Optum's filing limit for behavioral health claims is 90 days
Optum counts the 90 days from the date of service, so moving a claim's follow-up date doesn't give your biller more time.
Co-founder, JotPsych
Your biller moves an unpaid claim's follow-up date to next month. Call the payer that day instead. Ask whether Optum has the claim and what's missing.
Optum's Provider Express claim tips, read October 1, 2026. If Optum never received a claim, or is missing information it needs, the claim can pass the limit while its follow-up date moves to next month.
What Optum's 90 days cover.
Optum's claim tips say Optum must receive all the information it needs to process your claim within 90 days of the date of service. Your biller can send a claim on time and still miss the limit if Optum never got the claim or is missing information.
Send any correction within 90 days of the day Optum received the original claim.
What one practice found in its billing notes.
Jessica Phillips, chief operating officer of an anesthesia practice in Roanoke, Virginia, can read her billers' notes on every account they work. Each unpaid claim goes to a biller's work queue. The biller either acts on the claim or moves its follow-up date out. "And then it falls in thirty days later and then thirty days later," Phillips said.
One note showed up on account after account, copied and pasted: "pushed out to allow more time." Check your own notes for that line.
Pushed out to follow-up next month
Pushed out to allow time for processing
Pushed out to allow more time
Day 90 from the date of service: the filing limit passes, and Optum has no claim on file
Each note moves the follow-up date, and no note records a call to Optum. A call before day 90 would show that Optum never received the claim, in time to send the claim again.
What to check first.
- Pull your unpaid claims, oldest date of service first.
- Read your biller's last note on each claim.
- Count the days you have left before each payer's limit.
- Call the payer the same day you find a note that only moves the date.
Phillips calls a missed filing limit "completely avoidable." Give your biller a written first step for each kind of problem on an unpaid claim, such as "call the patient" when your patient's information is wrong.
Phillips wrote her steps after she found the pasted notes. She blamed herself. "That falls on me as a manager for not explaining to my team what my expectations are," she said. Her reason for writing each step down: "what's obvious to us isn't always obvious to our employees."
What Cigna and Medicare allow.
Cigna gives claims from clinicians in its network the same 90 days, and under Cigna's contract you can't bill your patient for a claim denied as late. Traditional Medicare allows one calendar year.
| Payer | Filing limit | Applies to |
|---|---|---|
| Optum | 90 calendar days | Claims for behavioral health care sent to Optum |
| Cigna | 90 days | Claims from clinicians in Cigna's network |
| Medicare | 1 calendar year | Claims sent to traditional Medicare |
Optum's Provider Express claim tips, Cigna's When to File Claims page, and Medicare's federal filing rule; at Cigna, a contract or state law can allow more time. A claim the payer never received can pass its limit while your biller waits.
Set JotPsych's Next step filter to Track payer and sort by Oldest service date to list claims waiting on payers.
Book 15 minutes- Jessica Phillips, chief operating officer of Anesthesiology Consultants of Virginia, and Deepak Sharma, “The Rural Health Revenue Problem No Dashboard Shows,” session D5, Medical Group Management Association (MGMA) 2026 Annual Conference, San Antonio, September 28, 2026.
- Optum, Provider Express, “Very Useful Claim Tips”, the Timely Filing section, read October 1, 2026.
- Cigna Healthcare, When to File Claims, read September 30, 2026.
- Title 42 of the Code of Federal Regulations, section 424.44, Time limits for filing claims, paragraph (a)(1), via the Legal Information Institute, Cornell Law School, read September 30, 2026.