Wellpoint Timely Filing Limit 2026: Deadlines by State, Plan, and Contract

Key filing deadlines at a glance

• Initial claim submission: 90 days to 12 months. Clock starts at the date of service. Governed by Policy G-06050.
• Corrected claims: 120 days to 12 months. Clock starts at the date of service or the last payment notification, depending on the state. Governed by Policy G-16001.
• Claim payment appeals: 90 to 120 days on most markets. Clock starts at the Explanation of Payment date or the adverse determination. Governed by the state provider manual.
• Secondary insurance and coordination of benefits: Same limit as the initial claim. Clock starts at the other carrier's Explanation of Payment date. Governed by Policy G-06050.

Every figure below is traced to a Wellpoint policy number and its effective date. Where two official documents disagree, both appear.

Why Google Says 365 Days and Bing Says 90 Days

Run this search on two engines and you'll get two different answers. Google's AI Overview returns roughly 365 days. Bing Copilot returns 90 days for participating providers and 12 months for nonparticipating. Both cite wellpoint.com.

Both are quoting real Wellpoint documents. Neither one is a national rule.

Sources: Washington provider orientation and Wellpoint claims timely filing policy.

Google's number is real. It's also scoped to a single Washington new provider orientation deck published in March 2024, which is a training document rather than a reimbursement policy.

There's a giveaway sitting in Google's own answer. It references HCA guidelines without ever expanding the acronym, because HCA is the Washington State Health Care Authority. That deck says plainly that Wellpoint follows HCA billing guidelines for Medicaid claims. A state agency abbreviation ended up inside what reads as a national answer.

Bing's number is also real, and it's the better of the two. It comes from the Medicare Advantage reimbursement policy, which is why it carries a participating and nonparticipating split. Google's answer has no split at all, and that split is the whole structure of the policy.

Here's what that means for you. Both engines are quoting genuine policy. Neither is quoting the number that applies to the claim sitting in your queue right now.

Wellpoint, Amerigroup, Anthem, and Elevance Health: Which One Is on the Claim

The name on the card, the name on the remittance, and the name on the provider manual don't always match. That gap is where teams pull a deadline from the wrong document and never realize it.

Getting this wrong costs real days. File a Wellpoint payment dispute on an Anthem dispute form and it lands in a different queue at a different company. It comes back eventually. The clock doesn't stop while it travels.

Then there's the legacy chart problem. Payer reference tables all over the internet still list Amerigroup timely filing limit as a flat 90 days participating and 12 months nonparticipating. That pairing is genuine, but it belongs to the Medicare Advantage policy. Drop the 12-month nonparticipating figure on a Texas Medicaid claim and you're 270 days past the real deadline.

I'm a billing manager at MedSole RCM billing team, and this payer comes up constantly on our accounts. MedSole RCM runs full-service medical billing at 2.99% of monthly collections and provider credentialing at $99 per insurance enrollment, with no setup fee and no long-term contract.

Providers touch Wellpoint through two separate systems. Enrollment is one, and our Wellpoint provider enrollment guide covers that side. Claims filing is the other, and that's what the rest of this page handles.

Wellpoint Timely Filing Limits 2026 by State and Line of Business

Find the row that matches your product and state. Check the clock-start column before you look at the day count, because two rows showing the same number can land in completely different weeks.

Every row above is taken from a Wellpoint Claims Timely Filing reimbursement policy carrying Policy Number G-06050. Each state publishes its own edition at provider.wellpoint.com plus the two-letter state code. Where a market is not listed here, pull that state's G-06050 rather than assuming a neighboring state's figure applies.

One row deserves a flag. Texas is a single state carrying four different windows inside one Medicaid program, and the difference between 95 and 365 days comes down to whether the claim is a nursing facility unit rate claim or a nursing facility add-on service.

If you've got Wellpoint claims sitting past the halfway mark of any of these windows, that's the queue worth pulling first.

How Wellpoint Calculates the Filing Clock

Wellpoint publishes its own math, and it's a three-step hierarchy rather than a single number. Understanding the order matters, because the published timely filing limits are the last thing checked, not the first.

1. Subtract the date of service from the date Wellpoint receives the claim. Receipt date, not transmission date.
2. Compare that number to the applicable federal or state mandate. If a mandate exists, the mandate controls.
3. Only if no mandate applies, compare it to the health plan standard. The published figure is the fallback.

