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Timely Filing Calculator

Pick the payer and enter the date of service. The calculator counts the days the way that payer counts them, and gives you the last day to file, to correct the claim and to appeal it.

The claim
For corrections and appealsoptional
Last day to file
Tuesday November 2, 2027
365 days left 0 of 365 days used
Nov 2, 2026 Nov 2, 2027

12 months, or 1 calendar year, after the date of service. Medicare has to receive the claim by then.

The other clocks on this claim
  1. Adjustment claim, Part A Tue, Nov 2, 2027

    in 365 days Inside the same 12 months. CGS, a Medicare contractor, says adjustment claims fall under the one year limit too.

  2. Reopening, to fix an error

    1 year from the date of the initial determination, for any reason.

  3. Redetermination

    120 days from receipt of the initial determination, which Medicare presumes is 5 days after its date.

  • A claim denied as late isn’t an initial determination, so it can’t be appealed. Four exceptions can extend the window.
Claim note 
Medicare: TFL 11/02/2027 (12 months from DOS 11/02/2026).

Every rule, quoted from the source: Medicare’s four exceptions, in the CO-29 guide

The limits behind each date

Every date comes from the payer’s own documents or from federal regulation, and the guides quote each rule with its source. Choose a plan in the table to load it into the calculator.

PlanFile withinClock startsCorrections and disputes
Medicare Medicare’s four exceptions, in the CO-29 guide
12 months Date of service. The Through date on an institutional claim that spans days Reopening: 1 year from the initial determination. Redetermination: 120 days from receipt of the notice
Cigna Healthcare Cigna timely filing guide
90 days Date of service, or the last day of a stay. As secondary, the primary payer’s processing date Corrections: the same clock. Appeal: 180 calendar days from the payment or denial notice
180 days Date of service, or the last day of a stay. As secondary, the primary payer’s processing date Corrections: the same clock. Appeal: 180 calendar days from the payment or denial notice
Aetna Aetna timely filing guide
Your agreement Date of service Reconsideration: 180 calendar days from the claim decision. Appeal: 60 calendar days from the reconsideration decision
12 months Date of service. Aetna doesn’t say, so the calculator counts from there Reconsideration: 180 calendar days from the claim decision. Appeal: 60 calendar days from the reconsideration decision
95 days Date of service Reconsideration: 180 calendar days from the claim decision. Appeal: 60 calendar days from the reconsideration decision
120 days Date of service Late claim right ends 365 days after the service. Reconsideration: 180 calendar days. Appeal: 60 calendar days after that
12 months Date of service Appeal: 65 days from the plan decision notice, with a signed Waiver of Liability
180 days Date of service, or discharge Corrections: the same 180 days. Reconsideration: 90 calendar days from the original determination
365 days Date of service, or discharge Revised processed claim: 730 days from the paid date
180 days Date of service, or discharge Revised processed claim: 180 days from the paid date. Dispute: 180 days from the paid date, then 90 calendar days for a second level
UnitedHealthcare UnitedHealthcare timely filing guide
Your agreement Date of service, discharge or final outpatient visit Corrections: the same window. Reconsideration and appeal: 12 months for both
Not published Ask UnitedHealthcare Payment dispute: 120 calendar days from the initial payment. Payment reconsideration: 60 days from the denial
90 days Date of service. As secondary, the primary payer’s EOB Reconsideration: 90 calendar days from the original EOB
180 days, or your agreement Date of service. As secondary, 60 days from the primary EOB or 180 from the date of service, whichever is later Reconsideration: within 90 days of the determination
Your agreement Date of service Corrections: 180 calendar days from the original remittance. Reconsideration: 60 calendar days from it
365 days Date of service Corrections: 180 calendar days from the original remittance. Reconsideration: 60 calendar days from it
Optum Optum behavioral health guide
90 days Date of service Corrections: 90 days from Optum’s receipt of the first claim. Clinical appeal: 180 days
90 days Date of service. As secondary, the primary payer’s EOB Reconsideration: 60 calendar days from the original EOB. Appeal: 60 days after a failed reconsideration
At least 90 days Date of service. As secondary, the primary payer’s payment or denial Not covered here
At least 180 days Date of service. As secondary, the primary payer’s payment or denial Not covered here
90 days, or your contract Date of service Reconsiderations and disputes: 60 days
UMR UMR timely filing guide
The shorter of the plan’s and your contract’s Date of service Corrections: inside the original limit. Member appeal: at least 180 days, on ERISA plans
VA Optum behavioral health guide
180 days Date care was provided Not covered here

How the days are counted

In calendar days, starting the day after. Ninety days after March 2 is May 31. That is how Cigna, Optum, UnitedHealthcare and Aetna count in their own examples. UnitedHealthcare’s, for one: a last date of service of May 1 and 90 days in the agreement means it must have everything, corrections included, by July 30.

Months count by the calendar. CMS’s own example gives a claim with a March 15 date of service until March 15 the next year. When the end month has no matching day, like February 29 in a year that isn’t a leap year, the calculator uses the last day of that month.

Weekends and federal holidays. When a Medicare claim deadline lands on one, Medicare moves it to the next workday, under 42 CFR 424.44. The other payers here don’t promise that, so the calculator shows the last workday before it. That is the day to aim for.

What counts as filed

The day the payer receives the claim, not the day you send it. A claim rejected at the clearinghouse never reached the payer, so it never stopped the clock.

Keep the 277CA for every claim. It is the payer’s own record that it accepted the claim, and when. The 999 from your clearinghouse only proves the clearinghouse got your file. The timely filing proof guide explains the difference, and the CO-29 guide covers a claim the payer says was late.

When your contract says something else

Your contract wins. UnitedHealthcare, Aetna in network and UMR leave the number to your agreement or the employer’s plan, so the calculator asks for yours and does the counting.

For a payer not listed, choose Another payer and enter the limit from your contract or the payer’s provider manual. Medicaid states set their own, up to the 12 month ceiling in 42 CFR 447.45.

What it leaves out

  • Medicare’s four exceptions, which can extend the claim window through the last day of the sixth month after an event. The CO-29 guide covers them.
  • Resubmissions the payer asked for. Cigna, for one, counts those as timely.
  • State laws beyond the ones listed. Aetna’s state exceptions, for example, give Arizona 1 year, Maryland 365 days and Georgia 24 months to dispute a payment on fully insured plans.
  • Every other Medicaid plan. Each state contract sets its own limits.

Sources

Each guide lists the rest of its sources.