From 1 December 2026, participants and plan managers must claim within 90 days of service delivery — and claims submitted more than 90 days late face additional integrity holds of up to 28 days. For providers, this changes invoicing from back-office chore to cash-flow priority.

Audit your current lag

Pull your last three months of invoices and measure the gap between service date and claim date. Anything routinely landing past 60 days is now at risk. The most common culprits: batch invoicing at month-end, missing support item codes held up in email threads, and plan manager queries sitting unanswered.

Three fixes before December

Invoice weekly, not monthly. Weekly cycles keep every claim comfortably inside the window even when queries add a round trip.

Put the support item code on the job record, not just the invoice. Most 90-day failures start as missing data discovered too late. Capture item numbers, quantities and dates at the point of service.

Answer plan manager queries within 48 hours. With holds of up to 28 days on late claims, a slow query response can push payment out two months. Treat every query like it has a clock on it — because now it does.

What good looks like

Providers who already invoice weekly with coded job records will barely notice December. Those running monthly batches with manual reconciliation should start the transition now, while there's still slack in the system. Talk to your plan managers about their own cut-off expectations — many will set internal deadlines earlier than 90 days to protect themselves.

Dates reference NDIA and Department of Health publications, October 2026. Check the latest claiming guidance for your specific supports.