What is the time period when you submit a medical claim until it is paid?

Answer 1

There is no set answer to that question. Claims payers are notoriously backlogged.

How long ago was it submitted? I'd allow 6 weeks before I started calling them to find out why it wasn't paid. But I've actually seen them take even longer then that.

Answer 2

< 30 days if a claim is received with all the information needed to complete the processing.

I work in insurance, and 95% of our complete/clean claims are processed in <15 days. If it takes longer, it can be because info is missing, or because its a complicated claim.

For an insurance co to receive a claim, process & pay it, and then cut & mail a check, and for a provider to cash & post the check.... We're looking at about 1 mo total for most services.
Most provider's have agreement with insurance companies, that an insurance will pay, pend or deny a claim in <30 days, or they receive late interest...

If you sent in the claim yourself, I'd give it 7-14 days. (Unless it was for a service rendered overseas, which takes longer due to currency conversion, and translation.) If its longer than that, I'd call and make sure they don't need additional info.

Answer 3

Generally, six weeks, but some take as many as six months or more to pay. Denials usually come within 2-3 weeks. Almost always by six weeks, you can find out claim status.