Molina Healthcare Timely Filing Limit

The most important thing to confirm with Molina Healthcare 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

• Molina’s timely filing rules vary by state and product. Official materials reviewed show common windows such as 365 days from date of service for some Medicaid and Marketplace products, but other markets use shorter or different rules. Corrected-claim filing windows also vary.

Initial claim filing limits

• Ohio Medicaid manual: original claims must be received within 365 days from date of service.
• South Carolina Medicaid manual: claims must be submitted within 12 months/365 days after discharge for inpatient or date of service for outpatient; if not primary payer, within 12 months/365 days after final determination by the primary payer.
• Some states/products may have different contractual or program-specific filing limits; official sources do not support a single universal Molina filing limit.

Corrected claim filing limits

• Ohio Medicaid manual: corrected claims must be received no later than 365 days from the remit date of the claim being corrected.
• Corrected Claims policy shows state variation, including 30 days in Virginia and 90 days in New York; other states/products differ.
• South Carolina Medicaid manual indicates corrected claims should be submitted via regular EDI clearinghouse, with state-specific timeframe not flattened into one universal rule.

Appeal and reconsideration deadlines

• Ohio Medicaid manual: claim disputes/appeals must be requested within 90 days of Molina's original remittance advice date.
• New York materials reviewed also reference 90 days for written claim disputes after original remittance advice date.
• Appeal/dispute deadlines vary by state and contract.

Trigger basis and caveats

• Initial filing is typically measured from date of service or discharge, but some coordination-of-benefits/third-party-liability situations measure from the primary payer's final determination.
• Corrected-claim timing is often measured from the remit/adjudication date of the original claim, but this varies by state and product.
• Use the applicable state-specific provider manual and contract for the controlling rule.
• Do not rely on a single Molina nationwide timely-filing deadline.
• Some official sources discuss exceptions for retroactive eligibility or other good-cause situations in specific states.
• Contractual terms or government program rules can override the general published rule.

Provider resources

• Molina Healthcare Provider Portal (login) (official)
• Molina Healthcare EDI Transactions / Provider Services Web Portal (official)
• Molina Healthcare Provider Home - South Carolina Medicaid (official)
• Molina Healthcare Provider Home - Idaho Medicaid (official)
• Molina Healthcare Provider Claims Submission - Virginia Medicaid (official)
• Molina Healthcare Provider Prior Authorization - Virginia Medicaid (official)
• Molina Healthcare Provider Manual - Ohio Medicaid 2026 (official)
• Molina Healthcare Corrected Claims Policy (official)

Sources