Molina Healthcare has no single national timely filing limit. For Medicaid claims, the window is set by each state's managed care contract — ranging from 95 days in Texas to 180 days in California, Virginia, and Washington, to 365 days in Ohio and Kentucky. Molina Medicare Advantage follows the CMS minimum of 365 days from the date of service. CO-29 denials from Medicaid plans must be appealed within the state-specific window, typically 60–180 days from the denial notice.
Why Molina's Timely Filing Limits Are Different From Other Major Payers
Unlike Aetna, UHC, or BCBS — which publish nationally uniform commercial timely filing limits — Molina Healthcare's Medicaid timely filing deadlines are governed by individual state contracts. There is no single Molina national TFL, and the difference between states is not marginal.
Molina is the fifth-largest Medicaid managed care organization in the U.S., covering approximately 6.5% of comprehensive Medicaid MCO enrollment as of mid-2024, according to KFF analysis. It operates in 18–19 states under separate Medicaid contracts — each of which sets its own timely filing window. Texas requires claims within 95 days. Ohio and Kentucky allow 365 days. California and Virginia allow 180 days.
This creates two predictable failure modes for billing teams:
Under-filing in lenient states: A team applies Texas's 95-day window everywhere. In Ohio, they have 365 days — but they stop trying to recover claims at day 100 and leave months of filing opportunity on the table.
Over-filing in strict states: A team applies Ohio's 365-day window everywhere. In Texas, they file on day 150 and receive CO-29 denials on every one of those claims — denials that are nearly impossible to overturn without documented proof of timely original submission within 95 days.
Knowing which state's window applies is not optional when billing significant Molina Medicaid volume. It is the threshold question.
Molina Medicaid TFL Is State-Specific — Not National
Texas (95 days), California and Virginia (180 days), and Ohio and Kentucky (365 days) are all Molina Medicaid. Applying the wrong state's window generates preventable CO-29 denials or missed recovery opportunities. Confirm your state's specific TFL in Molina's state provider manual before filing.
Molina Medicaid Timely Filing Limits by State
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Each state window below reflects the Medicaid managed care contract between Molina and the applicable state Medicaid agency, as required under 42 CFR §447.45.
| State | Initial Claim TFL | Clock Starts | Source / Notes |
|---|---|---|---|
| Texas | 95 days | Date of service | Confirmed — TMHP standard for Medicaid MCOs; applies to Molina TX Medicaid and CHIP claims |
| California | 180 days | Date of service | Medi-Cal managed care contract; non-participating provider windows may differ — verify separately |
| Virginia | 180 days | Date of service | Six calendar months from DOS per Molina VA provider agreement terms |
| Washington | 180 days | Date of service (or per contract) | Contract provision governs where provider agreement specifies a different window |
| Iowa | 180 days (in-network) / 365 days (out-of-network) | Date of service | Out-of-network window is 365 days from DOS or discharge per Molina Iowa 2023 Claims & Billing Manual |
| Kentucky | 365 days | Date of service / discharge | Inpatient: 365 days from discharge. Outpatient: 365 days from DOS. Per Molina KY Payment Policy (Passport by Molina) |
| Ohio | 365 days | Date of service | Ohio Administrative Code (OAC) Rule 5160-1; confirmed in Molina 2026 MyCare Ohio Provider Manual |
| FL, NM, NV, MI, IL, UT, ID, MS, SC and other active states | Verify in state provider manual | — | Molina's state-specific provider manuals are authoritative. Do not apply another state's window. |
Always confirm the applicable window before filing a late claim or submitting a timely filing exception. The most reliable sources are: (1) the state-specific Molina provider manual at provider.molinahealthcare.com, (2) the denial notice itself, which Molina is required to include per 42 CFR §438.404, or (3) Molina's state provider services line.
