Deadlines
Health Plans Inc Timely Filing Limits: How the Deadline Works
Searching for one timely filing number for Health Plans, Inc. (HPI) usually ends in frustration, because HPI does not set one. The deadline comes from the provider network attached to the member's plan. This page explains where to find the right number and lays out the rules that are published for the Harvard Pilgrim network, which many HPI plans use. Mailing details are on the Health Plans Inc claims address page.
Quick answer
HPI tells providers to check the member's participating provider network for filing limit terms, and its provider appeal form says the prevailing network's filing limit applies. For the Harvard Pilgrim network, the 2026 provider manual sets 90 days from the date of service.
Why HPI has no single deadline
HPI is a third-party administrator. Each employer's plan is paired with a provider network, and the network contract between the provider and that network sets the filing window. A practice that is in-network through Harvard Pilgrim, for example, is bound by Harvard Pilgrim's filing rules even when HPI processes the claim. Your contract with the network always takes priority over a general summary like this one.
Harvard Pilgrim network rules, in one table
| Situation | Window | Clock starts |
|---|---|---|
| Initial claim | 90 days | Date of service |
| Rejected or returned claim, corrected and resubmitted | Must be accepted within the same 90 days | Date of service |
| Secondary claim (coordination of benefits) | 90 days | Date the other insurer processed the claim |
| COB in Maine | 120 days | Primary insurer's processing date or retroactive denial |
| COB in New Hampshire, after a retroactive denial | 180 days | Date the primary insurer retroactively denied a paid claim |
| COB for behavioral health in Massachusetts | 365 days | Date of the denial |
| Filing limit appeal | Received within 90 days | Original EOP date |
| Misidentified member (patient did not show the card) | Not considered if over one year old | Harvard Pilgrim denial date |
Two points in that table cause most lost claims. First, a rejected claim does not stop the clock: the corrected version must be accepted inside the original 90 days. Second, for electronic claims Harvard Pilgrim counts the receipt date as the day its EDI system receives the file, and files arriving after 2:00 p.m. get the next business day's date.
Worked examples
Example 1: a routine office visit
Date of service March 3, 2026. Counting 90 days forward lands on Monday, June 1, 2026. If you submit electronically at 4:00 p.m. that Monday, Harvard Pilgrim's rules would assign a receipt date of Tuesday, June 2, one day late. Sending a few days earlier, rather than on the last afternoon, avoids that trap.
Example 2: HPI is the secondary payer
Date of service January 10, 2026; the primary insurer processes the claim on May 20, 2026. The original 90 days ran out in April, but the COB rule gives 90 days from the primary's processing date, so the secondary claim is timely through August 18. Attach the primary insurer's EOB, which is the evidence that makes the later date count.
Example 3: the claim was rejected
Date of service July 1, 2026; the first electronic submission on July 20 is rejected for an invalid member ID. The deadline is still September 29. Correct the ID and resubmit right away, and keep both the rejection report and the later acceptance report.
What to keep as proof of timely filing
- Electronic claims: the clearinghouse or payer acceptance report (a 277 acknowledgment or response report) showing the claim was accepted within the window. Harvard Pilgrim suggests keeping response reports for at least 90 days after the filing limit.
- Paper claims: a printout of the patient account ledger with the submission date clearly marked.
- Secondary claims: the primary insurer's EOB or remittance with its processing date.
- Misidentified members: proof you billed another insurer or the patient, and when you learned of the HPI coverage.
If a timely filing denial arrives anyway, the appeal needs exactly this evidence. The steps and address are in our guide to the Health Plans Inc appeals address and process.
Members: deadlines for claims you file yourself
If you submit a reimbursement claim yourself, the deadline is set by your plan, not by a provider network. Look in the Summary Plan Description under a heading such as "filing a claim" or "claims procedures", or call the member services number on your card. HPI's member forms page also reminds members to check the SPD before sending a claim or reimbursement form, since not every form applies to every plan.
Other networks on HPI cards
HPI cards can show other network partners, such as UnitedHealthcare, Cigna, Employers Health Network or Prime Health Services. Each publishes its own provider rules, and their filing windows can be different from Harvard Pilgrim's. If the card shows one of those networks, use that network's provider manual or your contract. The network logo on the card tells you which rulebook applies; our guide to reading your HPI ID card shows where to look. When the card lists a payer ID, our payer ID guide explains how to route the claim.
Related guides
Sources
Official and primary sources we checked for this page (accessed November 2026). Addresses, IDs and phone numbers can change; the member ID card and HPI's own website are authoritative.
- Health Plans, Inc. client site, Submitting a Claim (pioneer)
- HPI, Provider Appeal Form, non-HPHC network (PDF)
- Harvard Pilgrim Provider Manual, Clean Claims (2026, PDF)
- Harvard Pilgrim Provider Manual, Filing Limit Appeals (July 2025, PDF)
- Harvard Pilgrim Provider Manual, Electronic Claims (April 2026, PDF)
- HPI, Member Forms & Resources
- U.S. Department of Labor (EBSA), Filing a Claim for Your Health Benefits