Source: Iowa proof of timely filing policy, Policy G-06133, and the parallel G-06050 policies.

Limits run on calendar days unless a policy says otherwise. That sounds minor until a 95-day Texas window ends on a Saturday and your batch goes out Monday. Nobody gets those two days back.

The receipt gap is what catches most teams. Your system logs the day you hit send. Wellpoint logs the day the claim arrives.

A clearinghouse holding a batch overnight, a rejection nobody worked for three days, a resubmission that took a week to correct, all of it burns against the Wellpoint timely filing limit while your records still show the claim as sent.

Wellpoint Medicare Advantage Timely Filing Limit

The Wellpoint timely filing limit for Medicare Advantage is 90 days from the date of service for participating providers and facilities, and 12 months from the date of service for nonparticipating providers and facilities. That standard can be overridden by your provider agreement, or by a state, federal, or CMS requirement.

Now the mistake that costs the most money on this payer. Original Medicare gives you one calendar year from the date of service under federal regulation. A Medicare Advantage plan runs on a private contract instead, and Wellpoint's contract says 90 days.

Apply the Medicare TFL limit of 12 months to a participating Wellpoint Medicare Advantage claim and you're nine months past the real deadline. Our Original Medicare filing rules guide covers the federal side.

There is 2026 movement on the corrected claims side too. The Medicare Advantage corrected claims policy carries a January 1, 2026 approval and effective date, and its policy history logs South Carolina and West Virginia Medicare Advantage entering on that same date.

If you bill either of those markets, the Wellpoint TFL limit you set up in 2025 may no longer be the current one.

Source: Medicare Advantage corrected claims policy, Policy G-16001.

Wellpoint Medicaid Timely Filing Limits by State

Medicaid is where the Wellpoint timely filing limit stops being one number. State Medicaid agencies write their own contracts, so a plan operating in eight states is operating under eight sets of filing rules. The policy number stays the same. The day count doesn't.

New Jersey Medicaid timely filing

New Jersey runs 180 days for participating and nonparticipating providers alike, counted from the last date of service in the course of treatment. That last-date-of-service wording matters on any episode spanning multiple visits, because the clock starts at the end of treatment, not the beginning.

Source: New Jersey Medicaid claims timely filing policy, Policy G-06050, effective June 3, 2025.

If you are still working through New Jersey enrollment, our New Jersey Medicaid enrollment guide walks the application side.

Maryland Medicaid timely filing

Maryland gives participating providers 180 days from the date of service. Nonparticipating providers get 180 days as well, with one carve-out: undisputed claims where the member self-referred run on a six-month window. Read your denial letter carefully, because those two figures are close enough that a plan can apply the shorter one without it being obvious.

Source: Maryland Medicaid claims timely filing policy, Policy G-06050, effective June 3, 2025.

Texas Medicaid timely filing

Texas is the one that catches people. A single state carries four separate windows, which is why Medicaid Texas timely filing limit searches return conflicting numbers depending on which page you land on. All four figures below come from the same policy.

Source: Claims Timely Filing, Policy G-06050, Texas Medicaid edition, effective June 3, 2025.

Texas also publishes a rule almost nobody uses, and it's worth money. If you first submit a claim to the wrong health plan inside the 95-day period and you can produce documentation of that filing, you may resubmit to the correct plan within 95 calendar days of the denial date from the wrong plan.

That's a second window, and it only exists if you kept the proof. Our Texas Medicaid enrollment steps guide covers getting set up in the first place.

Iowa, Tennessee, Washington, and other Medicaid markets

Each remaining market publishes its own G-06050 edition, and I'm not going to hand you a number I haven't pulled from the current policy. What I can tell you is where to get it yourself.

Go to provider.wellpoint.com, add the two-letter state code, then open Claims and Reimbursement Policies. Filing sits under Reimbursement Administration, General. Our Iowa Medicaid enrollment guide covers the Iowa Health Link and Hawki enrollment path.

