CalOptima Health Timely Filing Limit

Coverage: California Medi-Cal and OneCare; the verified CalAIM billing rules below apply only to CalAIM services. Separate direct and delegated health-network responsibility.

CalOptima Health filing guidance from the reviewed sources: CalAIM claims: 365 days from the date of service. Confirm the plan, provider agreement, and event that starts the filing period before submission.

At a glance

• The CalAIM FAQ gives a 365-day filing period from the date of service for CalAIM claims only.

Initial claim filing limits

• CalAIM claims: 365 days from the date of service.

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

• Date of service; not a universal OneCare or delegated-network filing rule.
• The FAQ is dated November 19, 2024. Confirm the applicable CalAIM contract and current instructions. Other products and corrected claims require separate confirmation.

Provider resources

• Official policy source (official)
• Official policy source (official)

Sources

Update notes

Last updated: 2026-10-30.

• Reviewed official authorization lists and CalAIM billing guidance on October 30, 2026. Kept the specific CalAIM filing rule without extending it to other products.
• Some provider pages limited direct access; official indexed text and the linked FAQ supplied public evidence. Provider credentials and the signed network contract remain necessary.