COB and Retroactive Eligibility: The Clock Resets
For claims where Molina Medicaid is secondary to Medicare or another primary payer, most state contracts measure the timely filing window from the date of the primary payer's EOB, not the service date. Attach the primary remittance. For retroactive eligibility — when a patient's Molina Medicaid enrollment is confirmed after the service date — the window typically starts from the date Molina receives the enrollment notice from the state broker, not from the DOS. Document the enrollment notification date and include it with any late filing.
Molina Medicare Advantage Timely Filing
For all Molina Medicare Advantage plans, the timely filing limit is 365 days from the date of service — the CMS minimum required for all Part C plans under 42 CFR §422.
Unlike Medicaid, Molina cannot apply a shorter TFL to its Medicare Advantage plans. The 365-day federal minimum applies uniformly across all Molina MA markets.
Dual-Eligible Patients: Two Different Clocks
A patient enrolled in both Molina Medicare Advantage and Molina Medicaid (dual-eligible) generates two separate billing events — each with a different TFL. The MA claim runs on 365 days from the service date. The Medicaid secondary claim runs on the state-specific window measured from the Medicare EOB date, not the service date. Track these separately. Missing the secondary Medicaid TFL while correctly filing the primary MA claim is a common AR gap for practices billing high volumes of dual-eligible patients.
For CO-29 appeal procedures on Molina MA claims and corrected claim submission windows, see Corrected Claim Timely Filing Limits 2026 for multi-payer corrected claim policy comparisons.
Molina ACA Marketplace (Ambetter) Timely Filing
In states where Molina operates a marketplace product — often branded as Ambetter from Molina — the standard timely filing limit is 180 days from the date of service, consistent with ACA marketplace regulations under 45 CFR §147.136.
Molina's marketplace footprint is narrower than its Medicaid and Medicare Advantage presence. If you are billing Ambetter or other Molina marketplace products, confirm the plan's provider manual for the applicable window. Some state marketplace contracts specify a shorter window than the 180-day regulatory minimum.
CO-29 Denials: How to Prove Timely Filing to Molina
A CO-29 denial from any Molina plan means the claim was received outside the applicable filing window. The appeal response must focus on proving the original submission was within the correct window — not on clinical justification.
Molina accepts the following as proof of timely filing:
- 277CA clearinghouse acknowledgment (preferred): This report confirms the claim submission date at the clearinghouse level. It is the strongest proof Molina accepts and should be archived for at least seven years. Many practices retain 277CA reports for only 90 days — losing the ability to appeal CO-29 denials after that window.
- Availity Essentials portal confirmation: A confirmation email or screenshot from Molina's provider portal showing the claim submission date within the filing window.
- Fax transmission confirmation: Fax report showing the date, time, page count, and recipient fax number. Must be the original fax confirmation from the time of submission — a later fax of the claim without a transmission report does not establish prior timely submission.
- Certified mail return receipt: USPS postmarked receipt with a date within the filing window.
Recognized exceptions that extend the TFL window:
- Retroactive eligibility: If the member's Molina coverage was applied retroactively after the service date, the filing window runs from the date Molina receives notification from the state enrollment broker — not from DOS. Include the retroactive enrollment notice from Molina with the claim.
- COB delay: When Molina is secondary and the primary payer's payment was delayed, the window runs from the date on the primary payer's EOB, not the service date. Attach the primary remittance to the secondary claim.
- Documented systemic disruptions: Where a clearinghouse or payer system outage (such as the Change Healthcare disruption in early 2024) prevented timely submission, Molina and state Medicaid agencies extended TFL windows. Retain documentation of any systemic disruption as part of the exception package.
