Centene Venture Company Florida Timely Filing Limit

The most important thing to confirm with Centene Venture Company Florida 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 Florida Ambetter, the official materials show a 180-calendar-day timely filing limit for initial claims from date of service. For claim payment disputes/reconsiderations, the plan distinguishes participation status and uses 180 calendar days for initial claims reconsiderations/disputes/appeals, but 90 calendar days for claim disputes/appeals and coordination-of-benefits disputes measured from the primary payer EOP date to the date received. The manual also states corrected claims and certain appeal items have their own filing rules.

Initial claim filing limits

• 180 calendar days from date of service

Corrected claim filing limits

• Corrected claims must be submitted within the plan’s filing requirements; the manual ties corrected/rejected claims to the applicable timely filing deadline.
• Corrected paper claims go to P.O. Box 5010, Farmington, MO 63640-5010.

Appeal and reconsideration deadlines

• Initial claims reconsiderations / claim disputes / appeals: 180 calendar days for participating and non-participating providers per the CCU guide.
• Claim disputes / appeals and coordination of benefits: 90 calendar days from the primary payer’s EOP date to the date received, per the CCU guide.
• First-level reconsideration will be resolved within 60 calendar days of receipt.
• Second-level claim dispute will be reviewed within 60 days of receipt from the health plan.

Trigger basis and caveats

• Initial timely filing is based on date of service.
• Some dispute deadlines are based on the date on the explanation of payment (EOP).
• COB dispute timing is based on the primary payer EOP date.
• The official Florida sources use different timing language for initial claims versus disputes/appeals; preserve this distinction when operationalizing.
• Rejected electronic or paper claims are not considered received until they pass edits; resubmission must still fit within the filing deadline.
• If a claim dispute is submitted without a prior reconsideration on file, it may be treated as a reconsideration request.

Provider resources

• Florida Provider Toolkit Quick Reference Guide (official)
• Florida Provider and Billing Manual (2026) (official)
• Florida Prior Authorization Tool / Pre-Auth Needed (official)
• Florida Member and Provider Appeals Processes (official)
• Claims, Disputes & Recovery / CCU Guide (official)

Sources