Reviewed Sep 20, 2026 · maintained by Erin Rose · general reference, not legal advice
Read this first: which plans this table reaches
Every row below is state insurance law. It reaches plans the state regulates — fully-insured employer plans, individual and small-group policies, HMOs, and in some states Medicaid managed care. It does not reach self-funded (ERISA) employer plans, which cover roughly 63% of workers with employer coverage, and it never reaches Medicare or Medicare Advantage. So before you put a state prompt-pay deadline or interest rate in a demand letter, confirm the plan is not self-funded. The "reaches" column records what each statute's own text says it covers.
Late-payment interest calculator
Simple interest on a clean claim paid after the state deadline, at the statutory rate. Only states whose statute sets one flat, automatic rate are computed; pick any other state to see why it is not.
Clean-claim deadlines and interest, all 50 states + DC
Deadlines run from the payer's receipt of a clean claim — one with nothing missing that the payer needs to adjudicate. A claim the payer pends for records is not clean, and the clock usually stops. That is why the fastest path to interest is to send the claim clean the first time: Claim Check runs the NCCI, MUE and modifier edits before the claim leaves your office.
| State | Electronic claim | Paper claim | Interest | Extra penalty | Reaches | Statute | Status |
|---|---|---|---|---|---|---|---|
| Alabama | 30 days | 45 days | formula | yes | fully-insured, HMO, PPO | Ala. Code § 27-1-17 | Unverified |
| Alaska | 30 days | same | 15%/yr | yes | fully-insured, HMO, PPO | Alaska Stat. § 21.36.495 | Unverified |
| Arizona | 30 days | 30 days | formula | yes | fully-insured, HMO, PPO | Ariz. Rev. Stat. § 20-3102 | Confirmed |
| Arkansas | — | — | 12%/yr | yes | fully-insured, HMO | Ark. Code Ann. § 23-66-215 | Unverified |
| California | 30 days | 30 days | 15%/yr | yes | HMO | Cal. Health & Safety Code § 1371 | Confirmed |
| Colorado | 30 days | 45 days | 10%/yr | yes | fully-insured, HMO, PPO | Colo. Rev. Stat. § 10-16-106.5 | Confirmed |
| Connecticut | 20 days | 60 days | 15%/yr | yes | fully-insured, HMO, PPO | Conn. Gen. Stat. § 38a-816(15) | Confirmed |
| Delaware | 30 days | 30 days | formula | yes | fully-insured, HMO | 18 Del. Admin. Code § 1310… | Confirmed |
| District of Columbia | 30 days | 30 days | formula | none found | fully-insured, HMO, PPO | D.C. Code § 31-3132 | Confirmed |
| Florida | 20 days | 40 days | 12%/yr | yes | fully-insured group health insurer, fully-insured individual health insurer, PPO +1 | Fla. Stat. § 627.6131 | Confirmed |
| Georgia | 15 days | 30 days | 12%/yr | yes | fully-insured health benefit plans, TPA-administered claims | O.C.G.A. §§ 33-24-59.5 and 33-24-59.14 | Unverified |
| Hawaii | 15 days | 30 days | 15%/yr | yes | accident and health or sickness insurers, mutual benefit societies, dental service corporations +1 | Haw. Rev. Stat. § 431:13-108 | Confirmed |
| Idaho | 30 days | 45 days | 12%/yr | yes | fully-insured, HMO/managed care organization, hospital/medical/long-term-care/vision insurers +1 | Idaho Code §§ 41-5601 to 41-5606… | Confirmed |
| Illinois | 30 days | 30 days | 9%/yr | none found | fully-insured, HMO, PPO +3 | 215 ILCS 5/368a… | Confirmed |
| Indiana | 30 days | 45 days | formula | none found | fully-insured, HMO | Indiana Code 27-8-5.7… | Unverified |
| Iowa | 30 days | 30 days | 10%/yr | none found | fully-insured, HMO, state-regulated PPO/other health benefit plans | Iowa Code §507B.4A… | Confirmed |
| Kansas | 30 days | 30 days | formula | yes | fully-insured, HMO, PPO/other accident-and-sickness insurers, TPAs, and entities that pay claims under such policies | K.S.A. 40-2442… | Confirmed |
| Kentucky | 30 days | 30 days | formula | none found | fully-insured, HMO, Medicaid MCO | KRS 304.17A-702… | Confirmed |
| Louisiana | 25 days | 45 days | 12%/yr | yes | fully-insured, HMO, PPO | La. R.S. 22:1831… | Confirmed |
| Maine | 30 days | same | formula | yes | fully-insured, HMO, PPO | 24-A M.R.S. §2436 | Confirmed |
| Maryland | 30 days | same | formula | yes | fully-insured, HMO | Md. Code Ann., Ins. §15-1005 | Confirmed |
| Massachusetts | 45 days | same | 18%/yr | none found | fully-insured | Mass. Gen. Laws c. 175, §108, Fourth (c) | Confirmed |
| Michigan | 45 days | same | 12%/yr | yes | fully-insured | MCL 500.2006(8) | Confirmed |
| Minnesota | 30 days | same | formula | yes | fully-insured, HMO | Minn. Stat. §62Q.75 | Confirmed |
| Mississippi | 25 days | 35 days | formula | yes | fully-insured | Miss. Code Ann. §83-9-5(1)(h) | Unverified |
| Missouri | — | — | formula | yes | fully-insured, HMO, Medicaid MCO | Mo. Rev. Stat. §376.383 | Confirmed |
| Montana | 30 days | same | 10%/yr | none found | fully-insured | Mont. Code Ann. §33-18-232 | Confirmed |
| Nebraska | 30 days | 45 days | 12%/yr | none found | fully-insured, HMO, prepaid limited health service organization +2 | Neb. Rev. Stat. §§ 44-8001 to 44-8010… | Confirmed |
| Nevada | 21 days | 30 days | 10%/yr | yes | fully-insured individual health insurance, group health insurance, HMO/managed care organizations +4 | NRS 689A.410… | Confirmed |
| New Hampshire | 15 days | 30 days | 18%/yr | yes | individual policy of accident or health insurance providing benefits for medical or hospital expenses, group policy of accident or health insurance providing benefits for medical or hospital expenses | RSA 415:6-h… | Confirmed |
