Sentara Health Plans Timely Filing Limit

Coverage: Sentara Health Plans Virginia; filing facts below are commercial-only, not Medicaid or D-SNP rules.

Sentara Health Plans filing guidance from the reviewed sources: Commercial initial claims: 365 days from service. Confirm the plan, provider agreement, and event that starts the filing period before submission.

At a glance

• The commercial manual gives a 365-day service-date filing period and separate COB terms.

Initial claim filing limits

• Commercial initial claims: 365 days from service.
• Commercial COB claims: 18 months from service.

Corrected claim filing limits

• Commercial corrections and reconsiderations remain within 365 days of the last date of service under the manual’s filing rule.

Appeal and reconsideration deadlines

• Not clearly published in the researched sources.

Trigger basis and caveats

• The 365-day window includes initial and paid/denied claim reconsideration; it is not a new clock after each denial. Medicaid and D-SNP periods were not verified. Confirm contract exceptions.

Provider resources

• Official provider manuals (official)
• Official policy source (official)
• Official policy source (official)
• Official policy source (official)

Sources

Update notes

Last updated: 2026-10-30.

• Verified official medical authorization, billing and manual resources, including the commercial manual linked from the October 2026 manual page. Kept commercial deadlines separate from Medicaid/D-SNP.
• The manual is hosted on Sentara’s linked Sitecore document service. Product-specific contracts and login-only details remain provider checks; future-effective notices are excluded.