UnitedHealthCare of Texas, Timely Filing Limit

The most important thing to confirm with UnitedHealthCare of Texas, 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

• Texas Community Plan provider materials state that claims must be received within 95 days of the service date to be considered for payment. The manual also notes that if the member had other coverage, the date on the other carrier’s payment correspondence starts the timely-filing period for submission to UnitedHealthcare Community Plan, and that rejected claims must be corrected within 90 days from date of service or close of business from the primary carrier or they may be denied as late-billed. A separate manual section says to refer to the Provider Agreement if the timely-filing limit is unknown, indicating that limits can vary by state requirements and contract.

Initial claim filing limits

• Claims must be received within 95 days of the service date to be considered for payment (Texas Community Plan manual).

Corrected claim filing limits

• If a claim is rejected, and corrections are not received within 90 days from date of service or close of business from the primary carrier, the claim is considered late billed and will be denied timely filing.
• Timely filing limits can vary based on state requirements and contracts; refer to the Provider Agreement if unknown.

Appeal and reconsideration deadlines

• Appeals for recoupment/denial issues in Texas Medicaid-related pathways must adhere to all filing and appeal deadlines for HHSC review; the manual also states all claims must be finalized within 24 months from the date/service date for certain appeal paths.
• For some reconsideration/recovery workflows, the provider manual directs providers to follow the appeals and grievances grid for submission information.

Trigger basis and caveats

• For other-insurance situations, the date on the other carrier’s payment correspondence starts the timely-filing period.
• Proof of timely filing requires documentation such as a denial/rejection letter, EOB, or employer/insurer letter showing no coverage/terminated coverage; a submission report alone is not enough for electronic claims and must be accompanied by an acceptance report.
• The timely-filing guidance found is specific to Texas Community Plan/Medicaid-oriented materials and may not apply to every UnitedHealthcare Texas plan.
• Some appeal timing details vary by managed care program and whether the issue is fee-for-service, managed care recoupment, STAR Kids, or HHSC review.

Provider resources

• Texas Care Provider Manual (2026) (official)
• Prior Authorization and Notification - Texas Community Plan (official)
• Prior Authorization Timelines - Texas Community Plan (official)
• Texas: Help avoid service delays (official)
• Digital and paperless initiatives (official)
• Aug. 1: Electronic reconsideration and appeal submissions required (official)

Sources