| New Jersey | 30 days | 40 days | 12%/yr | yes | fully-insured, HMO, health service corporation +3 | N.J.S.A. 17B:26-9.1… | Confirmed |
| New Mexico | 30 days | 45 days | 18%/yr | yes | fully-insured, HMO, individual health plans +4 | 13.10.28 NMAC… | Confirmed |
| New York | 30 days | 45 days | 12%/yr | none found | insurers/organizations/corporations licensed or certified under NY Insurance Law Article 43, NY Insurance Law Article 47, NY Public Health Law Article 44 | N.Y. Insurance Law § 3224-a… | Confirmed |
| North Carolina | 30 days | 30 days | 18%/yr | yes | fully-insured accident and health policies, nonprofit hospital/medical service corp contracts, HMO subscriber contracts +2 | N.C. Gen. Stat. § 58-3-225… | Confirmed |
| North Dakota | 15 business days | 15 business days | — | yes | accident and health insurance policies | N.D. Cent. Code § 26.1-36-37.1… | Confirmed |
| Ohio | 30 days | same | 18%/yr | yes | fully-insured sickness and accident policies / benefits contracts, health insuring corporation contracts) | Ohio Rev. Code §§ 3901.38… | Confirmed |
| Oklahoma | 30 days | 45 days | 10%/yr | yes | fully-insured, HMO, non-profit health service/indemnity corporations +2 | 36 O.S. § 1219 | Confirmed |
| Oregon | 30 days | same | 12%/yr | yes | fully-insured, HMO, individual and group health benefit plans | ORS 743B.450… | Confirmed |
| Pennsylvania | 45 days | same | 10%/yr | yes | fully-insured, HMO, PPO +1 | 40 P.S. § 991.2166… | Confirmed |
| Rhode Island | 30 days | 40 days | 12%/yr | yes | fully-insured, HMO, nonprofit hospital/medical/dental service corporation +1 | R.I. Gen. Laws § 27-41-64… | Confirmed |
| South Carolina | 20 business days | 40 business days | 8.75%/yr | yes | fully-insured, HMO, health insurance plan) | S.C. Code Ann. §§ 38-59-210, 38-59-230, 38-59-240… | Confirmed |
| South Dakota | 30 days | 45 days | — | yes | fully-insured, HMO | S.D. Codified Laws §§ 58-12-19… | Confirmed |
| Tennessee | — | 30 days | — | none found | fully-insured, HMO | Tenn. Code Ann. § 56-7-109… | Confirmed |
| Texas | 30 days | 45 days | 18%/yr | yes | fully-insured, PPO, HMO | Tex. Ins. Code § 1301.103… | Unverified |
| Utah | 30 days | 30 days | formula | yes | fully-insured, HMO, TPA-administered plans | Utah Code § 31A-26-301.6… | Confirmed |
| Vermont | 30 days | same | 12%/yr | none found | fully-insured, HMO, PPO +4 | 18 V.S.A. § 9418… | Confirmed |
| Virginia | 40 days | same | 6%/yr | yes | fully-insured, HMO, PPO +1 | Va. Code §38.2-3407.15… | Confirmed |
| Washington | 30 days | same | formula | none found | fully-insured, HMO, PPO +1 | WAC 284-170-431… | Confirmed |
| West Virginia | 30 days | 40 days | 10%/yr | yes | fully-insured, HMO, PPO | W. Va. Code §33-45-2… | Confirmed |
| Wisconsin | 30 days | same | 7.5%/yr | none found | fully-insured, HMO, PPO | Wis. Stat. §628.46… | Confirmed |
| Wyoming | 45 days | same | 10%/yr | yes | fully-insured, life insurance, accident and health insurance | Wyo. Stat. §26-15-124… | Confirmed |
"same" = the statute does not distinguish paper from electronic. "formula" = interest is tiered or monthly rather than a flat annual rate; "yes" under Penalty = the statute adds a penalty beyond interest. Both link to the state's entry, which carries the rule as written. "—" = the statute we opened sets no figure.
How to collect it
- Confirm the plan type. Self-funded means none of this applies; the remedy is the plan's own appeal process and, ultimately, ERISA §502. How to tell.
- Prove the claim was clean on the date received. Keep the clearinghouse acceptance report (999/277CA) with the timestamp. If the payer pended it for records, the clock generally stopped — check the state's definition, cited in each entry below.
- Compute the interest and cite the section. Use the calculator above; paste the paragraph into the reconsideration or the state insurance department complaint. Most states make interest automatic ("shall pay"), so you do not have to ask for it — but you do have to notice it is missing.
- Escalate to the regulator, not the payer's own appeal queue. Prompt-pay is enforced by the state insurance department; a pattern of late payment on clean claims is what they act on. Attach the table of late claims, not one claim.
The statute text, state by state
The operative sentence from each state's own code, as we found it. Quote it; link it; do not paraphrase it in a dispute letter.
Alabama · Ala. Code § 27-1-17 Unverified
Each insurer, health service corporation, and health benefit plan ... shall pay for services rendered by Alabama health care providers within 45 calendar days upon receipt of a clean written claim or 30 calendar days upon receipt of a clean electronic claim.
As quoted by a secondary source; not checked against the state's own statute text this cycle.
Clean-claim deadline: 30 days electronic, 45 days paper. Interest: 1.5% per month, prorated daily, accruing from the date payment was overdue. Penalty beyond interest: Commissioner may impose an administrative fine (reported up to $1,000 per violation, capped around $100,000) in addition to the 1.5%/month interest; not confirmed verbatim against primary text. Enforcement: not stated in the section.
Interest is 1.5% per month (not stated as an annual rate in the statute), prorated daily, accruing from the date payment became overdue.