Washington is the market behind most of the confusion online, so it's worth separating what's documented from what's assumed. Wellpoint's Washington new provider orientation, dated March 2024 and covering both Medicaid and Medicare Advantage, publishes these figures:

• Initial claim submission: 365 days from the date of service
• Corrected claim submission: 365 days from the date of service
• Rejected claim resubmission: 365 days from the date of service
• Coordination of benefits claims: 365 days from the other carrier's EOP date

Source: Washington new provider orientation, March 2024. This is an orientation document, not a reimbursement policy. Confirm against your executed contract.

Treat these as Washington figures from a training deck rather than a national standard. That distinction is the whole reason the wrong number spread.

It's also the exact document Google's AI Overview is currently reading, which is how a timely filing medicaid figure for one Washington program became a national answer.

One more thing on Medicaid generally. A deadline you learned on a different Texas managed care organization doesn't transfer. Superior Health Plan timely filing limit rules are Superior's rules. Wellpoint STAR+PLUS runs on the policy above, and the two are separately published.

If you bill Wellpoint in more than one state, these stop being memorizable somewhere around the third market. That's the point where a filing matrix stops being nice to have.

Wellpoint Commercial and Individual Plans: Why There Is No Published Number

Search for a commercial Wellpoint timely filing limit and you'll come up empty. That's not a gap in your research. Wellpoint's commercial and individual provider manuals do not publish a universal day count. They point you to the timeframe specified in your Provider or Facility Agreement.

Florida commercial operates through Simply Healthcare Plans doing business as Wellpoint Florida, and its provider manual carries that same contract-based language. Massachusetts reads the same way.

The number exists. It just lives in your contract instead of on a website.

Three things to do about that:

• Pull the timely filing clause out of your executed agreement and save it as a dated excerpt.
• Store it where your billing team can reach it without requesting the full contract from legal.
• Record the agreement date next to the figure, because a renegotiated contract changes the window.

A provider with no Wellpoint agreement at all has no contractual filing period to read, which changes what recovery looks like on a late denial. That situation usually calls for a different conversation entirely, and our single case agreements guide covers how those get structured.

Wellpoint Corrected Claim Timely Filing Limit

A corrected claim has to land inside the applicable window, and the Wellpoint timely filing limit for corrected claims depends on both the product and the state. Corrected claims run under their own policy number, G-16001, separate from the initial claim policy.

Source: Corrected Claims, Policy G-16001, including the Texas Medicaid corrected claims policy.

Look at the Texas and Tennessee rows together. Both moved to 120 days from the last payment notification with the same October 6, 2025 approval and effective date. That's a coordinated refresh across markets, and it changed the corrected-claim clock from a date-of-service measure to a remittance-date measure in both states.

The practical effect is bigger than it sounds. A date-of-service clock is fixed the day you see the patient. A remittance-date clock doesn't start until Wellpoint sends the EOP, which means the window opens and closes entirely inside your posting workflow.

Two corrected-claim rules that generate denials on their own

Frequency codes. Wellpoint publishes its own definitions: 1 for an original claim, 7 for a replacement of a prior claim. Paper corrections must be marked Corrected Claim in writing. Electronic corrections must carry the frequency code. Miss either one and the system reads it as a duplicate. Our resubmission code 7 guide covers the mechanics.

No batching. Corrected claims must be submitted separately for each member and each episode of care. Wellpoint's policy states plainly that they cannot be accepted by batch, bulk, or packaged submissions. Practices that fix a systemic coding error across 40 claims and push them in one file usually find out the hard way.

Here is where posting speed turns into a filing problem. If your team posts remittances once a week in Texas or Tennessee, you have already spent up to seven of your 120 days before anyone knows a correction is needed. Same-day payment posting and reconciliation isn't a bookkeeping preference on these two markets. It's what keeps the correction window usable.

When Wellpoint Is the Secondary Payer

When the member has other health insurance that is primary, the Wellpoint timely filing limit counts from the date of the other carrier's Explanation of Payment, not from the date of service. That language appears in every G-06050 edition I pulled, across every product line.

This is a protection, and most teams underuse it. A claim that sat 90 days at the primary carrier has not burned 90 days of your Wellpoint window. Your clock hadn't started yet.

It only holds up if the primary EOP is in the file with its date visible. Keep three things:

• The primary carrier's EOP or remittance showing the determination date
• The date your office received that determination
• The qualifying event named in your agreement, since the wording varies by market

Texas dual products measure from the third-party response rather than a standard commercial EOP. Those aren't the same event, and on a 95-day window the difference isn't academic.

