Timely filing
Timely filing is the deadline by which a payer must receive a claim. Miss it and the claim is denied on the date alone, whatever its merits.
Updated
Timely filing is the window within which a payer requires a claim to be received, measured from the date of service or discharge. A claim received after the window closes is denied for that reason alone — the coding, the documentation, and the medical necessity are never reached.
The length of the window is set by the payer, in its policy or in the provider contract, and it varies. There is no single industry deadline, so the applicable window is always the one in the agreement with that specific payer.
In practice
Timely-filing denials are the most preventable category and among the least recoverable, because the defense is documentary: proof that the claim was received inside the window. Where a claim was submitted on time and the payer has no record of it, the clearinghouse acknowledgement is the evidence — which is why those acknowledgements are worth retaining.
A separate, often shorter clock governs appeals, and it runs from the payer's decision rather than the date of service. Meeting one deadline says nothing about the other.
Commonly confused with
- Appeal deadline: Timely filing governs when the original claim must arrive; the appeal deadline governs how long after a denial the decision can be contested.