Timely filing for claim submission
Last Updated on June 12, 2026
Submitting claims to Security Health Plan as soon as possible after services occur is beneficial to both providers and members. Security Health Plan’s timely filing limits are outlined below based on product, unless otherwise defined in your Security Health Plan provider contract.
Claims with date spans will be handled as follows:
- Professional claims: Service line ‘Thru date’ must be within timely filing
- Outpatient facility claims: Service line ‘Thru date’ must be within timely filing
- Inpatient facility claims: The ‘Thru date’ on the claim must be within timely filing
- Dental claims: Service line ‘Thru date’ must be within timely filing
When there is coordination of benefits (COB), claims must be submitted appropriately as indicated. Providers may not seek reimbursement from members for claims denied due to late submission.
Claim filing timelines do not end with the original claim submission. Providers who submit original claims to Security Health Plan within appropriate timeframes can submit corrected claims or adjustment requests within normal timely filing limits or 60 days from date of payment/denial/rejection, whichever is later. Resubmitted claims outside of normal timely filing limits or 60 days from date of payment/denial/rejection will be denied and cannot be resubmitted for payment.
BadgerCare
- Original claim submission: All providers have 365 days from the date of service.
- Correction or adjustment claims: 365 days from the date of service or 60 days from date of payment/denial/rejection of the original claim, whichever is later.
- COB: 365 days from the date of service or 60 days from the date of the other payer’s statement, whichever is later.
- Effective date of service Jan. 1, 2025, when COB occurs, providers must submit documentation with the secondary claim that proves that claim submission to the other insurer was within Security Health Plan’s filing limit of 365 days from the date of service. If claims are submitted outside this timeframe, they will be denied.
Commercial
- Original claim submission:
- Affiliated providers have 180 days from the date of service.
- Non-affiliated providers have 15 months from the date of service.
- Correction or adjustment claims:
- Affiliated providers have 180 days from the date of service or 60 days from date of payment/denial/rejection of the original claim, whichever is later.
- Non-affiliated providers have 15 months from the date of service.
- COB:
- Affiliated providers have 180 days from the date of service or 180 days from date of the other payer's statement, whichever is later.
- Non-affiliated providers have 15 months from the date of service.
Family Health Center (unless otherwise defined in your FHC agreement)
- Original claim submission:
- Professional Claims: 90 days from the date of service
- Facility Claims: 180 days from the date of service
- Correction or adjustment claims: 60 days from the statement date of the most recent claim received during the original claim submission timely filing period
- COB: 60 days from the date of the primary payer’s statement or within the original claim submission timely filing period, whichever is later
Medicare Advantage HMO-POS and Medicare Advantage Ally Rx D-SNP
- Original claim submission: All providers have 365 days from the date of service.
- Correction or adjustment claims: 365 days from the date of service or 60 days from the date of payment/denial/rejection of the original claim, whichever is later.
- COB: 365 days from the date of service or 60 days from the date of the other payer’s statement, whichever is later.
Medicare Select-Senior Security
- Original claim submission: All providers have 180 days from the date of service.
- Correction or adjustment claims: 180 days from the date of service or 60 days from the date of payment/denial/rejection of the original claim, whichever is later.
- COB: 180 days from the date of service or 180 days from the date of the other payer’s statement, whichever is later.
Medicare Supplement with riders
- Original claim submission: All providers have 12 months from the date of service.
- Correction or adjustment claims: 12 months from the date of service or 60 days from the date of payment/denial/rejection of the original claim, whichever is later.
- COB: 12 months from the date of service or 12 months from the date Medicare made payment.
Insite by Security Health Plan
- Original claim submission:
- All Groups: Affiliated providers have 180 days from the date of service.
- Non-affiliated providers – timely filing is 12 or 15 months based on group’s SPD.
- Correction or adjustment claims:
- All Groups: Affiliated providers have 180 days from the date of service or 60 days from date of payment/denial/rejection of the original claim, whichever is later.
- Non-affiliated providers – timely filing is 12 or 15 months based on group’s SPD.
- COB:
- All Groups: Affiliated providers have 180 days from the date of service or 180 days from date of payment/denial/rejection, whichever is later.
- Non-affiliated providers – timely filing is 12 or 15 months based on group’s SPD.