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Last Updated: 2026-04-07

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Overview

Filing deadline calculations are now driven by the organization’s jurisdiction profile (PF-96). This replaces the previously hardcoded 365-day AHCCCS assumption with a configurable value that varies by state Medicaid program.

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Fallback Chain

The system resolves the filing deadline in this order:
  1. Jurisdiction Profile — billing.filing_deadline_days from the organization’s PF-96 profile (e.g., 365 for Arizona, 180 for California)
  2. PM Module Settings — claim_filing_deadline_days from the organization’s PM settings (overrides the profile if set)
  3. Hardcoded Default — 365 days (used if neither profile nor settings are configured)
Note: The PM Module Settings value, when set, overrides the jurisdiction profile. This allows per-organization customization independent of state rules.

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Configuration

Jurisdiction profiles are managed at the platform level. Contact your system administrator to assign the correct state profile to your organization. Common profiles:
StateProgramFiling Deadline
ArizonaAHCCCS365 days
CaliforniaMedi-Cal180 days
TexasMedicaid95 days
New YorkMedicaid120 days

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PM Settings Override

To override the profile value for your organization:
  1. Navigate to Practice Management → Settings
  2. Under Claims Configuration, locate Claim Filing Deadline (days)
  3. Enter the desired number of days
  4. Click Save
The description reads: “Days from the date of service to file a claim. Overrides the jurisdiction profile value if set.”

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Arizona Parity

Organizations configured with the Arizona/AHCCCS jurisdiction profile receive identical behavior to the previous hardcoded 365-day default. No action is required for existing Arizona organizations.

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Compliance Reports

The Timely Filing Report now uses the profile-driven deadline when calculating filing compliance rates. The complianceWindowHours parameter (default: 72 hours) is also profile-driven for future use.

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References