Alaska · Alaska Stat. § 21.36.495 Unverified
A health care insurer shall pay or deny ... within 30 calendar days after the insurer or a third-party administrator under contract with the insurer receives a clean claim. ... interest shall accrue at a rate of 15 percent annually beginning on the day following the day that the notice was due.
As quoted by a secondary source; not checked against the state's own statute text this cycle.
Clean-claim deadline: 30 days electronic. Interest: 15% per year. Penalty beyond interest: No flat additional penalty found beyond interest; de minimis exception — interest need not be paid if the amount due is $1 or less. If the insurer misses the 30-day notice deadline, the claim is presumed clean and interest begins accruing. Enforcement: not stated in the section. “Clean claim” is defined at Alaska Stat. § 21.36.495 (defined within the same section: a claim with 'no defect or impropriety, including a lack of any required substantiating documentation, or a particular circumstance requiring special treatment that prevents timely payment').
A $1-or-less claim balance is exempt from interest, and if the insurer misses its own 30-day notice deadline the claim is presumed clean and interest starts running.
Arizona · Ariz. Rev. Stat. § 20-3102 Confirmed
A health care insurer shall adjudicate any clean claim from a contracted or noncontracted health care provider relating to health care insurance coverage within thirty days after the health care insurer receives the clean claim or within the time period specified by contract.
Clean-claim deadline: 30 days electronic, 30 days paper. Interest: the 'legal rate' (statutory legal rate under A.R.S. § 44-1201), not a flat percentage stated in this section. Penalty beyond interest: Claims cannot be retroactively adjusted more than one year after payment or denial except in cases of fraud; insurer may not repeatedly request previously-submitted documentation or unreasonably delay clean-claim payment without justification. Enforcement: insurance department complaint. “Clean claim” is defined at Ariz. Rev. Stat. § 20-3102 (same section): "'Clean claim' means a written or electronic claim for health care services or benefits that may be processed without obtaining additional information ... except in cases of fraud.".
Interest on a late clean claim is Arizona's statutory 'legal rate' (A.R.S. § 44-1201), not a fixed percentage set in this section — check the current legal rate separately.
Arkansas · Ark. Code Ann. § 23-66-215 Unverified
A health carrier shall pay a penalty of twelve percent (12%) per annum for late payment of claims under a health insurance contract pursuant to rules promulgated by the Insurance Commissioner, without necessity for demand for payment by a claimant.
As quoted by a secondary source; not checked against the state's own statute text this cycle.
Interest: 12% per year. Penalty beyond interest: The 12%/year penalty is self-executing (no demand required) and survives delegation to a third-party administrator. The actual clean-claim day-count trigger is set by Insurance Commissioner rule, not by this statute directly — secondary sources (not independently confirmed) describe a 60-day pay-or-deny window under that rule. Enforcement: insurance department complaint.
The 12%/year late-payment penalty is set directly by statute, but the actual clean-claim day-count trigger is set by a separate Insurance Commissioner rule this research could not locate — confirm the day count before citing it.
California · Cal. Health & Safety Code § 1371 Confirmed
A health care service plan, including a specialized health care service plan, shall reimburse a complete claim ... as soon as practicable, but no later than 30 calendar days after receipt of the claim. ... Interest shall accrue at a rate of 15 percent per annum beginning with the first calendar day after the 30-calendar-day period.
Clean-claim deadline: 30 days electronic, 30 days paper. Interest: 15% per year. Penalty beyond interest: Interest is self-executing once the 30-day window (or, for contested claims, 30 working days after receipt of information establishing payer liability) passes. Additional statutory penalties can apply under related Knox-Keene Act provisions for patterns of non-compliance, not detailed within this section. Enforcement: insurance department complaint. “Clean claim” is defined at Cal. Health & Safety Code § 1371 (defines 'complete claim' within the same section).
Applies to health care service plans (mostly HMOs) regulated by DMHC under the Knox-Keene Act. PPO/disability insurers are governed by a different statute, Cal. Ins. Code § 10123.13, not this section.
Colorado · Colo. Rev. Stat. § 10-16-106.5 Confirmed
Clean claims shall be paid, denied, or settled within thirty calendar days after receipt by the carrier if submitted electronically and within forty-five calendar days after receipt by the carrier if submitted by any other means.
Clean-claim deadline: 30 days electronic, 45 days paper. Interest: 10% per year. Penalty beyond interest: A carrier that fails to pay, deny, or settle any claim (clean or not) within 90 days after receipt owes an additional penalty equal to 20% of the total amount ultimately allowed, imposed on the 91st day; separately, if the carrier conducts a prospective charge audit it must, by day 45, pay at least 85% of the contracted rate to a participating institutional provider (60% if nonparticipating), completing the audit and any additional payment by day 90. Enforcement: insurance department complaint or court action. “Clean claim” is defined at Colo. Rev. Stat. § 10-16-106.5(2).
A carrier that misses the 90-day deadline on ANY claim (clean or not) owes a separate 20% penalty on top of the 10%/year interest — that stacks beyond the ordinary clean-claim clock.
Connecticut · Conn. Gen. Stat. § 38a-816(15) Confirmed
[paper] not later than sixty days after receipt by the insurer of the claimant's proof of loss form or the health care provider's request for payment ... [electronic] not later than twenty days ... pay the claimant or health care provider the amount of such claim plus interest at the rate of fifteen per cent per annum.
Clean-claim deadline: 20 days electronic, 60 days paper. Interest: 15% per year. Penalty beyond interest: Beyond the 15%/year interest, § 38a-816 as a whole is Connecticut's Unfair Insurance Practices Act (CUIPA); repeated violations can be pursued as an unfair claims-settlement practice. Insurer must send written notice of alleged deficiencies within 30 days (paper) / 10 days (electronic) of receipt, then pay within 30 days (paper) / 10 days (electronic) of receiving the requested information. If interest due is under $1, insurer deposits it in an interest-bearing account and donates the year's total annually to the University of Connecticut Health Center. Enforcement: insurance department complaint.