What Wellpoint Accepts as Proof of Timely Filing

Most billers treat a Wellpoint timely filing limit denial as final. Wellpoint's own policy says otherwise. The plan will reconsider a claim that was not accepted for timely filing when the provider can either supply a compliant date of claim receipt or demonstrate that good cause exists.

That's a written reconsideration path with published criteria, not a favor you talk someone into.

Source: Wellpoint proof of timely filing policy, Policy G-06133.

What counts as proof, and what does not

Wellpoint names accepted and rejected evidence explicitly. This is the part that surprises people, because two methods most practices rely on are named as not acceptable.

Read that right column again. If your timely filing appeal packet has been leaning on a fax confirmation sheet, Wellpoint's policy already told you it won't carry the argument.

The mailed claim log has 12 required fields

For mailed claims, the return receipt alone isn't enough. Wellpoint requires a claim log carrying all of the following:

• Name, address, telephone number, and federal tax identification number of the claimant
• Name of addressee, name of carrier, and the designated address
• Date of mailing
• Subscriber name and subscriber ID number
• Member's name
• Dates of service or occurrence, total charge, and delivery method

The six grounds for good cause

Good cause is the second path, and Wellpoint publishes the qualifying circumstances rather than leaving it to discretion. A filing delay may qualify when it was caused by:

• Administrative error, meaning incorrect or incomplete information furnished by official sources
• Retroactive enrollment, where the member was later notified of coverage effective on or before the date of service
• Incorrect information from the member that led you to bill another plan, Original Medicare, or state Medicaid
• Unavoidable delay securing supporting documentation from third parties, despite reasonable effort
• Unusual or unavoidable circumstances beyond your control where you could not reasonably have known to file
• Destruction or damage of your records, unless you caused it through a willful act or oversight

Wellpoint decides good cause primarily on the explanation attached to the claim. If the evidence raises doubt, the plan contacts you for clarification before deciding. Attaching the explanation up front is the difference between a decision and a phone tag cycle.

The gap that costs practices real money is the difference between a claim leaving your system and Wellpoint accepting it. Those are two separate events, and only the second one stops the clock. A file-level acknowledgment tells you a batch arrived somewhere. Payer-level EDI acknowledgment tracking tells you Wellpoint took the claim into adjudication.

Save the acknowledgment the day the claim goes out, not the day the denial arrives. Eight months later, nobody can reconstruct which reconciliation report covered which batch. Our guide to clearinghouse acceptance reports covers which report actually proves receipt.

What to Do When Wellpoint Denies a Claim as CO-29

CO-29 means the time limit for filing has expired. The CO prefix stands for contractual obligation, which is why a contracted provider absorbs the write-off instead of billing the member for it.

A missed Wellpoint timely filing limit is one of the few denials with no clinical argument available. Medical necessity doesn't matter. Documentation quality doesn't matter. The claim is denied on the receipt date and nothing else.

Three reasons a CO-29 lands, and what each one means

Genuine late filing. The claim reached Wellpoint after the window closed. Without documented good cause, this is usually a write-off. Prevention is the only real protection here.

Filed on time, no payer record. A clearinghouse rejection stopped the claim before adjudication while your system showed it as sent. The window kept running. This one is recoverable if you have a payer-level acknowledgment.

Wrong window applied. Somebody calendared a national figure against a state Medicaid claim, or a Medicare Advantage figure against a Medicaid product. Check the actual policy before you write it off, because the claim may still be inside its real window.

Rejected is not the same as denied

This distinction decides whether you correct or dispute, and getting it backward wastes the days you have left.

A rejection isn't a denial, and a 277 acknowledgment showing a rejection is your evidence that the claim never landed. Our CO-16 denial code guide covers the adjacent code that generates the most confusion with this one.

Order of operations after a CO-29

1. Confirm which window actually applied, using the product and state, not a general chart.
2. Pull the transmission and acceptance history from your clearinghouse reconciliation report.
3. Assemble the proof package against the G-06133 criteria above.
4. Decide the route: a correction fixes claim data, a reconsideration disputes a decision.
5. Submit through Availity Essentials or the written channel for that market.
6. Calendar the next-level deadline before the first response comes back.

