Dentovio public answer
Medicaid timely filing limit
Sourced answer
The initial dental filing window for State Medicaid programs (fee-for-service) is 12 months — the federal floor: “The Medicaid agency must require providers to submit all claims no later than 12 months from the date of service” (42 CFR § 447.45(d)(1)) — with exceptions at (d)(4) for retrospective-payment adjustments, Medicare crossover claims (6 months after the Medicare disposition), claims from providers under investigation, and court- or hearing-ordered claims. Provider contracts and plan documents override published manuals — the contract number controls. Last verified 2026-08-30.
- Cluster
- Practice operations
- Last verified
- 2026-08-30
- Reviewer
- None — owner-published
Dentovio is an independent publisher — not a payer, the American Dental Association, or any government agency, and it is unaffiliated with the insurers named here. This page was drafted with AI assistance and verified against the primary sources linked here. It has not been reviewed by a credentialed dental billing specialist or attorney. These pages record filing, correction, appeal, records, and recoupment windows as read in each payer's published documents on the last-verified date — and record honestly where no public number exists. Provider contracts override published manuals, editions change, and several payers set different rules per state, network, or program. Educational reference only, not billing or legal advice; confirm the controlling number in your participation contract and the payer's current provider manual before relying on it.
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Query patterns
- Medicaid timely filing limit
- Medicaid dental claim timely filing 2026
- Medicaid corrected claim deadline
- Medicaid dental claim appeal deadline
- how long to file a dental claim with Medicaid
Source citations
- TIMELYFILING-MEDICAID-1 42 CFR § 447.45 — Timely claims payment (GPO-authenticated CFR, 2024 ed.) (govinfo.gov)
- TIMELYFILING-MEDICAID-2 AFMC — MMIS Annual Billing Conference Spring 2024 (Arkansas DHS host) (humanservices.arkansas.gov)
- TIMELYFILING-MEDICAID-3 Virginia DMAS provider manual, billing chapter (rev. 2/27/2024, Virginia Regulatory Town Hall) (townhall.virginia.gov)