How soon must I submit a claim in order for it to be considered valid ?
Timely payment of claims depends on their timely submission to health plans, but it should be noted that delaying claim submissions could result in a plan rejecting a claim as invalid. California Insurance Code 10133.66 and Title 28 California Code of Regulations 1300.71(b)(1) of the Knox-Keene Act prohibit a health plan from requiring submission of a claim sooner than 90 days (for contracted providers) or 180 days (for noncontracted providers) from the date of service. However, individual dental plans have adopted their own policies as to the time frame in which a claim must be submitted in order to be considered valid. Be aware of each plan's policies and procedures related to receipt of claims. While one plan might accept claims up to a year after the date of service, another may require receipt of a claim within six months. Both plans are consistent with state law.