Molina Healthcare’s timely filing limit in 2026 remains unchanged from 2025. In-network providers must file claims within 180 days from the date of service in most states. However, this window can vary depending on the state, the provider’s contract with Molina, and the type of claim being submitted.
Out-of-network providers typically have up to 365 days from the date of service, though this is not universal across all Molina plans. Late-filing exceptions are only considered for special situations such as natural disasters, retroactive eligibility changes, or verified system outages — not for routine billing mistakes.
In this guide, we cover Molina Healthcare’s timely filing limits in detail — for initial claims, corrected claims and disputed payments, and secondary (COB) claims.
Molina Healthcare Timely Filing Limit for Initial Claims
The standard timely filing window for initial claims submitted to Molina Healthcare is 180 days from the date of service (DOS). However, this window varies by state and by the provider’s contract with the plan. In certain states, the deadline may be shorter for participating providers and longer for non-participating providers.
For inpatient and institutional claims, the filing clock typically starts on the discharge date, not the admission date. Always confirm the exact window in the Molina provider manual for your specific state.
| Provider / Plan Type | Filing Deadline | Clock Starts |
| Participating (PAR) — most states | 180 days from DOS | Date of Service |
| Participating (PAR) — select states | 90 days from DOS | Date of Service |
| Non-Participating (Non-PAR) | 365 days from DOS | Date of Service |
| Inpatient / Institutional claims | Same as above | DOS = Discharge date |
| Molina Medicare Advantage | 12 months from DOS | Date of Service |
Molina Healthcare Timely Filing Limit by Claim Type
Molina applies the same filing window to all initial claim types. The deadline is determined by the state and provider contract, not by the claim form used. However, the required form varies depending on the type of service.
| Claim Type | Form |
| Professional (physician/outpatient) | CMS-1500 |
| Institutional (hospital) | UB-04 |
| Inpatient hospital | UB-04 |
| Electronic claims (EDI 837P/837I) | 837P or 837I |
| Paper claims | CMS-1500 or UB-04 |
Molina Healthcare Timely Filing Limit for Corrected Claims
When a claim is denied or requires correction due to a billing or coding error, providers must submit the corrected claim within Molina’s reconsideration timeframe. In most states, participating providers have 180 days from the date of the Explanation of Payment (EOP) or EOB to resubmit. For non-participating providers, this window is typically reduced to 90 days.
Molina treats corrected claims and resubmissions as a separate post-service process with its own filing timeframe. Submitting a corrected claim does not restart the original filing clock. Always verify your state-specific window in the Molina provider manual before resubmitting.
| Molina Plan / State | Corrected Claim Filing Limit | Filing Basis |
| Molina Healthcare of Texas | 120 Days | From EOP or denial date |
| Molina Healthcare of Florida | 90 Days | From EOP or denial date |
| Molina Healthcare of California | 180 Days (PAR) / 90 Days (Non-PAR) | From EOP or denial date |
| Molina Healthcare of Ohio | 180 Days | From EOP or denial date |
| Molina Healthcare of Washington | 365 Days | From EOP or denial date |
| Molina Healthcare of Illinois | 180 Days (PAR) / 90 Days (Non-PAR) | From EOP or denial date |
| Other Molina Plans | Varies by state | Refer to state provider manual |
Molina Healthcare Timely Filing Limit for Secondary Claims (COB)
When Molina Healthcare is the secondary payer, the filing clock starts on the date the primary payer issues its Explanation of Payment (EOP) or EOB — not on the date of service. Providers must attach the primary payer’s EOB when submitting secondary claims. The same filing requirements apply to both paper and electronic secondary claims.
| Molina Plan Name | Filing Limit (Secondary/COB) | Filing Basis |
| Molina Healthcare of Texas | 120 Days | Primary EOP Date |
| Molina Healthcare of Florida | 180 Days | Primary EOP Date |
| Molina Healthcare of California | 180 Days | Primary EOP Date |
| Molina Healthcare of Ohio | 180 Days | Primary EOP Date |
| Molina Healthcare of Washington | 365 Days (Standard) | Primary EOP Date |
| Molina Healthcare of Illinois | 180 Days | Primary EOP Date |
| Molina Medicare Advantage (MSP) | 12 months from DOS or 60 days from primary EOB | DOS or Primary EOB Date |
Required Documents for Secondary Filing
- Primary payer’s EOB or Remittance Advice (RA)
- Patient’s primary insurance ID
- Claim showing the primary payment amount
- Coordination of Benefits (COB) form
Molina Healthcare Timely Filing Limit by State
Though the general initial claim submission window is 180 days, Molina applies different timeframes across states and plan types. Below is a summary of key states. Always confirm the current filing window directly with Molina or in your state-specific provider manual.
