Health Net Timely Filing Limit

Coverage: California; Medi-Cal authorization rules and CalAIM ECM/Community Supports claims guidance are separately scoped. Not a universal commercial, Medicare or delegated-group rule.

Health Net filing guidance from the reviewed sources: For the ECM/Community Supports claims guidance on this page, secondary claims must be received within 180 days after the later of the date of service or the physician’s receipt of the primary payer EOB. Confirm the plan, provider agreement, and event that starts the filing period before submission.

At a glance

• The claims procedures page begins with CalAIM Enhanced Care Management and Community Supports provider instructions. Its secondary-payer filing rule must not be used as a Health Net-wide initial filing deadline.

Initial claim filing limits

• For the ECM/Community Supports claims guidance on this page, secondary claims must be received within 180 days after the later of the date of service or the physician’s receipt of the primary payer EOB.

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

• Secondary-payer rule only; use the later trigger stated on the page.
• The page permits a reasonable waiver when the provider gives notice and evidence of extenuating circumstances; Health Net determines eligibility.
• No general primary or corrected-claim deadline was verified. Check the product contract and delegated group rules.

Provider resources

• Official provider policy or review source (official)
• Official provider policy or review source (official)
• Official provider policy or review source (official)

Sources

Update notes

Last updated: 2026-10-30.

• Reviewed official Medi-Cal requirements effective October 1, 2026, ECM/Community Supports claims procedures and EDI resources. Kept the secondary filing rule within the page’s CalAIM context. Primary filing, other products and delegated routing require contract review.