Interest (15%/yr) applies once the 60-day (paper) / 20-day (electronic) deadline is missed; if the interest owed is under $1 the insurer deposits it and donates the annual total to the UConn Health Center rather than paying the biller directly.
Delaware · 18 Del. Admin. Code § 1310… Confirmed
No more than 30 days after receipt of a clean claim from a provider or policyholder, a carrier shall take one of the following four actions ... The Commissioner may order a carrier found to have violated Section 6 of this Regulation to pay to a provider or policyholder the amount of the claim or bill plus interest at the maximum rate allowable to lenders under Delaware law.
Clean-claim deadline: 30 days electronic, 30 days paper. Interest: the maximum rate allowable to lenders under Delaware law (statutory legal rate, not a flat % stated in the regulation). Penalty beyond interest: If additional information is requested, the carrier has 15 days after receiving it to pay/deny. Relief (payment plus interest) is ordered by the Commissioner upon a finding of violation, rather than accruing automatically the way some states' statutes do. Enforcement: insurance department complaint. “Clean claim” is defined at 18 Del. Admin. Code § 1310, Section 3 — clean claim requires the CMS Form 1500 (individual providers) or CMS Form UB-92 (institutional providers) with all required fields complete, or the ASC X12N 837 electronic format per 45 CFR § 162.1102.
This is a Delaware Insurance Department regulation, not a statute, and it exempts accident-only, credit, Medicaid, Medicare supplement, long-term care, disability income, and workers' comp claims from its 30-day clock.
District of Columbia · D.C. Code § 31-3132 Confirmed
A health insurer shall reimburse any person entitled to reimbursement under the health benefits plan within 30 days after the receipt of a clean claim. ... interest [accrues] at a monthly rate of: (1) One and one-half percent from the 31st day through the 60th day; (2) Two percent from the 61st day through the 120th day.
Clean-claim deadline: 30 days electronic, 30 days paper. Interest: 1.5% per month for days 31-60; 2% per month for days 61-120; 2.5% per month after day 120 (tiered monthly, not a flat annual rate). Enforcement: not stated in the section.
Interest is tiered by lateness, not one annual rate: 1.5%/month for days 31-60, 2%/month for days 61-120, and 2.5%/month after day 120.
Florida · Fla. Stat. § 627.6131 Confirmed
(4) For all electronically submitted claims, a health insurer shall: ... (b) Within 20 days after receipt of the claim, pay the claim or notify a provider or designee if a claim is denied or contested. ... (5) For all nonelectronically submitted claims ... (b) Within 40 days after receipt of the claim, pay the claim ... (7) ... An overdue payment of a claim bears simple interest of 12 percent per year.
Clean-claim deadline: 20 days electronic, 40 days paper. Interest: 12% per year. Penalty beyond interest: OIR may fine an insurer under s. 624.4211 for claims-payment violations exceeding the 5% permissible error ratio; failure to pay/deny within 120 days (electronic)/140 days (paper) creates an uncontestable obligation to pay in full. Enforcement: insurance department complaint. “Clean claim” is defined at Fla. Stat. §627.6131(1) (defines 'claim' via HCFA-1500 data set for noninstitutional providers / UB-92 data set for institutional providers with all mandatory entries completed; statute does not use the specific phrase 'clean claim').
Applies to insurer-issued group/individual PPO and EPO major-medical policies under ch. 624 — HMOs are covered by the parallel §641.3155, not this section.
Georgia · O.C.G.A. §§ 33-24-59.5 and 33-24-59.14 Unverified
Georgia law, under O.C.G.A. §§ 33-24-59.5 and 33-24-59.14, requires the prompt payment of claims by insurers offering and administrators servicing health benefit plans, as defined in those statutes.
As quoted by a secondary source; not checked against the state's own statute text this cycle.
Clean-claim deadline: 15 days electronic, 30 days paper. Interest: 12% per year. Penalty beyond interest: Per secondary source (Justia/AAPC, not primary-verified): Commissioner may impose administrative penalties on insurers/administrators that pay/deny fewer than 95% of claims within the statutory deadlines in a calendar quarter. Enforcement: insurance department complaint. “Clean claim” is defined at O.C.G.A. §33-24-59.14 (definitions section referenced by §33-24-59.5) — not independently verified.
Georgia's own codified statute text has no free official mirror (state license to LexisNexis only) — these figures are corroborated by two independent secondary sources but not primary-confirmed.
Hawaii · Haw. Rev. Stat. § 431:13-108 Confirmed
Unless shorter payment timeframes are otherwise specified in a contract, an entity shall reimburse a claim that is not contested or denied not more than thirty calendar days after receiving the claim filed in writing, or fifteen calendar days after receiving the claim filed electronically, as appropriate.
Clean-claim deadline: 15 days electronic, 30 days paper. Interest: 15% per year. Penalty beyond interest: Additional penalties possible under the cross-referenced §431:13-201, based on factors like severity/history of violations — no fixed dollar amount specified in §431:13-108 itself. Enforcement: insurance department complaint. “Clean claim” is defined at Haw. Rev. Stat. §431:13-108 (definitions subsection of the same section).
Applies to insured/HMO/mutual-benefit/dental-service-corp plans only — the statute's own 'clean claim' definition expressly excludes self-insured employer-group claims.
Idaho · Idaho Code §§ 41-5601 to 41-5606… Confirmed
If a beneficiary, practitioner or facility submits an electronic claim to an insurer within thirty (30) days of the date on which service was delivered, an insurer shall pay or deny the claim not later than thirty (30) days after receipt of the claim.
Clean-claim deadline: 30 days electronic, 45 days paper. Interest: 12% per year. Penalty beyond interest: Director may impose an administrative fine up to $5,000 per enforcement action (41-5606(2)); director cannot suspend/revoke the insurer's certificate of authority for a violation (41-5606(3)); no private cause of action is created (41-5606(5)); safe harbor — no penalty at all if the insurer paid ≥95% of chapter-subject claims timely in the calendar year (41-5606(4)). Interest of less than $4.00 need not be paid (41-5603). Enforcement: insurance department complaint.