Step four is where money gets lost. Resubmitting a corrected claim against a CO-29 does nothing. A correction fixes billing data. A CO-29 is a payment determination you're disputing. Sending a replacement burns days without ever touching the decision.

When the same CO-29 keeps appearing across one payer, the problem sits upstream of the claim. Root-cause denial management services work the denial and then fix the workflow that produced it, so the pattern stops instead of repeating next month.

Building the reconsideration packet is its own job. Our team handles appeal package preparation with the payer-specific evidence each policy actually requires.

MedSole RCM prices standalone denial management at 4.49% of what gets recovered, or includes it at no separate charge inside full-service medical billing at 2.99% of monthly collections, with no setup fee and no long-term contract.

The Wellpoint Provider Dispute Ladder

The Wellpoint appeal timely filing limit runs on a two-stage internal process. Reconsideration comes first. An appeal filed without a reconsideration on file gets returned, and the clock keeps running while it travels.

Source: Wellpoint provider quick reference guides for New Jersey Medicaid and Texas Medicare Advantage, and the Washington new provider orientation. Dispute windows vary by state contract, so confirm your market before calendaring. Medicare Advantage and dual eligible special needs plan denials may route through the separate CMS Part C appeal process instead of this ladder.

Notice what varies. New Jersey counts from the adjudication date. Texas Medicare Advantage counts in business days rather than calendar days. Washington allows a reconsideration verbally but requires the appeal in writing.

Same payer, three markets, three different sets of rules. That's not an inconsistency you can average out.

File a Wellpoint dispute on an Anthem form and it goes to a different queue at a different company. Same for a wellpoint appeal form sent to the claims address instead of the disputes address. Written disputes go to the Payment Dispute Unit, and that address is different from the paper claims address covered below.

Retroactive Eligibility, Credentialing Gaps, and Filing Exceptions That Actually Work

Two of the six good cause grounds in Policy G-06133 come up constantly in real billing, and most practices never invoke either one because they don't know the grounds are published.

Retroactive enrollment

Wellpoint names retroactive enrollment explicitly: a member who is later notified of coverage effective on or before the date of service. Medicaid coverage churns, gets terminated, and gets restored backdated. Every one of those cycles produces claims that looked unbillable at the time and became billable afterward.

The catch is documentation timing. You need the eligibility verification response with its date, captured when you ran it, plus the notification showing the retroactive effective date. Evidence reconstructed eight months later rarely holds.

A coverage-termination denial is a claim to revisit, not a claim to close. Practices that write those off on receipt are writing off revenue that a retroactive determination would have paid.

Incorrect member information

Wellpoint also names this one: incorrect information from the member that caused you to file with another health plan, Original Medicare, or state Medicaid. If a patient handed you the wrong card and you billed the wrong payer in good faith, that's a named good cause ground.

You don't have to argue it from scratch. Keep the timely filing medicaid denial from the wrong payer, because that document dates your discovery of the error.

Credentialing lag

Credentialing sits next to these on the exceptions list, and it behaves differently than people expect. A provider seeing patients while enrollment is still pending is generating claims against a clock that started at the date of service. The enrollment gap doesn't extend the filing window by itself.

Texas builds a version of this into policy, counting the 95-day window from date of service, date of discharge, or receipt of Texas Medicaid enrollment, whichever applies. Most markets don't, which means every week a provider stays unenrolled is a week of claims aging against a window nobody is watching.

That's the argument for closing enrollment gaps before they turn into filing problems. MedSole RCM handles provider credentialing services at $99 per insurance enrollment, including CAQH profile management, weekly payer follow-up, and recredentialing deadline tracking. Applications go out within 48 hours of a complete file.

The Federal Rules Behind Every Medicaid and Medicare Filing Deadline

If the federal Medicaid rule says 12 months, how does a Wellpoint Medicaid plan legally enforce 95 days in Texas?

The answer is that the two rules govern different things. The federal 12-month requirement binds what a state Medicaid agency must require in its state plan. It's a ceiling on the state's requirement, not a floor under a managed care organization's provider contract.

A managed care contract can require a shorter window from participating providers, and that's exactly why 95, 120, and 180 day figures across Wellpoint markets are legitimate rather than violations. Once you see that, timely filing medicaid numbers stop looking arbitrary.

Sources: 42 CFR 447.45 on eCFR and 42 CFR 424.44 on eCFR.

