Anthem Elevance Timely Filing Limits

Overview

Anthem Elevance sets a 180-day timely filing deadline from the date of service for most commercial plans. State-specific BCBS plans under the Anthem umbrella may have shorter windows. Missing the deadline triggers an automatic CO-29 denial with no appeal rights.

Key Requirements

  1. Standard deadline: 180 days from date of service for commercial plans.
  2. Medicare Supplement: follows Medicare's 365-day filing limit.
  3. Corrected claims: 180 days from the original remittance date.
  4. State variations: California (90 days for HMO), New York (120 days for some plans). Always check the member's specific plan.
  5. Secondary claims: 180 days from the primary payer's EOB date.

Timeline

Day 1: Date of service. Days 1-30: Submit claim for fastest processing. Days 31-120: Standard submission window. Days 121-180: Final filing window. Day 181+: Automatic CO-29 denial. After denial: No standard appeal for timely filing. Exception requests only with proof of extraordinary circumstances.

Common Denials

CARC Code Reason Primary Cause Fix
CO-29 Timely filing deadline exceeded Claim submitted after 180 days Submit within 90 days for safety margin
CO-45 Charges exceed fee schedule Billed amount above contracted rate Verify fee schedule before billing
CO-16 Claim differs from submitted information Data mismatch with authorization Verify all claim fields match auth

Appeals

CO-29 denials for timely filing have limited appeal options. Submit an exception request within 365 days of the denial notice. Include proof that a system outage, payer error, or natural disaster caused the late filing. Anthem reviews exceptions case-by-case with no guaranteed overturn.

FAQ

Can I appeal an Anthem CO-29 timely filing denial?

Standard appeals do not apply to timely filing denials. You can submit an exception request with documented proof of extraordinary circumstances: payer system outages, incorrect member ID provided by the patient, or retroactive eligibility changes.

Does Anthem's 180-day limit apply to all plan types?

No. Medicare Supplement plans follow the 365-day Medicare deadline. Medicaid managed care plans under Anthem follow state Medicaid rules. Always verify the member's specific plan type before assuming the 180-day window.

What counts as the filing date for Anthem claims?

The date Anthem receives the claim, not the date you submit it. Electronic claims count as received the same day. Paper claims count as received on the date Anthem logs them, which can be 3-5 days after mailing.

Prevent These Denials

Altair flags claims approaching timely filing deadlines before they expire.

Related Resources

This reference is current as of 2026-03-23. Payer policies change. Always verify against the payer's latest policy documentation.
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