# SC Medicaid (DentaQuest) timely filing limit for dental claims

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

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

Payer of record: South Carolina Medicaid Dental (SCDHHS — DentaQuest ASO)

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 South Carolina Medicaid Dental (SCDHHS — DentaQuest ASO) is 12 months — only “clean” claims received and entered into the claims processing system within one year from the date of service (date of discharge for hospital claims) are considered for payment — an SCDHHS rule, not a DentaQuest-set limit (Provider Administrative and Billing Manual, July 1, 2026). Claim reconsideration (informal review): 30 days from the remittance advice showing the denial, on the SCDHHS-CR form. Provider contracts and plan documents override published manuals — the contract number controls. Last verified 2026-08-30.

## Filing windows

- **Initial claims:** 12 months — only “clean” claims received and entered into the claims processing system within one year from the date of service (date of discharge for hospital claims) are considered for payment — an SCDHHS rule, not a DentaQuest-set limit (Provider Administrative and Billing Manual, July 1, 2026) (Published openly)

## Appeals

- **Claim reconsideration (informal review):** 30 days — from the remittance advice showing the denial, on the SCDHHS-CR form
  - Route: SCDHHS-CR form to SCDHHS; claims themselves are filed to DentaQuest, the SCDHHS dental ASO.

## Verified caveats

- The one-year limit does not apply to retroactive member eligibility — but SCDHHS “will not consider claims that exceed the timely filing limits due to the provider being unaware of the member's coverage.”
- “Providers cannot bill the member for claims denied for ‘untimely filing.’”
- Untimely-filing denials surface on remittances as edit codes 509/510 or CARC 29.

## Sources

- [SCDHHS Provider Administrative and Billing Manual (scdhhs.gov)](https://www.scdhhs.gov/sites/dhhs/files/Provider%20Administrative%20and%20Billing%20Guide.pdf) — “Time Limit for Submitting Claims”, printed p. 32

## 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)