Medicare Managed Care Manual (Pub. 100-16), Ch. 16a § 120
Timely Filing Requirement
120 – Timely Filing Requirement
(Rev. 99, Issued: 05-27-11, Effective: 05-27-11, Implementation: 05-27-11)
For services furnished on or after January 1, 2010, deemed and non-contracting providers
furnishing services to PFFS plan members must submit a claim to the plan for an Original
Medicare-covered service within the same time frame the provider would have to submit
under Original Medicare, which is within 1 calendar year after the date of service
The rules for submitting timely claims under Original Medicare can be found at
https://www.cms.gov/MLNMattersArticles/downloads/MM6960.pdf.