Michigan Nursing Home Administrator (NHA) Practice Exam

What is the time limit for submitting a Medicaid claim?

1. 6 months from the date of service

2. 12 months from the date of service

3. 24 months from the date of service

4. 3 months from the date of service

The correct answer is: 12 months from the date of service

The time limit for submitting a Medicaid claim is 12 months from the date of service. This duration is established to ensure that providers have a reasonable window to submit claims while also maintaining efficient processing and payment cycles for Medicaid. The 12-month period allows for the collection of necessary documentation, the resolution of any discrepancies, and the overall management of billing processes. The other choices do not align with the established guidelines. A shorter time frame, such as 3 or 6 months, would be too restrictive and could disadvantage providers who need additional time for various legitimate reasons, including delays in documentation or administrative processes. The 24-month option exceeds the regulations in place, which aim to keep the claims process timely and organized. Thus, 12 months is the correct and compliant timeframe for submitting Medicaid claims.