Appealing a Molina CO-29 Denial
After receiving a CO-29, a secondary appeal window opens. The deadline — and the correct submission channel — depend on the plan type.
| Plan Type | CO-29 Appeal Window | Submission Method | After Plan Denial |
|---|---|---|---|
| Medicaid | 60–180 days from denial notice (state-determined) | State-specific Molina provider portal or mail per denial notice instructions | State Fair Hearing |
| Medicare Advantage | 60 days from unfavorable determination | Redetermination request to Molina MA plan; include claim number and denial reference | QIC → ALJ → Federal Court |
| ACA Marketplace (Ambetter) | 180 days from EOP receipt | Internal appeal per instructions on denial notice | External IRO review |
For Medicaid CO-29 appeals, the deadline and submission address vary by state. The denial notice must include this information — Molina is required under 42 CFR §438.404 to specify appeal rights and deadlines in every adverse action notice. If it doesn't, request it in writing before the window closes.
When Molina upholds a Medicaid CO-29 at the plan level, providers can escalate to a State Fair Hearing — an independent proceeding conducted by the state Medicaid agency, not Molina. The deadline to request a fair hearing is typically 90 days from the plan's final denial, but varies by state. For Medicare Advantage denials, the escalation ladder is QIC → ALJ → Medicare Appeals Council → Federal Court.
For a comprehensive overview of Molina's appeal framework across all denial types, see Molina Healthcare Appeal Guide 2026. For cross-payer timely filing comparisons, see the Insurance Appeal Deadlines Guide 2026.
Corrected Claims: Molina's Resubmission Window
A corrected claim (Box 22 Resubmission Code 7 on CMS-1500, or frequency code 7 on UB-04) is a separate administrative event from both the original claim and a CO-29 appeal. Molina generally requires corrected claims to be submitted within 90 days of the original remittance advice date.
Attach the original claim number and the remittance in every corrected claim submission. Without the frequency code 7 and the original claim reference number, Molina may process the submission as a new claim — triggering a duplicate-claim denial instead of a replacement. That error restarts the filing window from the service date, not the remittance date, and often results in a CO-29 denial on the resubmission.
For complete corrected claim guidance across UHC, Cigna, Anthem, Humana, and other payers, see Corrected Claim Timely Filing Limits 2026.
How Muni Appeals Handles Molina Timely Filing Denials
Tracking Molina's state-by-state TFL windows requires managing multiple filing deadline clocks simultaneously — a challenge compounded by Molina's significant denial volume. MoneyGeek's January 2026 analysis of CMS Transparency in Coverage data puts Molina's average denial rate at approximately 24%, compared to the national average of roughly 18%.
Muni Appeals supports the Molina CO-29 workflow across plan types:
- Identifies CO-29 denials from Molina Medicaid and MA remittances and flags the state-specific appeal window per denial
- Tracks the 60–180-day Medicaid and 60-day MA appeal windows per claim so nothing ages out
- Compiles 277CA clearinghouse reports, portal confirmations, and retroactive eligibility documentation into the CO-29 reconsideration package
- Generates state-specific Molina reconsideration letters with the correct submission addresses and documentation requirements
- Monitors appeal status through Molina's state provider portals
Frequently Asked Questions
What is the Molina Healthcare timely filing limit in 2026?
There is no single national Molina timely filing limit. For Medicaid, the window varies by state: Texas requires claims within 95 days of the date of service; California, Virginia, and Washington require 180 days; Ohio and Kentucky allow 365 days. Molina Medicare Advantage follows the CMS-mandated minimum of 365 days from DOS under 42 CFR §422. Molina ACA Marketplace plans are generally 180 days from DOS. Always verify your state's Medicaid TFL in Molina's state-specific provider manual before filing — individual state contracts are the authoritative source.
Why does Molina's timely filing limit vary by state?
Because Molina Medicaid is a managed care organization operating under state Medicaid contracts, not a national commercial insurer. Each state Medicaid agency sets timely filing requirements in its contract with Molina, subject to the federal minimum standard in 42 CFR §447.45. States with their own shorter windows (like Texas at 95 days) are operating under state-specific Medicaid managed care authority. Commercial payers like Aetna and UHC publish national commercial TFLs — but Medicaid MCO windows do not work the same way.
How do I appeal a Molina CO-29 denial?
