TMPPM 2008 > Provider Information > Claims Filing > Other Insurance Claims Filing

5.11.1.5 Filing Deadlines

Claims that involve filing to a TPR have the following deadlines:

•Claims with a valid disposition (payment or denial) must be received by TMHP within 95 days of the date of disposition by the TPR and within 365 days of the DOS. Appealed claims that were originally denied with EOB 00260, which indicates that the provider files with a TPR, must be received within 95 days of the date of disposition by the TPR or within 120 days of the date on which TMHP denied the claim.

•If more than 110 days have passed from the date a claim was filed to the TPR without a response, the claim is submitted to TMHP for consideration of payment.

•In accordance with federal regulations, all claims must initially be filed with TMHP within 365 days of the DOS.

Refer to: "Third Party Resources (TPR)" for more information.