Oscar Insurance Company of Florida Timely Filing Limit

The most important thing to confirm with Oscar Insurance Company of Florida 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

• For Florida, Oscar’s state supplement says in-network providers should follow their contracts; absent a different contract deadline, the timely filing deadline is 180 calendar days from the last date of service. Out-of-network Florida providers also have a 180-day deadline unless another state mandate controls. A separate Oscar disruption notice granted a temporary 7-calendar-day extension for claims with deadlines between February 21, 2024 and March 6, 2024 if received by March 7, 2024.

Initial claim filing limits

• Florida in-network: 180 calendar days from last date of service unless contract specifies אחרת
• Florida out-of-network: 180 calendar days from last date of service unless another state law controls

Corrected claim filing limits

• Florida supplement allows an updated/corrected claim within 180 calendar days of last date of service when claim information changes

Appeal and reconsideration deadlines

• Not clearly published in the researched sources.

Trigger basis and caveats

• Florida supplement ties timely filing to the last date of service.
• The change-healthcare outage notice created a temporary exception tied to the missed filing deadline window, not a standing policy.
• The Florida supplement is from 2023 and should be checked against current contracts and current provider materials.
• Appeal deadlines were not located in the official sources reviewed.

Provider resources

• Provider Resources (official)
• Provider Portal overview (official)
• Prior Authorization List (official)
• Prior Authorization Turnaround Times (official)
• Provider Cover Forms (official)
• Florida Provider Manual Supplement (2023) (official)
• Change Healthcare Outage Provider Resource Center (official)

Sources