Submit a timely filing exception appeal with documented proof the original claim was filed within the applicable window. Required documentation: 277CA clearinghouse acknowledgment report for electronic submissions, Availity portal confirmation screenshot for portal submissions, or fax transmission report for fax submissions. For Medicaid, submit through the state-specific Molina provider portal or the address on the denial notice, within 60–180 days of denial (state-determined). For Medicare Advantage, submit a redetermination to the Molina MA plan within 60 days of the unfavorable determination. Do not include clinical justification in a CO-29 appeal — it will not address the denial reason.
Does Molina accept retroactive eligibility as a timely filing exception?
Yes. When a member's Molina Medicaid enrollment is confirmed retroactively after the service date, most state contracts measure the filing window from the date Molina receives notification from the enrollment broker — not from the service date. Include the retroactive enrollment notice from Molina with the claim or appeal. Without that documentation, Molina will measure from the service date and the exception will not be credited.
What is Molina's CO-29 appeal window for Medicaid claims?
The Medicaid CO-29 appeal window is state-determined, typically ranging from 60 to 180 days from the denial notice. The exact deadline will be printed on the denial notice — Molina is required under 42 CFR §438.404 to include appeal rights and deadlines in every adverse action notice. If Molina upholds the CO-29 at the plan level, you can escalate to a State Fair Hearing, generally within 90 days of the plan's final denial (varies by state).
How do I find Molina's state-specific timely filing limit?
The most reliable sources are: (1) the state-specific Molina provider manual, available at provider.molinahealthcare.com for your state; (2) the denial notice itself, which must include the applicable TFL and appeal deadline under 42 CFR §438.404; or (3) Molina's state provider services line — call the number on your Molina provider ID card or remittance for your state. Do not rely on a different state's manual or a general Molina guide that does not specify your state.
What documentation should I archive to avoid Molina CO-29 denials?
Archive 277CA clearinghouse acknowledgment reports for at least seven years for every electronic claim submission. Most practices retain these for only 90 days — once the records are gone, CO-29 denials become very difficult to overturn. For portal submissions, save confirmation emails to a dated folder by claim number. For fax submissions, retain the transmission confirmation with date, time, page count, and recipient fax number. This documentation is the only evidence Molina accepts as proof of timely submission.
What happens if I submit a corrected claim without the frequency code 7?
Molina will process the submission as a new original claim rather than a replacement. This typically results in a duplicate-claim denial (CO-18) against the original paid claim, or — if the corrected claim is submitted outside the original TFL window from the date of service — a CO-29 denial. The original claim's adjudication stands. Resubmit with Box 22 Resubmission Code 7 (CMS-1500) or frequency code 7 (UB-04) and include the original claim reference number in every corrected claim.
Ready to Stop Losing Revenue to Molina Timely Filing Denials?
Molina's state-by-state Medicaid TFL variation — 95 days in Texas, 180 days in California and Virginia, 365 days in Ohio and Kentucky — makes it one of the more administratively complex payers for billing teams covering multiple states. A wrong assumption about the filing window costs real revenue, either through preventable CO-29 denials or abandoned AR that was still collectible.
Get Started:
- Automated CO-29 detection from Molina Medicaid and MA remittances
- State-specific appeal window tracking per denial so nothing ages out
- CO-29 reconsideration packages with 277CA documentation and state-specific submission instructions
- Corrected claim tracking with frequency code verification
- Appeal status monitoring through Molina's state provider portals
This guide reflects 2026 Molina Healthcare timely filing policies based on state Medicaid managed care contracts, Molina's published state provider manuals, Ohio Administrative Code Rule 5160-1, TMHP provider guidance, and federal regulations under 42 CFR §447.45 (Medicaid) and 42 CFR §422 (Medicare Advantage). State-specific Medicaid contracts govern over any general summary — verify your state's current TFL in the Molina state provider manual before relying on the deadlines above. For Molina's full denial appeal framework across all denial types, see our Molina Healthcare Appeal Guide 2026.