What is Molina Healthcare's timely filing limit for initial claims?

Molina Healthcare enforces an initial claim timely filing deadline of 90 calendar days from Date of Service (some states 180 days).

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

Appeals and payment disputes with Molina Healthcare must be filed within 90 calendar days from the explanation of payment (EOP) date.

What is the secondary claim timely filing limit for Molina Healthcare?

Secondary claims for Molina Healthcare must be submitted within 90 days from primary EOB date.

Molina Medicaid & Marketplace 90 Days Limit

Molina Healthcare Timely Filing Limit & Appeal Deadlines

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

Initial Claim Limit

90 Days from DOS

Secondary Claim Limit

90 Days from EOB

Level 1 Appeal Limit

90 Days

Level 2 Dispute Limit

60 Days

1. Initial Claim Submission Deadline

90 calendar days from Date of Service (some states 180 days)

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

2. Specific Filing Rules for Molina

Standard professional timely filing limit is 90 days from DOS.

Appeals and reconsiderations must be received within 90 days of the EOP date.

Submitting after deadline without accepted proof triggers irreversible PR/CO write-off.

3. Accepted Proof of Timely Filing

Official Proof Required by Molina

Molina Portal claim confirmation or clearinghouse 277CA acceptance record.

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

4. Appeal Letter Template for Molina

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: Molina Healthcare
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 Molina Healthcare, 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]