| State | Molina Plan | Initial Claim TFL (PAR) | Corrected/Reconsideration |
| Texas | Molina Healthcare of Texas | 180 Days | 120 Days from EOP |
| Florida | Molina Healthcare of Florida | 180 Days | 90 Days from EOP |
| California | Molina Healthcare of California | 180 Days | 180 Days from EOP |
| Ohio | Molina Healthcare of Ohio | 180 Days | 180 Days from EOP |
| Washington | Molina Healthcare of Washington | 180 Days | 120 Days from EOP |
| Illinois | Molina Healthcare of Illinois | 180 Days | 120 Days from EOP |
| Michigan | Molina Healthcare of Michigan | 180 Days | 120 Days from EOP |
| New Mexico | Molina Healthcare of New Mexico | 180 Days | 120 Days from EOP |
Molina Healthcare Timely Filing Limit for Out-of-Network Providers
Molina offers a longer filing window for non-participating (out-of-network) providers compared to in-network providers. While most in-network providers must submit claims within 180 days, out-of-network providers typically have up to 365 days from the date of service. This extended deadline is not universal across all Molina plans or states — always verify with the state-specific provider manual.
| Provider Type | Filing Deadline | Notes |
| In-network (PAR) — most states | 180 days from DOS | Per provider contract |
| In-network (PAR) — select states | 90 days from DOS | State-plan specific |
| Out-of-network (Non-PAR) | 365/180 days from DOS (varies) | Check state-specific provider manual |
How to Calculate Molina Filing Deadlines
Count every calendar day starting from the date of service. Weekends and holidays are included. Missing the deadline by even one day can result in a CO-29 denial with limited recovery options.
180-Day Window Example:
- Service date = March 10, 2026
- March has 31 days → 21 days remain in March
- 180 − 21 = 159 days remaining (April onward)
- April: 30 days → 159 − 30 = 129 left
- May: 31 days → 129 − 31 = 98 left
- June: 30 days → 98 − 30 = 68 left
- July: 31 days → 68 − 31 = 37 left
- August: 37 − 31 = 6 days into September
- Deadline = September 6, 2026
365-Day Window:
For a service date of March 10, 2026, the 365-day deadline is simply March 10, 2027.
| Service Date | 90-Day Deadline | 180-Day Deadline | 365-Day Deadline |
| January 1, 2026 | April 1, 2026 | June 30, 2026 | January 1, 2027 |
| March 1, 2026 | May 30, 2026 | August 28, 2026 | March 1, 2027 |
| July 1, 2026 | September 29, 2026 | December 28, 2026 | July 1, 2027 |
| October 1, 2026 | December 30, 2026 | March 30, 2027 | October 1, 2027 |
What Happens If You File a Claim Late
If a claim reaches Molina after the filing window closes, it is denied with denial code CO-29, “The time limit for filing has expired.” Because CO-29 carries the Contractual Obligation (CO) group code, the unpaid amount becomes the provider’s responsibility and generally cannot be billed to the patient.
Recovery after a CO-29 denial is only possible if you can prove the claim was received on time or that a recognized exception applies — such as retroactive eligibility, a documented system outage, or a FEMA-declared natural disaster.
How to Prove Timely Filing (POTF)
If Molina denies a claim for timely filing but you submitted it on time, you can appeal with proof of timely filing (POTF). The key is demonstrating the date Molina received the claim — not just when you generated or mailed it. Acceptable forms of proof include:
- EDI acceptance reports and 277CA acknowledgment files
- Clearinghouse acceptance timestamps
- Payer-portal submission confirmations
- Certified-mail tracking for paper claims
- Primary payer’s EOB (for secondary/COB claims)
Frequently Asked Questions
Does the filing clock start on the date of service or the date I submit?
For initial claims, the clock starts on the date of service (discharge date for inpatient). For secondary claims, it starts on the date the primary payer’s EOP or EOB is issued.
Is the deadline based on when I send the claim or when Molina receives it?
Molina counts the date it receives the claim. Build in time for mailing or clearinghouse processing, and always file early to remain safely inside the window.
Can a timely-filing denial be appealed?
Sometimes. If you can show proof of timely filing or a recognized exception — such as retroactive eligibility or a documented system outage — you can request reconsideration within Molina’s appeal window. Routine billing errors are generally not accepted as grounds.
Are filing windows counted in calendar days or business days?
Filing windows are counted in calendar days. Molina does not add grace days for weekends or holidays, so treat the stated number of days as a hard deadline.
