Presbyterian Health Plan Timely Filing Limit

Coverage: New Mexico Presbyterian plans; numeric filing evidence is limited to the 2026 Presbyterian Insurance Company PPO HDHP/HSA group metal agreement.

Presbyterian Health Plan filing guidance from the reviewed sources: 2026 PIC PPO HDHP/HSA group metal agreement only: in-network providers, 90 days from date of service; out-of-network providers, one year from date of service. Confirm the plan, provider agreement, and event that starts the filing period before submission.

At a glance

• A 2026 PIC PPO agreement states distinct in-network and out-of-network provider filing limits.

Initial claim filing limits

• 2026 PIC PPO HDHP/HSA group metal agreement only: in-network providers, 90 days from date of service; out-of-network providers, one year from 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

• Do not apply these limits to all Presbyterian Health Plan, Medicaid or Medicare products. Confirm the applicable agreement. The separate notice-of-loss and member reimbursement provisions are not provider filing limits; corrected-claim timing was not verified.

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 authorizations and claims pages and the 2026 PIC PPO HDHP/HSA agreement. Retained provider deadlines only for that identified agreement. PHP, Medicaid and Medicare contract limits still require confirmation.