The 12%/yr rate isn't stated in the prompt-pay chapter itself — it's the general contract legal rate under IC §28-22-104(1), incorporated by reference. No private lawsuit right; DOI-fine only, capped at $5,000 per action.
Illinois · 215 ILCS 5/368a… Confirmed
All insurers, health maintenance organizations, managed care plans, health care plans, preferred provider organizations, and third party administrators shall ensure that all claims and indemnities concerning health care services other than for any periodic payment shall be paid within 30 days after receipt of due written proof of such loss.
Clean-claim deadline: 30 days electronic, 30 days paper. Interest: 9% per year. Enforcement: insurance department complaint.
The 9%/yr interest and 30-day clock in §368a(c) apply to insurers/HMOs/PPOs/TPAs; independent practice associations and physician-hospital organizations are on a separate periodic-payment schedule under §368a(a)-(b), also 9%/yr.
Indiana · Indiana Code 27-8-5.7… Unverified
...an insurer shall pay or deny each clean claim ... within thirty (30) days after the date the claim is received by the insurer [electronic claims] ... within forty-five (45) days after the date the claim is received by the insurer [paper claims] ... using the same interest rate as provided in IC 12-15-21-3(7)(A)
As quoted by a secondary source; not checked against the state's own statute text this cycle.
Clean-claim deadline: 30 days electronic, 45 days paper. Interest: Variable, not a flat %: same rate as IC 12-15-21-3(7)(A) — rounded whole-percent equal to the prior-fiscal-year average investment yield on state general fund money (excl. pension funds), per the state comptroller's CAFR. Accrues from day 31 (electronic claims) / day 46 (paper claims) until paid. [Per FindLaw mirror, unverified against primary.]. Enforcement: not stated in the section. “Clean claim” is defined at IC 27-8-5.7-2 (per FindLaw mirror, unverified).
Indiana's interest rate is not a flat percent — it floats yearly with the state's Medicaid provider-interest formula, so confirm the current rate each year rather than quoting one number.
Iowa · Iowa Code §507B.4A… Confirmed
Insurers subject to this subrule shall either accept and pay or deny a clean claim for health care benefits ... within 30 days after the insurer's receipt of such claim. ... Interest shall accrue at the rate of 10 percent per annum commencing on the thirty-first day after the insurer's receipt of all information necessary to establish a clean claim.
Clean-claim deadline: 30 days electronic, 30 days paper. Interest: 10% per year. Enforcement: insurance department complaint. “Clean claim” is defined at Iowa Code §507B.4A(2)(b); Iowa Admin. Code r. 191—15.32(1)(a) ('clean claim' means the same as defined in Iowa Code §507B.4A).
Excludes long-term care, disability income, liability, workers'-comp, and auto/homeowners med-pay claims by statute — the 30-day/10% rule only covers ordinary accident-and-sickness and HMO claims.
Kansas · K.S.A. 40-2442… Confirmed
Within 30 days after receipt of any claim ... any insurer issuing a policy of accident and sickness insurance shall pay a clean claim for reimbursement in accordance with this section. ... such insurer shall pay interest at the rate of 1% per month on the amount of the claim that remains unpaid 30 days after the receipt of the claim.
Clean-claim deadline: 30 days electronic, 30 days paper. Interest: 1% per month simple interest on the unpaid clean-claim amount, accruing starting the 31st day after receipt (K.S.A. 40-2442(b)); an additional 1%/month applies if payment/denial is not made within 15 days of receiving requested additional information (K.S.A. 40-2442(d)). Penalty beyond interest: Violations committed with 'flagrant and conscious disregard' of the act, or with a frequency constituting a general business practice, are deemed violations of the Kansas Unfair Trade Practices Act (K.S.A. 40-2442(g)). Enforcement: insurance department complaint. “Clean claim” is defined at K.S.A. 40-2441.
Interest is 1% per MONTH (not year) on the unpaid balance — don't read it as a 12%/yr rate; it compounds faster than a typical annual-interest state.
Kentucky · KRS 304.17A-702… Confirmed
Except for claims involving organ transplants, each insurer shall reimburse a provider for a clean claim or send a written or an electronic notice denying or contesting the claim within thirty (30) calendar days from the date that the claim is received by the insurer.
Clean-claim deadline: 30 days electronic, 30 days paper. Interest: Tiered simple annual interest on the unpaid amount, per KRS 304.17A-730(1): 12%/yr if paid 1-30 days after the KRS 304.17A-702 due date; 18%/yr if paid 31-60 days late; 21%/yr if paid more than 60 days late. Enforcement: insurance department complaint. “Clean claim” is defined at KRS 304.17A-700(3).
Interest is tiered, not flat: 12%/yr if paid 1-30 days late, 18%/yr at 31-60 days, 21%/yr past 60 days — and organ-transplant clean claims get a 60-day (not 30-day) clock.
Louisiana · La. R.S. 22:1831… Confirmed
shall be paid, denied, or pended not more than forty-five days from the date upon which a nonelectronic clean claim is received by the issuer or its agent, unless it is not payable under the terms of the applicable contract of health insurance coverage or unless just and reasonable grounds exist
Clean-claim deadline: 25 days electronic, 45 days paper. Interest: 12% per year. Penalty beyond interest: Commissioner-enforced fines only (not paid to the provider): up to $1,000/violation (max $100,000 aggregate) for ordinary violations; up to $25,000/violation (max $250,000 per 6-month period) for knowing violations (La. R.S. 22:1837). Enforcement: insurance department complaint. “Clean claim” is defined at La. R.S. 22:1831(2).
Applies to fully-insured issuers incl. HMOs; self-funded ERISA plans are excluded. The 12%/yr interest is automatic and separate from DOI's own civil penalties (up to $25,000/violation) under §1837.
