L.A. Care Health Plan Timely Filing Limit

Coverage: Los Angeles County; 2026 provider manual rules distinguish L.A. Care Covered, Medi-Cal, PASC-SEIU and HMO D-SNP products and delegated provider groups.

L.A. Care Health Plan filing guidance from the reviewed sources: L.A. Care Covered, Medi-Cal and PASC-SEIU: 180 calendar days from the date of service. Confirm the plan, provider agreement, and event that starts the filing period before submission.

At a glance

• The 2026 provider manual section 12.9 gives different direct-claim filing periods by product. Contract terms, good-cause exceptions and regulator instructions must also be checked.

Initial claim filing limits

• L.A. Care Covered, Medi-Cal and PASC-SEIU: 180 calendar days from the date of service.
• HMO D-SNP: 365 calendar 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

• These are initial claim periods measured from date of service, not appeal periods.
• Good-cause exceptions can apply. Regulatory disaster instructions can change applicable deadlines.
• Confirm delegated group filing requirements separately.
• Reviewed bounded October 2026 errata passages, not an exhaustive reconciliation of every manual section. Do not substitute the separately posted 2027 manual.

Provider resources

• Official provider policy or review source (official)
• 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 the 2026 manual, October 2026 errata passages, authorization tool and claims page. Preserved product-specific initial filing limits and direct-versus-delegated responsibility. Corrected claims and contract amendments require further confirmation.