Claim Adjustment Requests Must Be Filed Within 15 Months of Original Claim Finalization Date
Published Date: Wed, Aug 26, 2026
Effective Dec. 1, 2026, all claim adjustment requests must be received within 15 months (455 calendar days) from the finalization date of the original claim.
Claim adjustment requests that are submitted after 455 days will be denied for not adhering to timely filing. This policy update applies to claim adjustment requests for our Commercial, Medicare Advantage, and Federal Employee Program (FEP) lines of business.
Note: This administrative change excludes claim adjustment requests for BlueCard Home.
Finalization Date
The “receipt date” is the date the original claim was received by Highmark. The “finalization” date is the date Highmark completes processing of that claim.
Highmark Provider Manual 6.1: Timely Filing Requirements will be updated effective Dec. 1, 2026, to reflect this change.
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