# MCNA (TX Medicaid/CHIP) timely filing limit for dental claims

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

URL: https://dentovio.com/dental-timely-filing-limits/mcna-texas

Payer of record: MCNA Dental — Texas Medicaid & CHIP

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 MCNA Dental — Texas Medicaid & CHIP is 95 days — “Providers must file claims within 95 days of date of service (DOS). If your claim is not received within 95 days from the date of service, it will be denied for late submission.” (MCNA Texas Provider Manual v1.31, effective March 1, 2026, §VII). Corrected claims: 365 days — the cap on MCNA's enumerated late-filing exceptions — COB (the clock starts at the primary EOB/RA date), wrong-plan filing, clearinghouse failure, and circumstances beyond the provider's control — all still capped at 365 days from the date of service; deficient claims get 30 calendar days to supply missing x-rays or narratives. Reconsideration: 120 days for main-dental-home, timely-filing, no-prior-authorization, duplicate, and eligibility denials. Provider contracts and plan documents override published manuals — the contract number controls. Last verified 2026-08-30.

## Filing windows

- **Initial claims:** 95 days — “Providers must file claims within 95 days of date of service (DOS). If your claim is not received within 95 days from the date of service, it will be denied for late submission.” (MCNA Texas Provider Manual v1.31, effective March 1, 2026, §VII) (Published openly)
- **Corrected claims:** 365 days — the cap on MCNA's enumerated late-filing exceptions — COB (the clock starts at the primary EOB/RA date), wrong-plan filing, clearinghouse failure, and circumstances beyond the provider's control — all still capped at 365 days from the date of service; deficient claims get 30 calendar days to supply missing x-rays or narratives (Published openly)

## Appeals

- **Reconsideration:** 120 days — for main-dental-home, timely-filing, no-prior-authorization, duplicate, and eligibility denials
- **Claims appeal:** 120 days — from MCNA's initial claim determination (calendar days), for medical-necessity and benefit-coverage disputes; written decision within 30 calendar days
  - Route: Mail: MCNA Dental, Attention: MCNA Appeals Department – Provider Appeals, P.O. Box 740370, Atlanta, GA 30374-0370.
- **Second Level Appeal (Medicaid medical necessity only):** No public number — Available when a Medicaid medical-necessity appeal is upheld: a non-network provider of the same or similar specialty reviews the decision, and that determination is binding. Medicaid members only — not CHIP.

## Verified caveats

- Submission routes: electronically through MCNA's Provider Portal at portal.mcna.net, via clearinghouse (Payor ID 65030), or paper ADA form to MCNA Dental, P.O. Box 23920, Oakland Park, FL 33307. Faxed and handwritten claims are not accepted.
- MCNA distinguishes reconsiderations (administrative denials) from appeals (medical necessity / benefit coverage) — both run 120 days, but they are different tracks with different subjects.

## Sources

- [MCNA Dental — Texas Provider Manual v1.31 (manuals.mcna.net)](https://manuals.mcna.net/texas) — §VII Claims Administration, “Claim Submission”, p. 52

## 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)