Claims Filing Deadlines

This section provides general instructions for submitting claims to HMSA. 

Introduction

Filing deadlines   

For HMSA’s Preferred Provider plans and HMO commercial plans, claims must be submitted within one year of the last day on which the services covered by the claim were rendered.

All claims (e.g., initial submissions, resubmissions) for services to Federal Employee Program (Federal Employees Health Benefits (FEHB) and Postal Service Health Benefits (PSHB), Fed 87 plan, and HMSA Plan for Postal Service Employees must be submitted by the end of the year following the year during which services were rendered.

Military facility claims must be submitted to HMSA within 6 years of the date of service.

Medicare Advantage

Participating Medicare Advantage providers have one year from the date of service to file all claims (e.g.; initial submissions, resubmissions, adjusted submissions) to HMSA.

Revision History