Blue Cross Blue Shield of Texas
Blue Cross Blue Shield of Texas Timely Filing Limit
Timely filing varies by line of business. For BCBSTX Medicaid/CHIP, claims must be submitted within 95 days of the date of service. For Blue Choice PPO…
Short answer
Timely filing varies by line of business. For BCBSTX Medicaid/CHIP, claims must be submitted within 95 days of the date of service. For Blue Choice PPO provider manual guidance, the manual references a 365-day filing deadline, and corrected claims must still…
Blue Cross Blue Shield of Texas's first published filing rule in the reviewed sources is: Medicaid/CHIP: within 95 days of the date of service. Confirm the plan, provider agreement, and event that starts the filing period before submission.
At a glance
- Timely filing varies by line of business. For BCBSTX Medicaid/CHIP, claims must be submitted within 95 days of the date of service. For Blue Choice PPO provider manual guidance, the manual references a 365-day filing deadline, and corrected claims must still follow the applicable filing deadline. For disputes, BCBSTX allows claim disputes within 180 days of the check date/EOP/PCS, and timely-filing reviews accept specific proof such as TDI mail logs or Availity EBR reports.
Initial claim filing limits
- Medicaid/CHIP: within 95 days of the date of service
- Blue Choice PPO manual: filing deadline referenced as 365 days
Corrected claim filing limits
- Corrected claims must follow the applicable claims filing deadline in the manual or subscriber contract
- Corrected claim submission requirements vary by claim type and frequency code
Appeal and reconsideration deadlines
- Claim dispute: within 180 days following the check date/date of the BCBSTX Explanation of Payment (EOP), or the date of the BCBSTX Provider Claims Summary (PCS)
Trigger basis and caveats
- Deadline basis varies: date of service for filing, and check date/EOP/PCS for disputes.
- For timely-filing reviews, BCBSTX accepts specific proof of filing, including TDI mail logs and Availity electronic batch response reports.
- Timely filing varies by line of business and may also vary by provider contract.
- A late corrected claim may be denied if it misses the applicable filing deadline.
- The claim review/dispute deadline is not the same as the original claim filing deadline.
Provider resources
- Provider home (official)
- Contact Us / provider contacts (official)
- Claims and eligibility - claim status (official)
- Claims and eligibility - claim review process (official)
- Utilization Management / prior authorization (official)
- Availity Essentials / electronic transactions (official)
- Blue Choice PPO Provider Manual - general claims filing (official)
- Blue Choice PPO Provider Manual - electronic filing (official)
- Medicaid claims page (official)
- Medicaid/CHIP provider manual (official)
Sources
| Fact | Value | Source | Confidence |
|---|---|---|---|
| Medicaid/CHIP filing limit | Claims submitted electronically or on standard paper forms within 95 days of the date of service; services billed beyond 95 days are not eligible for reimbursement. | Official | high |
| Blue Choice PPO manual filing deadline | The PPO provider manual references the 365-day filing deadline. | Official | medium |
| Claim dispute deadline | Claim dispute requests must be submitted within 180 days following the check date/EOP/PCS. | Official | high |
| Timely filing proof | Acceptable proof includes TDI Mail Log, Certified Mail Receipt with TDI mail log, and Availity Electronic Batch Response Reports. | Official | high |
Last reviewed: March 27, 2026
Sources used: 3 official
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