Timely filing · Medicaid managed care (Indiana)
Anthem Indiana Medicaid timely filing limit
Short answer
The Anthem Indiana Medicaid timely filing limit is 90 calendar days from the date of service, and Anthem Blue Cross and Blue Shield applies it to participating and nonparticipating providers alike, counting from the last date of service on the claim to the day Anthem receives it. The rule covers its Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect and Indiana PathWays for Aging members.
When Anthem pays second, the 90 days start on the other payer's RA date. A dispute is due within 60 calendar days of the EOB date, and a formal appeal within 60 calendar days of the dispute response. Compare other payers in the timely filing limits table.
Last reviewed by the Remitwright billing team. Editorial policy
The windows
- Initial claim
- 90 calendar days from the date of service for participating and nonparticipating providers, counted from the last date of service on the claim to the day Anthem receives it1
- Counted from
- Primary claims: the last date of service on the claim to the Anthem receipt date. Secondary claims: the date on the other payer's RA or EOP, or on its letter denying coverage. A claim first sent to the wrong carrier: the date of that carrier's denial letter or RA.
- Appeal
- A claim dispute on the Provider Dispute Resolution Request form within 60 calendar days from the date on the EOB, then a formal claims appeal within 60 calendar days from the date on the dispute response
- Corrected claim
- Send a replacement claim with frequency code 7, clearly marked Corrected, with the original claim number and every service line, so it is not denied as a duplicate. A void goes in with frequency code 8 and takes back the full payment.
- Verified
- , against the payer document in the sources
Your participation agreement can set a different window. Where the contract and the manual disagree, the contract applies.
A visit on Monday, March 2, 2026
Counting 90 days forward from a date of service of Monday, March 2, 2026 gives Sunday, May 31, 2026. That is the last day to file under the first limit shown above; a claim filed after it is outside the window unless one of the exceptions below applies.
Exceptions the payer allows
The claim went to the wrong carrier first
Anthem processes the claim without a timely filing denial when you have documentation that it was first filed on time and you send the corrected claim within 90 calendar days of the other carrier's denial letter or RA. The same applies when the wrong insurer paid and later recouped.
Retroactive eligibility
A claim denied after the filing limit qualifies for an exception when the member's eligibility is later made retroactive.
Authorization loaded after the denial
A claim denied for no authorization qualifies when the authorization has since been loaded, or the service no longer needs one.
EOB denial with no other coverage
A claim denied for a missing primary EOB when there is in fact no coordination of benefits qualifies, as do Anthem processing issues and other conditions FSSA sets in rule or policy.
Good cause or proof of timely submission
Anthem will review a claim denied for timely filing when you can provide documentation that it was submitted on time, or show that good cause exists for the delay.
What counts as proof of timely filing
- Documentation that the claim was submitted on time, which Anthem asks for before it reviews a timely filing denial
- For a claim first sent to the wrong carrier, proof of the timely original filing and that carrier's denial letter or RA, dated within 90 calendar days of your corrected claim
- For a secondary claim, the other program's RA or EOP, or its letter denying coverage, with every code on it explained
- Documentation that supports the exception you claim, such as notice of the member's retroactive eligibility or the authorization loaded after the denial
Notes for billers
- Anthem's fall 2026 seminar ranked claims submitted after the plan filing limit as its second-largest Indiana Medicaid denial by dollars, about $182k, for claims processed from January through July 2026.
- Anthem Medicaid is the payer of last resort. A paper claim that needs coordination of benefits is mailed back with a request to bill the other payer first, and an electronic one is denied with a code asking for more material.
- Disputes and appeals go through the Availity Payment Appeal Tool, which acknowledges the upload at once, or by mail to Anthem Blue Cross and Blue Shield, Provider Disputes and Appeals, P.O. Box 61599, Virginia Beach, VA 23466. Allow 60 calendar days for an adjustment, and follow up before 90.
- Anthem's two 2026 seminar decks start the 60-day dispute clock at different points: the denials deck counts from the date on the EOB, and the claims process deck from receipt of the RA. Counting from the date printed on the EOB keeps a dispute on time under either reading.
- Providers who contract with Anthem through an accountable care organization, participating medical group or independent physician association follow that group's claim submission guidelines.
- Carved-out services for managed care members are billed fee-for-service to Gainwell, or to Optum Rx for pharmacy, and the IHCP fee-for-service limit is 180 calendar days from the date of service, or from discharge for an inpatient claim.
FAQ
Questions about Anthem Indiana Medicaid deadlines
What is Anthem's timely filing limit for Indiana Medicaid claims?
How long do I have when Anthem is the secondary payer?
I billed the wrong plan first. Is the claim still timely with Anthem?
How do I dispute an Anthem Indiana Medicaid denial?
Does the 90-day limit apply to Indiana fee-for-service claims?
Does this page cover Anthem commercial or Medicare Advantage claims?
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