS timely filing limit - DelawareHighmark Blue Cross Blue Shield of Delaware timely filing limit for filing initial claims: 120 Days from the DOS

Highmark BCBS of Delaware timely filing limit for filing the claim as seconday payer: 120 Days from the Primary payer EOB date
Blue Cross Blue Shield timely filing limit - MississippiBlue Cross Blue Shield of Mississippi timely filing limit for initial claim submission: December 31 of the calendar year following the year in which the service was rendered

BCBS of Mississippi timely filing for appeal: 180 days from the date of denial
Highmark BCBS timely filing limit - Pennsylvania and West VirginiaHighmark Blue Cross Blue Shield of Pennsylvania and West Virginia timely filing limit for filing an initial claims: 365 Days from the Date service provided

Highmark BCBS of Pennsylvania and West Virginia timely filing limit for filing claim as seconday payer: 365 Days from the Primary payer EOB date
Carefirst Blue Cross Blue Shield timely filing limit - District of ColumbiaCarefirst BCBS of District of Columbia limit for filing an initial claim: 365 days from the DOS

Carefirst Blue Cross Blue Shield of District of Columbia timely filing limit for reconsideration: 6 months from the orginal rejection notification notice of payment or electronic remittance advice
Florida Blue timely filing limit - FloridaFlorida Blue timely filing limit for filing an initial claim: 180 days from the DOS

Appeals:
Participating providers: 1 year from date of remittance advice

Non participating providers submitting appeals for Medicare advantage denials: 60 days from the date of remittance advice
BCBS timely filing limit - HawaiiBlue Cross Blue Shield of Hawaii timely filing limit for initial claim submission: End of the calendar year following the year in which you received care
Blue Cross Blue Shield timely filing limit - LouisianaBlue Cross timely filing limit for filing an initial claims: 15 months from the DOS

Blue cross for OGB members - 12 months from the DOS

Appeals: 180 days from the denial date
Anthem Blue Cross Blue Shield timely filing limit - Ohio, Kentucky, Indiana and WisconsinAnthem BCBS of Ohio, Kentucky, Indiana and Wisconsin timely filing limit for filing an initial claims: 90 Days form the date service provided
Wellmark Blue Cross Blue Shield timely filing limit - Iowa and South DakotaWellmark BCBS of Iowa and South Dakota timely filing limit for filing an initial claims: 180 Days from the Date of service
Blue Cross Blue Shield timely filing limit - AlabamaBCBS of Alabama timely filing limit for filing an claims: 365 days from the date service provided

Blue Cross Blue Shield of Alabama timely filing limit for appeal: 180 days from the date you are notified
BCBS timely filing limit - ArkansasBlue Cross Blue Shield of Arkansas timely filing limit: 180 days from the date of service
Blue Cross timely filing limit - IdahoBlue Cross of Idaho timely filing limit for filing an claims: 180 Days from the DOS
BCBS timely filing limit - IllinoisBlue Cross Blue shield of Illinois timely filing limit for filing an claims: End of the calendar year following the year the service was rendered
BCBS timely filing limit - KansasBlue Cross Blue shield of Kansas timely filing limit for filing an claims: 15 months from the Date of service
Blue Cross timely filing limit to submit an initial claims - MassachusettsHMO, PPO, Medicare Advantage Plans: 90 Days from the DOS

Indemnity: 1 year from the DOS

If initially filed to an incorrect payer: 90 Days from the incorrect payer rejection date (Note: Claim should be submitted to other payer within 90 days)

If its secondary insurance: 1 year from the primary payer payment date

If its secondary insurance (Denied by primary payer (HMO, PPO, Medicare Advantage plan)): 90 days from the primary payer denial date

If its secondary insurance (Denied by primary payer (Indemnity Plan)): 1 year from the primary payer denial date
Blue Cross Complete timely filing limit - MichiganBlue Cross Complete timely filing limit for filing an initial claims: 12 months from the DOS or Discharge date

Resubmission or corrected claims: Must be resolved within 1 year from the DOS unless an exception exists as they follow MDHHS guidelines. (Please call customer care for exception details)

When its secondary payer: 120 days from the primary insurance letter or remittance date

Authorization decision:
Standard Appeal: 60 days from the date of denial
Expedited Appeal: 10 days from the date of denial

Utilization management decision (Standard Appeal): 30 days from the date of denial
Blue Cross Blue Shield Timely filing limit - MinnesotaBCBS of Minnesota Timely filing limit for filing an initial claim: 120 days from the DOS

Blue Cross Blue Shield Timely filing limit for filing as secondary claim: 120 days from the primary payer EOB date
BCBS timely filing limit - MontanaBlue Cross Blue Shield of Montana timely filing limit for filing an claim: 120 Days from DOS
Horizon BCBS timely filing limit - New JerseyHorizon Blue Cross Blue shield of New Jersey timely filing limit for filing an initial claims: 180 Days from the date of service
BCBS timely filing limit - New MexicoBlue Cross Blue Shield of New Mexico timely filing limit for filing an claims: 180 Days from the date of service

BCBS of New Mexico timely filing limit for submitting Appeals: 90 Days form the Remittance Advice/Provider Claim summary
BCBS timely filing limit - New YorkBlue Cross Blue Shield of Western New York timely filing limit for filing an claims: 120 Days from the Date of service

Blue Shield of Northeastern New York timely filing limit for filing an claims: 120 Days from the Date of service
Blue Cross Blue Shield timely filing limit - North CarolinaBCBS of North Carolina timely filing limit for filing an claims: December 31 of the calendar year following the year the service was rendered
Blue Cross Blue Shield timely filing limit - OklahomaBCBS of Oklahoma timely filing limit for filing an initial claims: 180 days from the Date of Service
BCBS timely filing limit - NebraskaBlue Cross Blue Shield of Nebraska timely filing limit for filing an initial claims: It depends on the plan, please check with insurance

Adjustments or revisions: 18 months from the date of the last payment

If its secondary payer: 120 days form the date provider receives the primary EOB
Capital Blue Cross timely filing limitFiling an initial claims: 12 months from the date of service
Independence Blue Cross timely filing limitFiling an initial claims: 120 Days from the date of service
Blue Cross Blue Shield timely filing limit - Rhode IslandBCBS of Rhode Island timely filing limit for filing an claims: 180 Days from the date of service

Non Participating Providers:
365 Days from the Date of Service

Appeals: 60 Days from the EOP date
BCBS timely filing limit - TennesseeBlue Cross Blue shield of Tennessee timely filing limit for filing an claims: 120 Days from the date of service
BCBS timely filing limit - Texas180 days from the DOS
Blue Cross Blue Shield timely filing limit - Vermont180 Days from the DOS

If its secondary payer: 180 Days from the Primary EOB date

Adjustments: 180 days from the date of original denial or payment
BCBS timely filing limit - WyomingBlue Cross Blue Shield of Wyoming timely filing limit for filing an initial claims: 12 months from the date of service

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