Simply Healthcare Plans dba WellPoint Florida, Timely Filing Limit

Simply Healthcare Plans dba WellPoint Florida,'s first published filing rule in the reviewed sources is: Not stated in the reviewed manual; governed by the Provider or Facility Agreement.. Confirm the plan, provider agreement, and event that starts the filing period before submission.

At a glance

• The provider manual does not state a single universal timely-filing number in the text reviewed; instead it says claims must be submitted within the timely-filing timeframe specified in the Provider or Facility Agreement. Claims submitted after the period expires are denied unless proof of timely filing is shown. Appeals for timely-filing denials must be submitted in writing.

Initial claim filing limits

• Not stated in the reviewed manual; governed by the Provider or Facility Agreement.

Corrected claim filing limits

• Corrected claims should be resubmitted within the applicable timely-filing period if the original claim was rejected.
• The manual does not publish a separate universal corrected-claim filing deadline in the reviewed text.

Appeal and reconsideration deadlines

• Timely-filing denial appeals must be submitted in writing; no phone appeals.
• Claims payment appeals tied to reconsideration outcomes have a 90-day deadline from the reconsideration determination, but that is a different process from timely-filing appeals.

Trigger basis and caveats

• The trigger is the filing timeframe in the Provider or Facility Agreement, not a universal date in the manual.
• Proof of timely filing can include a claim copy with computer-printed filing date, an electronic acceptance/rejection report showing acceptance, or a letter requesting additional information.
• Because the actual timely-filing period is contract-specific, this response intentionally leaves the numeric limit unspecified.
• Do not assume the same timely-filing limit across all Wellpoint / Simply products.

Provider resources

• Florida provider home (official)
• Provider manual (official)
• Claims submission (official)
• Prior authorization (official)
• Policies, guidelines, and manuals (official)
• Forms and guides (official)
• Availity registration / access (official)

Sources