Definition
Timely Filing Limit is the payer-defined deadline for submitting a claim to be eligible for payment. Limits vary by payer and plan (often 90–180 days), and Medicare requires submission within 12 months from the date of service. Claims filed after the limit are typically denied with no payment.
Why it matters
Missing timely filing windows converts collectible claims into unrecoverable denials. For example, if 1% of 200,000 annual claims at a $250 average allowed amount miss the deadline, that’s $500,000 lost. At scale, DSOs and health systems need proactive monitoring across payers to prevent deadline-driven revenue leakage.
How Ventus helps
Ventus checks claim status with each payer on a schedule, which surfaces claims the payer has no record of while there is still time to resubmit. Deadlines themselves are managed by your team in the practice management system.
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