The Medicare side splits the same way. Original Medicare runs on federal regulation at one calendar year. A Medicare Advantage plan runs on a private contract, and Wellpoint's contract says 90 days for participating providers.

When a payer figure and a federal figure disagree, they're usually governing two different things. Check which one your claim is actually subject to before you assume somebody made a mistake.

Wellpoint Claims Submission: Payer ID, Addresses, and Provider Contacts

Routing errors produce denials that look exactly like a missed Wellpoint timely filing limit. A claim sent to the wrong address never arrived, and the window kept running while it sat somewhere else.

Wellpoint claims payer ID

The current Wellpoint claims payer ID is WLPNT. Availity is the electronic data interchange partner for Wellpoint claims, and the payer ID goes on every electronic submission routed through the Availity gateway.

Source: Wellpoint provider news, electronic data interchange payer ID change, effective January 1, 2024. Payer IDs can differ by product and state, and the ID printed on the member card is the controlling source. Confirm against the card and your clearinghouse payer list before submitting.

Wellpoint claims mailing address

The Wellpoint claims mailing address for paper submissions and the address for payment disputes are two different post office boxes. Sending a dispute to the claims box is a common way to lose two weeks.

Source: Wellpoint Texas Medicare Advantage quick reference guide, Texas Medicaid provider manual, and New Jersey provider quick reference guide. Addresses vary by state and product. Verify against your market's current guide before mailing.

Wellpoint provider phone numbers

Every Wellpoint provider phone number for claims below routes by product line rather than by topic, so pick the line that matches the member's plan before you pick the reason for your call.

Source: Wellpoint contact pages for Texas and New Jersey, and the Texas Medicare Advantage quick reference guide. Verify the number on the member card before calling, since service lines change by market.

A Texas plan closure that still affects aged claims

Wellpoint's STAR+PLUS MMP program discontinued operations in Texas as of December 31, 2024. If you are working aged Texas dual claims, that plan no longer adjudicates new business, and claim inquiries route through the Medicaid and CHIP line instead. Rejected claims go through the electronic data interchange line.

Where Wellpoint actually publishes its filing policies

The reason so many billers can't find these numbers is that Wellpoint doesn't file them under a heading that says timely filing. Reimbursement policies are organized into roughly eleven categories, and filing lives under Reimbursement Administration, General.

One more thing about those policy PDFs. The version string at the end of the URL is the document version, and it changes when the policy is revised. A bookmarked link can quietly serve you a copy that's months out of date, which is precisely how stale figures spread across payer charts.

Practices that outsource Wellpoint billing to MedSole RCM pay 2.99% of monthly collections for full-service revenue cycle management, covering eligibility verification, coding review, claim submission, payment posting, denial management, appeals, and accounts receivable follow-up. Provider credentialing runs $99 per insurance enrollment. There is no setup fee and no long-term contract.

How to Stop Losing Wellpoint Claims to Filing Deadlines

Filing fast doesn't prevent a Wellpoint timely filing limit denial. Practices that avoid them are doing something different, which is tracking acceptance instead of transmission.

Build a filing matrix, not a payer note

One row in your system labeled Wellpoint is where this goes wrong. You need a row per product and market, and each row carries seven fields:

• Product and state
• Network status, participating or nonparticipating
• Initial claim window and what starts the clock
• Corrected claim window and what starts that clock
• Dispute and appeal windows
• Controlling policy number and effective date
• Date your team last verified it

That last field is the one people skip. Payer documents get revised, and a matrix nobody has checked in a year is a liability rather than a control.

Watch acceptance, not the send button

Four controls catch almost everything that turns into a CO-29 later:

• Review clearinghouse reports daily, not weekly
• Work payer-level rejections the same day they appear
• Confirm payer acceptance on every batch, not just spot checks
• Archive the acknowledgment on the day it arrives

Escalate on percentages, not fixed days

A 95-day Texas window and a 365-day out-of-state window can't share a fixed alert date, but they can share a percentage. We run first alert at 50% of the window, escalation at 70%, and management review at 85%. Those are MedSole workflow thresholds, not Wellpoint requirements, and they scale across every timely filing limits figure in the matrix above.

