What is Aetna's timely filing limit for initial claims?

Aetna enforces an initial claim timely filing deadline of 90 calendar days from Date of Service (standard network contract).

How many days do you have to appeal a denial with Aetna?

Appeals and payment disputes with Aetna must be filed within 180 calendar days from initial denial/EOB date.

What is the secondary claim timely filing limit for Aetna?

Secondary claims for Aetna must be submitted within 90 days from primary payer EOB date.

Aetna Commercial / Medicare Advantage 90 Days Limit

Aetna Timely Filing Limit & Appeal Deadlines

Official filing rules, submission windows, appeal timeframes, and acceptable electronic clearinghouse proof for billing Aetna.

Initial Claim Limit

90 Days from DOS

Secondary Claim Limit

90 Days from EOB

Level 1 Appeal Limit

180 Days

Level 2 Dispute Limit

60 Days

1. Initial Claim Submission Deadline

90 calendar days from Date of Service (standard network contract)

Clean electronic 837P or 837I claims must be received and acknowledged by Aetna within this window. If a claim is rejected on front-end clearinghouse validation (Level 2), it is not considered received by Aetna until corrected and successfully re-transmitted.

2. Specific Filing Rules for Aetna

Standard participating provider agreement enforces 90 days from DOS (some hospital agreements allow 120 days).

Claims returned for missing information must be corrected and resubmitted within the original 90-day window.

Level 1 Provider Reconsideration must be filed within 180 days of the EOB date.

Screenshots of internal billing software audit logs without clearinghouse gateway acceptance are rejected as proof.

3. Accepted Proof of Timely Filing

Official Proof Required by Aetna

EDI 277CA acceptance acknowledgment with Aetna Payer ID 60054 confirmation, or certified mail return receipt signed by Aetna mail intake.

Important: Screenshots from your internal billing software or electronic health record (EHR) showing the date a claim was created are not accepted by Aetna as proof of submission. You must supply clearinghouse 277CA acceptance reports.

4. Appeal Letter Template for Aetna

Use this standardized appeal letter to overturn a CO-29 timely filing denial when you have verifiable clearinghouse proof:

RE: Timely Filing Denial Appeal (CO-29)
Payer: Aetna
Patient Name: [Patient Name] | Member ID: [Member ID]
Date of Service: [Date of Service] | Claim ID: [Claim Number]
Billed Charges: $[Billed Amount]

Dear Appeals Coordinator,

We are submitting this formal appeal in response to the timely filing denial (CO-29) issued on the Explanation of Benefits dated [Remittance Date]. Under our participating agreement with Aetna, the timely filing limit is 90 calendar days from the date of service.

The original claim was electronically transmitted and received prior to the timely filing limit expiration. Enclosed please find Exhibit A: The clearinghouse Electronic Data Interchange (EDI) 277CA Claims Acknowledgment Report confirming successful gateway acceptance on [Date of Initial EDI Transmission] with Payer Claim Control Number [ICN / CCN].

Because this documentation constitutes conclusive objective proof of timely electronic submission, we respectfully request that the claim be reprocessed and approved for reimbursement.

Sincerely,
[Billing Manager / Practice Representative]
[Practice Name]
[Phone Number]