Highmark: timely filing limit
Initial claim
365 days from the last date of service in Pennsylvania and West Virginia (unless the specific provider contract states otherwise); 180 days from date of service in Delaware; New York initial claims also cited at 365 days from date of service or discharge
Clock starts from: date of service, discharge date, or last date of treatment depending on state and claim type
Appeal window
No published default appeal window. Check the payer's own appeals policy.
Caveats
Confirmed directly on Highmark's own provider manual page. Highmark explicitly states that a specific provider contract can override these defaults, so always check the individual participation agreement first.
Retrieved 2026-07-18.
Denied for timely filing already
See CARC 29 for the corrective actions and whether an appeal is worth filing.
DenialPath provides billing and administrative guidance based on published CMS and X12 sources. It is not medical advice, not a coverage determination, and not a guarantee of payment. NCCI and MUE edits are republished quarterly and payer policies vary by contract. Always confirm against the payer's own current policy before submitting or appealing.