Overview
Centene timely filing deadlines are set by each state's Medicaid contract, not by Centene corporate. Deadlines range from 90 to 365 days depending on the state and plan type. Missing the deadline results in an automatic CO-29 denial with limited recourse.
Key Requirements
- Filing deadlines are state-specific. Examples: Florida (Sunshine Health): 180 days. Georgia (Peach State): 365 days. Missouri (Home State Health): 180 days. Texas (Superior HealthPlan): 95 days.
- Corrected claims: typically must be filed within 90 days of the original remittance date.
- Secondary claims: file within the state deadline starting from the primary payer's EOB date.
- Electronic submission strongly recommended. Paper claims may have shorter deadlines in some states.
- Always check your state-specific provider manual for exact deadlines.
Timeline
Day 1: Date of service (deadline clock starts). Optimal: submit within 30 days. Mid-range: submit by day 90. Final window: varies by state (90-365 days). After deadline: CO-29 denial, no standard appeal. Exception requests only with documented proof of extraordinary circumstances.
Common Denials
| CARC Code | Reason | Primary Cause | Fix |
|---|---|---|---|
| CO-29 | Timely filing exceeded | Claim filed after state deadline | Submit within 30 days for safety |
| CO-4 | Coding inconsistency | Procedure/modifier mismatch | Run edits before submission |
| CO-18 | Duplicate claim | Claim already processed | Check status before resubmitting |
Appeals
CO-29 timely filing denials have limited appeal rights under Medicaid. File an exception request with documentation of the delay cause: payer system outage, retroactive eligibility, or incorrect member information provided. Each state handles exceptions differently.
FAQ
What is Centene's timely filing deadline?
There is no single deadline. Each state Medicaid contract sets its own filing limit. Check the provider manual for your specific Centene subsidiary (WellCare, Ambetter, Peach State, etc.) in your state.
Can I appeal a Centene CO-29 denial?
Standard appeals do not apply to timely filing denials. You can file an exception request with proof of extraordinary circumstances. Some states allow a state fair hearing if you can document that Centene or the state caused the delay.
Does Centene have different deadlines for corrected claims?
Yes, in most states. Corrected claims typically must be filed within 90 days of the original remittance date, even if the original filing deadline was longer.
Prevent These Denials
Altair tracks state-specific filing deadlines for every Centene plan and flags claims before they expire.