Maine · 24-A M.R.S. §2436 Confirmed
A claim for payment of benefits under a policy or certificate of insurance delivered or issued for delivery in this State is payable within 30 days after proof of loss is received by the insurer and ascertainment of the loss is made... A claim that is neither disputed nor paid within 30 days is overdue.
Clean-claim deadline: 30 days electronic. Interest: 1 1/2% per month after the due date. Penalty beyond interest: Reasonable attorney's fee owed to the claimant if overdue benefits are recovered in an action against the insurer, or paid after the insurer receives notice of the attorney's representation (§2436(4)). Enforcement: insurance department complaint or court action. “Clean claim” is defined at 24-A M.R.S. §2436(2-C) ("undisputed claim").
The Superintendent must set a minimum interest amount payable to health care providers by rule; that adopted rule/amount was not located this pass (Bureau of Insurance rule index 404'd) — needs a follow-up.
Maryland · Md. Code Ann., Ins. §15-1005 Confirmed
within 30 days after receipt of a claim for reimbursement from a person entitled to reimbursement under § 15-701(a) of this title... an insurer, nonprofit health service plan, or health maintenance organization shall: (1) mail or otherwise transmit payment for the claim...; or (2) send a notice of receipt and status of the claim
Clean-claim deadline: 30 days electronic. Interest: graduated monthly: 1.5% (31st-60th day), 2% (61st-120th day), 2.5% (after the 120th day). Penalty beyond interest: Fine not exceeding $500 for each violation that is arbitrary and capricious, based on all available information, plus penalties prescribed under Ins. §4-113(d) for violations committed with a frequency indicating a general business practice (§15-1005(h)). Enforcement: insurance department complaint. “Clean claim” is defined at Md. Code Ann., Ins. §15-1005(a), cross-referencing regulations adopted under §15-1003; see also COMAR 31.10.11.
This graduated-interest law binds insurers, nonprofit health plans, and HMOs (and ERISA TPAs, to the extent allowed) — it does NOT reach Medicaid MCOs or mental-health ASOs, which are governed separately under Maryland's Health-General Article/HealthChoice rules.
Massachusetts · Mass. Gen. Laws c. 175, §108, Fourth (c) Confirmed
Within forty-five days from said receipt of notice if payment is not made the insurer shall notify the claimant in writing specifying the reasons for the nonpayment... interest on such benefits...shall accrue beginning forty-five days after the insurer's receipt of notice of claim at the rate of one and one-half percent per month, not to exceed eighteen percent per year.
Clean-claim deadline: 45 days electronic. Interest: 18% per year. Enforcement: not stated in the section.
Only covers c.175 fully-insured accident & sickness policies; HMOs (c.176G) are excluded by statute (§4's cross-reference list omits §108). Correct citation is c. 175, §108, Fourth (c) -- not "Third (4)(c)".
Michigan · MCL 500.2006(8) Confirmed
A clean claim must be paid within 45 days after receipt of the claim by the health plan. A clean claim that is not paid within 45 days bears simple interest at a rate of 12% per annum.
Clean-claim deadline: 45 days electronic. Interest: 12% per year. Penalty beyond interest: Failure to pay a clean claim within 45 days, or to pay the required interest, is an "unfair trade practice" unless the claim is reasonably in dispute (§500.2006(1), incorporated for the provider-claim regime); the director may impose a civil fine of not more than $1,000 per violation, not to exceed $10,000 in the aggregate for multiple violations. Enforcement: insurance department complaint or court action. “Clean claim” is defined at MCL 500.2006(8)-(9) (procedural clean-claim cure/tolling mechanics).
The 45-day/12% rule (subsec. 8) applies only to provider claims (excludes pharmacies, self-funded ASO plans); a separate 60-day/12% rule (subsec. 1-6) governs member/insured claims.
Minnesota · Minn. Stat. §62Q.75 Confirmed
All health plan companies and third-party administrators must pay or deny claims that are clean claims within 30 calendar days after the date upon which the health plan company or third-party administrator received the claim.
Clean-claim deadline: 30 days electronic. Interest: 1.5% per month or any part of a month. Penalty beyond interest: The commissioner may assess a financial administrative penalty against a health plan company for violation of the payment subdivision when there is a pattern of abuse demonstrating a lack of good-faith effort and a systematic failure to comply (§62Q.75, subd. 2(f)). Enforcement: insurance department complaint. “Clean claim” is defined at Minn. Stat. §62Q.75, subd. 1(b).
30-day clean-claim deadline and 1.5%/month interest apply to "health plan companies" (incl. HMOs) and TPAs; pharmacies are excluded; DOI can fine for a pattern of bad-faith noncompliance (subd. 2(f)).
Mississippi · Miss. Code Ann. §83-9-5(1)(h) Unverified
will be paid within twenty-five (25) days after receipt of due written proof of such loss in the form of a clean claim where claims are submitted electronically, and will be paid within thirty-five (35) days after receipt of due written proof of such loss in the form of clean claim where claims are submitted in paper format.
As quoted by a secondary source; not checked against the state's own statute text this cycle.
Clean-claim deadline: 25 days electronic, 35 days paper. Interest: 3% per month, accruing from the day after payment was due until the claim is finally settled or adjudicated (does not apply to Medicare Advantage or Medicare Advantage Prescription Drug plan claims). Penalty beyond interest: If the insurer acted in bad faith as evidenced by a repeated or deliberate pattern of failing to pay benefits/claims when due, the claimant (provider or insured) may recover damages up to 3 times the unpaid benefit amount, in addition to the benefits and interest owed (§83-9-5(1)(h)(4)). Enforcement: insurance department complaint or court action. “Clean claim” is defined at Miss. Code Ann. §83-9-5(1)(h).
Numbers check out against a non-official mirror only -- Mississippi has no free official statute portal (4 official sources tried and failed). HMO coverage is unconfirmed in this section's own text.
Missouri · Mo. Rev. Stat. §376.383 Confirmed
If the health carrier has not paid the claimant on or before the forty-fifth processing day from the date of receipt of the claim, the health carrier shall pay the claimant one percent interest per month and a penalty in an amount equal to one percent of the claim per day.
