# MassHealth (DentaQuest) timely filing limit for dental claims

> What is the timely filing limit for dental claims with MassHealth (DentaQuest), and how long do you have to correct or appeal? Verdict: Published filing window.

URL: https://dentovio.com/dental-timely-filing-limits/dentaquest-masshealth

Payer of record: MassHealth Dental Program (Massachusetts Medicaid — DentaQuest TPA)

Last verified: 2026-08-30

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.

## Direct answer

The initial dental filing window for MassHealth Dental Program (Massachusetts Medicaid — DentaQuest TPA) is 90 days — “claims must be received within 90 days of the date of service or the date of the explanation of benefits from another insurer” — an untimely-filing denial cannot be billed to the member (Office Reference Manual §4.6, February 1, 2026 edition). Corrected claims: 12 months — corrections to initially-timely claims within 12 months of the date of service (18 months for third-party-liability claims). Reconsideration: 30 days from the determination — untimely-filing denials are expressly listed as a valid reconsideration subject. Provider contracts and plan documents override published manuals — the contract number controls. Last verified 2026-08-30.

## Filing windows

- **Initial claims:** 90 days — “claims must be received within 90 days of the date of service or the date of the explanation of benefits from another insurer” — an untimely-filing denial cannot be billed to the member (Office Reference Manual §4.6, February 1, 2026 edition) (Published openly)
- **Corrected claims:** 12 months — corrections to initially-timely claims within 12 months of the date of service (18 months for third-party-liability claims) (Published openly)

## Appeals

- **Reconsideration:** 30 days — from the determination — untimely-filing denials are expressly listed as a valid reconsideration subject
  - Route: Via the MassHealth Provider Web Portal (claims site: www.masshealth-dental.org) or in writing: P.O. Box 2906, Milwaukee, WI 53201-2906.
- **Final Deadline Appeal:** 30 days — from the denial, for claims past the 12/18-month correction deadline — date of service must be within 36 months and the provider must demonstrate a MassHealth error (130 CMR 450.323)

## Verified caveats

- The manual's own words on untimely filing: “Any claim received beyond the 90-day timely filing limit specified in the contract will be denied for ‘untimely filing.’ If a claim is denied for ‘untimely filing’ the provider cannot bill the member.”
- 90-Day Waiver: a MassHealth billing-deadline waiver under 130 CMR 450.309 (not an HSN rule), with three enumerated exceptions — retroactive enrollment covering the date of service, a member's failure to timely disclose MassHealth eligibility, and exceptions expressly authorized by transmittal letter or provider bulletin.
- Third-party-liability claims: within 90 days of the other insurer's final-disposition notice and no later than 18 months after the date of service (130 CMR 450.313).
- Health Safety Net (HSN) dental claims — per EOHHS Billing Update HSN-ALL BU-21 (Feb 2026) — accept only frequency codes XX1 (original), XX7 (replacement, active claims only, same original TCN), and XX8 (void, original ICN and TCN, no corrections on the void). Corrections are cut off by the state fiscal-year closure (FY23 closed effective 2/20/2026); HSN timely filing runs under 101 CMR 613.07(02)–(04). These are HSN/EOHHS rules; DentaQuest is the dental TPA effective 2/1/2026.

## Sources

- [MassHealth Dental Program — Office Reference Manual (mass.gov)](https://www.mass.gov/doc/masshealth-dental-program-office-reference-manual-0/download) — §4.6 “Filing Limits”, PDF p. 21
- [EOHHS Health Safety Net — Billing Update HSN-ALL BU-21, February 2026 (mass.gov)](https://www.mass.gov/doc/february-2026-dental-and-frequency-codes-updates-0/download) — “Replacement and Void Claims Reminders” and “FY23 Outstanding Resweeps” sections

## Related

- [All payer timely-filing pages](https://dentovio.com/dental-timely-filing-limits/index.html.md)
- [Dental claim denial codes](https://dentovio.com/dental-claim-denial-codes/index.html.md)
- [Dental prompt-pay laws by state](https://dentovio.com/dental-prompt-pay-laws/index.html.md)