Community Care Network, Inc. (22Healthplan) Timely Filing Limit

Community Care Network, Inc. (22Healthplan)'s first published filing rule in the reviewed sources is: Claims must be submitted within six (6) months of discharge for inpatient services or date of service for outpatient services, and the date the provider was furnished with the correct name and address of the patient’s health plan.. Confirm the plan, provider agreement, and event that starts the filing period before submission.

At a glance

• Official provider materials contain two related filing statements: claims must be submitted within six months of the specified trigger dates, and the provider manual also states clean claims must be submitted within 180 days. These appear consistent in substance, but the official sources reviewed do not provide a separate corrected-claim limit.

Initial claim filing limits

• Claims must be submitted within six (6) months of discharge for inpatient services or date of service for outpatient services, and the date the provider was furnished with the correct name and address of the patient’s health plan.
• Provider manual also states clean claims must be submitted within 180 days.

Corrected claim filing limits

• Not clearly published in the researched sources.

Appeal and reconsideration deadlines

• Non-urgent clinical appeals must be requested within 180 days of receipt of a denial notice.
• Post-service provider claim appeals are handled by the Claims department; the reviewed sources do not state a separate appeal filing deadline for claim reconsiderations.

Trigger basis and caveats

• The filing clock is tied to discharge/date of service and the date the provider receives the correct member plan name and address.
• The manual’s 180-day clean-claim statement is consistent with the six-month language in the billing page.
• No specific corrected-claim timely filing rule was identified in the official sources reviewed.
• Appeal deadlines are not the same as claim timely filing deadlines and should not be conflated.

Provider resources

• Provider Tools (official)
• Billing and Claims (official)
• Provider Portal PlanLink (official)
• Provider Manual (official)
• Important Contacts (official)
• Prior Auth Guidelines (official)

Sources