OakClaim

Molina Healthcare Timely Filing Limit

Molina Healthcare allows 90–180 days (state/program-specific) for initial claim submission, counted from date of service.

Initial claims
90–180 days (state/program-specific)
Counted from
Date of service
Appeals
Commonly 60–90 days by state program
Category
National Commercial

Published default as of 2026 — individual participation agreements and plan documents override payer defaults. Always verify against your contract and the current provider manual.

What billers should know

Predominantly Medicaid/marketplace; each state program publishes its own manual and the Medicaid MCO contract often controls. Verify per state and line of business.

Missed the Molina Healthcare deadline?

  1. 1

    Pull your proof of timely submission — clearinghouse acceptance reports (277CA), payer portal submission logs, or EDI acknowledgments. If the claim was submitted in time and lost or rejected downstream, most payers must reopen it.

  2. 2

    The denial arrives as CO-29 — appeal with documentation, citing the original submission date and any payer-side errors (wrong member ID on file, retroactive eligibility, COB delays).

  3. 3

    If the miss is genuinely yours, write it off correctly: timely filing denials are a contractual adjustment — billing the patient for them violates most network agreements.

  4. 4

    Fix the root cause: charges should leave the door within 48–72 hours of the encounter, with a worklist for anything unbilled after 7 days.

OakClaim files every claim within 48 hours — no deadline math required.

Free audit shows how much late filing and unworked denials are costing you.

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Other National Commercial payers