Interest: 1% per month interest plus a separate penalty of 1% of the claim per day, both accruing from the 45th processing day (2% per month interest after a 100-day penalty cap if the unpaid balance exceeds $35,000). Penalty beyond interest: A per-day penalty equal to 1% of the claim amount, in addition to 1%/month interest, beginning on the 45th processing day; both are calculated on the day-45 unpaid balance and included in the late reimbursement automatically (§376.383.6). Enforcement: insurance department complaint. “Clean claim” is defined at §376.383.1(2).
"Health carrier" nominally covers self-insured employer plans "to the extent allowed by federal law," but ERISA preemption generally bars state prompt-pay enforcement against true self-funded plans -- real-world reach is narrower than the text alone suggests.
Montana · Mont. Code Ann. §33-18-232 Confirmed
An insurer shall pay or deny a claim within 30 days after receipt of a proof of loss unless the insurer makes a reasonable request for additional information or documents in order to evaluate the claim.
Clean-claim deadline: 30 days electronic. Interest: 10% per year. Enforcement: insurance department complaint.
This is Montana's GENERAL (not health-specific) claims-payment statute -- 30 days, extendable to 60 if the insurer requests more info; 10% annual interest applies only once owed interest exceeds $5. A more specific Title 33 Ch. 22 health-only clean-claim statute could not be ruled out (site access blocked both passes).
Nebraska · Neb. Rev. Stat. §§ 44-8001 to 44-8010… Confirmed
A clean claim shall be paid, denied, or settled within thirty calendar days after receipt by the insurer if submitted electronically and within forty-five calendar days after receipt if submitted in a form other than electronically.
Clean-claim deadline: 30 days electronic, 45 days paper. Interest: 12% per year. Enforcement: not stated in the section. “Clean claim” is defined at Neb. Rev. Stat. §44-8002.
Act excludes Medicaid, self-insured/ERISA employer plans, and workers' comp. Interest may be aggregated and paid quarterly once it exceeds $10/provider.
Nevada · NRS 689A.410… Confirmed
an insurer shall approve or deny a claim relating to a policy of health insurance within 21 days after the insurer receives the claim, if the claim is submitted electronically, or 30 days after the insurer receives the claim, if the claim is not submitted electronically. If the claim is approved, the insurer shall also pay the claim within that period. Except as otherwise provided in this section, if the approved claim is not paid within that period, the insurer shall pay interest on the claim at a rate of 10 percent per annum.
Clean-claim deadline: 21 days electronic, 30 days paper. Interest: 10% per year. Penalty beyond interest: Commissioner may impose an administrative penalty for failure to approve/deny/pay a claim within the required time or for not being in substantial compliance (95% of approved claims / 90% of total dollar amount paid on time); penalties escalate for a second or subsequent determination of noncompliance. Separate from and in addition to the 10%/annum interest owed to the claimant. Enforcement: insurance department complaint or court action.
AB52 took effect 2026-01-01 and does not apply to contracts issued or claims submitted before that date until renewal. IMPORTANT: NRS 695C.185 (the old HMO cite) was REPEALED -- HMO claims are now governed by new NRS 695G.340, same 21-day/30-day/10% terms.
New Hampshire · RSA 415:6-h… Confirmed
pay for services rendered by New Hampshire health care providers within 15 calendar days upon receipt of a clean electronic claim ... or within 30 calendar days upon receipt of a clean non-electronic claim ... The insurer shall pay the health care provider or the insured person the amount of the overdue claim plus an interest payment of 1.5 percent per month beginning from the date the payment was due.
Clean-claim deadline: 15 days electronic, 30 days paper. Interest: 18% per year. Penalty beyond interest: DOI administrative fine up to $300,000 per year, or suspension/revocation of license, for a pattern of overdue payments; reasonable attorney's fees recoverable by provider upon proving insurer bad faith in a successful legal action. Enforcement: insurance department complaint or court action.
Applies to both individual (415:6-h) and group (415:18-k) accident/health policies -- identical 15-day electronic/30-day non-electronic deadlines and 1.5%/month interest for both. Does NOT apply to capitation or other periodic-payment arrangements. HMO coverage runs through RSA ch. 420-B, not this section.
New Jersey · N.J.S.A. 17B:26-9.1… Confirmed
no later than the 30th calendar day following receipt of the claim by the payer ... if the claim is submitted by electronic means, and no later than the 40th calendar day following receipt if the claim is submitted by other than electronic means ... An overdue payment shall bear simple interest at the rate of 12% per annum.
Clean-claim deadline: 30 days electronic, 40 days paper. Interest: 12% per year. Penalty beyond interest: Carriers must also provide internal and external appeal mechanisms (external review via independent party, costs split) for prompt-pay disputes. Enforcement: not stated in the section. “Clean claim” is defined at N.J.A.C. 11:22-1.5 (definitions embedded in same section as payment timelines; exact lettered subsection not independently confirmed).
The 2005 statute sets 12% per year. The DOBI regulation at N.J.A.C. 11:22-1.6, still posted online, reads 10% from the pre-2006 rule; the statute controls.
New Mexico · 13.10.28 NMAC… Confirmed
The health carrier shall reimburse the eligible provider within 30 days of the date of receipt if the clean claim has been submitted electronically or within 45 days of the date of receipt if the clean claim has been submitted manually.
Clean-claim deadline: 30 days electronic, 45 days paper. Interest: 18% per year. Penalty beyond interest: Minimum interest owed is $2 per NMAC 13.10.28.9(D)(1)(b) (confirmed verbatim at the official source); superintendent enforcement/penalties for unfair claims practices under NMSA 59A-16-20. Enforcement: not stated in the section. “Clean claim” is defined at 13.10.28.9 NMAC (definitions section within same rule as payment timelines; exact lettered subsection not independently confirmed).