Day to day, that means working aging claims by deadline proximity rather than by aging bucket alone. A 60-day-old Texas Medicaid claim is closer to death than a 200-day-old out-of-state claim, and an AR follow-up by aging bucket process that ignores the payer window will work them in the wrong order every time.

Silence is the other half of it. A claim with no payer response isn't a slow claim, it's an unconfirmed claim, and our guide to unpaid claim follow-up covers how to work non-response as its own category.

If you're billing Wellpoint across several states, building and maintaining that matrix is a fixed cost most teams never get around to. Happy to look at your Wellpoint aging and tell you which claims are closest to their window.

Wellpoint Timely Filing FAQs

What is the Wellpoint timely filing limit?

There isn't one universal number. Wellpoint sets filing deadlines by product and state, ranging from 90 days to 12 months, and your provider agreement can override the published figure. The controlling number sits in your state's Claims Timely Filing policy, G-06050.

Is Wellpoint the same as Amerigroup?

Yes. Wellpoint is the rebranded Amerigroup Medicaid and Medicare Advantage business under Elevance Health. Filing rules are now published under the Wellpoint name, which is why an Amerigroup timely filing limit pulled from an old payer chart may no longer match the current policy for your state.

Is Wellpoint the same as Anthem for claims?

No. Both sit under Elevance Health, but they run separate provider manuals, separate reimbursement policies, and separate dispute forms. A Wellpoint dispute filed on an Anthem form routes to the wrong queue. Our BCBS filing deadlines guide covers the Anthem side.

What is the Wellpoint timely filing limit for corrected claims?

It depends on the product. Medicare Advantage runs 12 months from the date of service. Texas and Tennessee Medicaid both run 120 days from the last payment notification, meaning the Explanation of Payment or remittance advice, not the date of service. All of it falls under Policy G-16001.

What is the Wellpoint appeal timely filing limit?

It varies by market and counting method. New Jersey Medicaid allows 90 days from the adjudication date on your Explanation of Payment. Texas Medicare Advantage allows 120 business days from receipt of the adverse determination. Reconsideration precedes a formal appeal in both.

What does the CO-29 denial code mean?

CO-29 means the time limit for filing has expired. CO stands for contractual obligation, so a contracted provider absorbs the balance and can't bill the member for it. It's decided on the claim receipt date, with no clinical argument available.

Does a rejected claim count as timely filed?

No. A rejection means the claim never entered adjudication, so nothing stopped the clock. Only an accepted claim does that. This is the single most common reason a claim your system shows as sent still comes back CO-29.

What proof does Wellpoint accept for timely filing?

For electronic claims, the clearinghouse assigned receipt date from your reconciliation reports. For mailed claims, an official mailing service return receipt plus a 12-field claim log. Fax confirmations and hand-delivery receipts are explicitly not accepted under Policy G-06133.

When does the clock start if Wellpoint is the secondary payer?

At the date of the other carrier's Explanation of Payment, not the date of service. Keep the primary EOP with its determination date visible in the file, because that document is what proves your window had not yet opened when the claim was still with the primary.

How long does Wellpoint take to process a claim?

Processing standards are set by state contract rather than one national figure. In Texas Medicaid, clean claims are adjudicated within 30 days of receipt, with 10 days for nursing facility unit rate and nursing facility Medicare coinsurance claims, 18 days for electronic pharmacy claims, and 21 days for nonelectronic submissions.

What is the timely filing limit for UnitedHealthcare Medicaid claims?

UnitedHealthcare publishes its own deadlines through separate state Medicaid manuals, so a Wellpoint figure never transfers. Our UnitedHealthcare filing limits guide covers those windows and where UnitedHealthcare splits by product.

Does a Wellpoint deadline apply to other Medicaid plans in the same state?

No. Every managed care organization publishes its own filing rules under its own contract, even inside one state Medicaid program. Our Fidelis timely filing limit and CareSource Indiana filing limits guides show how far apart two plans can sit.

Sources and Effective Dates

Every Wellpoint timely filing limit on this page is reviewed quarterly against Wellpoint's published reimbursement policies and provider guides. Current review date: September 11, 2026.

Figures on this page reflect Wellpoint's published policies and provider guides as of the review date above. State Medicaid contracts, product supplements, and individual provider agreements can set different periods than the published standard. Verify against your executed agreement before you calendar a deadline.