Anthem (Community Care Health Plan of Nevada) Timely Filing Limit

The most important thing to confirm with Anthem (Community Care Health Plan of Nevada) is not just the number of days, but also what event starts the clock. Some payer documents measure from date of service, some from discharge, and some publish different rules for corrected claims or appeals.

At a glance

• For Nevada Medicaid managed care, the published reimbursement policy states the standard timely filing limit is 180 days for participating providers/facilities and 180 days for nonparticipating providers/facilities, with 365 days for out-of-state nonparticipating providers/facilities. The count generally runs from date of service, or from the last date of service for consecutive-day services; when another carrier is primary, the count starts from the other carrier’s EOP date.

Initial claim filing limits

• 180 days for participating care providers and facilities
• 180 days for nonparticipating care providers and facilities
• 365 days for out-of-state nonparticipating care providers and facilities

Corrected claim filing limits

• Not clearly published in the researched sources.

Appeal and reconsideration deadlines

• Not clearly published in the researched sources.

Trigger basis and caveats

• Generally measured from date of service to date claim is received and accepted.
• For consecutive-day services, the limit is counted from the last day of service.
• If primary other health insurance exists, timely filing is counted from the other carrier's EOP date.
• Claims outside the limit are not reimbursable unless documentation proves a clean claim was filed within the applicable filing limit.
• I did not locate a separate Nevada-specific corrected-claim deadline or appeal deadline in the reviewed official sources.
• Temporary waivers may apply after documented natural disasters or under applicable state guidance.

Provider resources

• Nevada Medicaid provider portal (official)
• Claims overview (official)
• Claims submissions and disputes (official)
• Policies, guidelines and manuals (official)
• Precertification lookup tool (official)
• Electronic Data Interchange (EDI) (official)
• Contact us (official)
• Provider manual (PDF) (official)

Sources