Notes on payer behavior

Timely filing limits by payer: the deadlines Florida practices can't miss

Clearia · November 2026 · claims and deadlines · last checked against each source on November 7, 2026

A timely filing limit is the deadline to submit a claim after the date of service. Miss it and the claim comes back denied as CO-29, timely filing, and most contracts bar billing the patient, so the money is simply gone. Among the payers below, limits run from 90 days (Cigna, in network) to one year (Medicare).

This is the cheapest money a practice ever loses. Nothing was wrong with the care or the coding. The claim went out late, or it went out on time and nobody kept the proof. Here are the limits at the payers Florida practices bill most, each tied to the payer's own document or the statute.

Timely filing limits at a glance

Your provider agreement sits above every line in this table. If it gives you more time, use it. If it gives you less on a fully insured Florida plan, the statute sets the floor.

Florida's six-month floor, and who it covers

For fully insured health insurance in Florida, the statute says outpatient claims must be mailed or sent electronically to the primary insurer within 6 months after the date of service, counted once the provider has the patient's correct insurer name and address (§ 627.6131(3)). HMO business has the parallel rule in § 641.3155. In practice that means a fully insured claim filed on day 120 can survive a 90-day contract limit. Raise the statute in the reconsideration.

Two limits on the floor. It does not reach self-funded employer plans, where your agreement and the plan documents control. And a secondary claim gets its own clock: the same section allows 90 days to file with the secondary insurer after the primary's final determination. The statutory text, clause by clause, is in Florida provider payment rights.

Corrected claims and resubmissions run on the same clock

The fastest way to lose a claim you filed on time is to fix it late.

• Cigna: a resubmission Cigna didn't request, and that isn't filed as an appeal, is still subject to the filing limit (When to File). A corrected claim sent on day 100 can fail even if the original went in on day 10.
• UnitedHealthcare: corrected claims carry the same limit, counted from the date of service, as summarized in our UnitedHealthcare payer profile.
• Florida Blue: its manual says supplemental claims must go in within 180 days of the original E&M service.

How to prove you filed on time

Most timely filing denials that get reversed are won on paper, not argument. Keep the claim-level acceptance report from your clearinghouse for every claim. A batch acknowledgment only proves a file arrived, not that your claim was in it. UnitedHealthcare says plainly that rejected claims are not proof of timely filing, and that proof must show the claim was received and accepted inside your limit (2026 guide, pp. 135 to 136).

Medicare is the exception to keep in mind. A Medicare timely filing denial is not an initial determination, so it can't be appealed. The route that exists is a reopening for specific reasons, such as contractor error. The date math and the proof hierarchy are in our CO-29 timely filing note.

What this means for your practice

Timely filing losses cluster. They show up after a biller leaves, a clearinghouse switch, or a month of eligibility problems, and they arrive as a batch of CO-29s that nobody has time to sort. Three habits keep the money:

• Diary every claim against your shortest limit, which for most Florida practices is Cigna's 90 days.
• Pull the last 12 months of CO-29 denials. On fully insured Florida plans, anything filed within six months of the date of service may still be recoverable under the statute.
• Work a backlog by which payer's dispute window closes first, not by date of service. The windows are in our appeal deadlines table.