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

Humana enforces an initial claim timely filing deadline of 90 calendar days from Date of Service (Commercial); 365 days (MA).

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

Appeals and payment disputes with Humana must be filed within 180 calendar days from initial remittance notice date.

What is the secondary claim timely filing limit for Humana?

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

Humana Commercial / Medicare Advantage 90 Days Limit

Humana Timely Filing Limit & Appeal Deadlines

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

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 (Commercial); 365 days (MA)

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

2. Specific Filing Rules for Humana

Commercial network contracts require submission within 90 days of DOS.

Humana Medicare Advantage plans allow up to 365 days for initial claim filing.

Disputes and payment reconsiderations must be received within 180 calendar days.

3. Accepted Proof of Timely Filing

Official Proof Required by Humana

Availity / Humana gateway 277CA acceptance acknowledgment or certified mail receipt.

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

4. Appeal Letter Template for Humana

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: Humana
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 Humana, 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]