Health Plan of Nevada (HPN) Timely Filing Limit

The most important thing to confirm with Health Plan of Nevada (HPN) 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

• HPN’s 2024 provider claims guide gives different filing windows by line of business and coordination-of-benefits scenario. Commercial claims are to be submitted within 30 calendar days of the date of service and no later than 90 calendar days after the date of service. Medicaid claims are to be submitted within 30 calendar days of service and no later than 180 calendar days after service, with out-of-state Medicaid provider claims due within 365 days. Secondary payer rules differ: HPN Commercial secondary is 9 months from date of service, and UHC HPN Medicaid secondary is 365 days from date of service.

Initial claim filing limits

• Commercial: within 30 calendar days of date of service; no later than 90 calendar days after date of service.
• Medicaid: within 30 calendar days of date of service; no later than 180 calendar days after date of service.
• Out-of-state Medicaid providers: within 365 days of date of service.
• Secondary payer: HPN Commercial as secondary payer = 9 months from date of service; UHC HPN Medicaid as secondary payer = 365 days from date of service.

Corrected claim filing limits

• Commercial reconsiderations/resubmissions/follow-up must be clearly identified and submitted within one year from date of service.
• Medicaid reconsiderations/resubmissions/follow-up must be clearly identified and submitted within 30 calendar days from the date on the remittance advice.

Appeal and reconsideration deadlines

• Claim reconsiderations are allowed; HPN says to allow 30 days from date of receipt for claim reconsiderations.
• If further review is needed after reconsideration, the 2024 guide references appeal rights via the HPN Medical Director and/or peer review committee, but does not give a single universal deadline in the extracted text.

Trigger basis and caveats

• Timely filing is stated to be based on date of service or date of eligibility.
• For Medicaid out-of-state providers, the 365-day limit is calculated from the last date of service to the date the claim was received.
• The cited timely-filing language comes from the 2024 claims section; I did not verify whether later provider manuals changed these exact limits.
• Because HPN has multiple lines of business, these limits should be applied only where the line of business matches the cited rule.

Provider resources

• Provider home / contact information (official)
• Online Provider Center (official)
• Submit or Appeal a Claim (official)
• Provider Advocates (official)
• 2025 Provider Summary Guide - Utilization Management (official)
• 2025 Claim Reconsideration Request Form (official)
• 2024 Provider Summary Guide - Claims (official)

Sources