A separate, overlapping rule -- 13.10.22.12(O) NMAC (Managed Health Care Plan Compliance) -- sets a flat 45-day deadline for MHCPs with NO electronic/paper distinction (confirmed to exist). HMO-type carriers may be governed by that flat rule instead of this 30/45 split.
New York · N.Y. Insurance Law § 3224-a… Confirmed
such insurer or organization or corporation shall pay the claim to a policyholder or covered person or make a payment to a health care provider within thirty days of receipt of a claim or bill for services rendered that is transmitted via the internet or electronic mail, or forty-five days of receipt of a claim or bill for services rendered that is submitted by other means, such as paper or facsimile.
Clean-claim deadline: 30 days electronic, 45 days paper. Interest: 12% per year. Enforcement: not stated in the section.
No interest owed if the amount due is under $2. Statute shows a 2025-09-19 revision (substance not independently confirmed this pass) and a nonparticipating-ambulance payment mandate at subsection (l) -- confirm no other recent change affects billing workflow before relying on this table alone.
North Carolina · N.C. Gen. Stat. § 58-3-225… Confirmed
An insurer shall, within 30 calendar days after receipt of a claim, send ... payment of the claim ... Health benefit plan claim payments that are not made in accordance with this section shall bear interest at the annual percentage rate of eighteen percent (18%) beginning on the date following the day on which the claim should have been paid.
Clean-claim deadline: 30 days electronic, 30 days paper. Interest: 18% per year. Penalty beyond interest: Violation subjects insurer to sanctions under G.S. 58-2-70 (DOI enforcement authority); does not impair claimant's right to pursue any other legal remedy (subsection (j)). Insurer paying statutory interest in good faith is not subject to additional sanctions for that claim. Enforcement: insurance department complaint or court action.
Interest clock resets to the 31st day after the insurer's info request is fulfilled -- a contested/incomplete claim doesn't accrue interest from the original 30-day mark. No amendment found since 2019-202, s.8 (confirmed still current as of 2026).
North Dakota · N.D. Cent. Code § 26.1-36-37.1… Confirmed
After receipt of a health insurance proof of loss form, the insurer shall, within fifteen business days, pay the claim or that portion of the claim that is not contested, deny the claim, or make an initial request for additional information. Within fifteen business days of the receipt of the information initially requested, the insurer shall pay or deny the claim.
Clean-claim deadline: 15 business days electronic, 15 business days paper. Penalty beyond interest: No interest/monetary penalty for late payment is specified anywhere in Ch. 26.1-36 (confirmed by two independent full-chapter text searches). The only enforcement is chapter-wide N.D. Cent. Code §26.1-36-40: willful violation is a class A misdemeanor and the commissioner may suspend or revoke the insurer's or producer's license. Days stated are BUSINESS days, not calendar days. Enforcement: not stated in the section.
North Dakota has NO interest or monetary penalty for late claim payment -- only a chapter-wide misdemeanor/license-suspension provision (§26.1-36-40) for willful violations. Confirmed no parallel provision exists for HMOs (Ch. 26.1-18.1) either.
Ohio · Ohio Rev. Code §§ 3901.38… Confirmed
when a third-party payer receives from a provider or beneficiary a claim on the standard claim form... the third-party payer shall pay or deny the claim not later than thirty days after receipt of the claim... when a provider or beneficiary has used the standard claim form, but the third-party payer determines that reasonable supporting documentation is needed to establish the third-party payer's responsibility to make payment, the third-party payer shall pay or deny the claim not later than forty-five days after receipt of the claim.
Clean-claim deadline: 30 days electronic. Interest: 18% per year. Penalty beyond interest: Superintendent of Insurance may levy administrative fines for noncompliance under R.C. 3901.3812: up to $100,000 for a first offense, up to $150,000 for a second offense within 4 years of the first (separate from and in addition to the 18% interest owed directly to the provider under R.C. 3901.389). Enforcement: insurance department complaint or court action.
The 30/45-day split in this statute is NOT electronic vs. paper -- it's complete claim (30 days) vs. claim needing supporting documentation (45 days, clock pauses while awaiting the provider's response). Do not read cleanClaimDays fields as a channel split for Ohio.
Oklahoma · 36 O.S. § 1219 Confirmed
[Every insurer] shall reimburse all clean claims of an insured, an assignee of the insured or a health care provider... within forty-five (45) calendar days after receipt of a paper claim and thirty (30) calendar days after receipt of an electronic claim... An overdue payment shall bear simple interest at the rate of ten percent (10%) per year.
Clean-claim deadline: 30 days electronic, 45 days paper. Interest: 10% per year. Penalty beyond interest: In litigation over an overdue payment, the prevailing party is entitled to recover a reasonable attorney's fee, set by the court and taxed as costs against the non-prevailing party. Enforcement: insurance department complaint or court action. “Clean claim” is defined at 36 O.S. § 1219 (same section) — a clean claim is one with no defect or impropriety, including lack of required substantiating documentation or a circumstance requiring special treatment that impedes prompt payment.
Oregon · ORS 743B.450… Confirmed
An insurer that fails to pay a claim to a provider within the timelines established in ORS 743B.450 shall pay simple interest of 12 percent per annum on the unpaid amount of the claim that is due and owing, accruing from the date after the payment was due until the claim is paid.
Clean-claim deadline: 30 days electronic. Interest: 12% per year. Penalty beyond interest: Interest under ORS 743B.452(1) is in addition to, not in lieu of, administrative actions/penalties the DCBS Director may impose under the Insurance Code; insurer not required to pay interest of $2 or less on a claim. Enforcement: insurance department complaint or court action. “Clean claim” is defined at ORS 743B.450(7) directs the DCBS Director to adopt a 'clean claim' definition by rule, considering the federal HHS/Medicare definition — implemented at OAR 836-052-0770.
The 30-day clean-claim clock applies equally to electronic and paper submissions — Oregon does not give paper claims extra time the way some states do.
Pennsylvania · 40 P.S. § 991.2166… Confirmed
Licensed insurers and managed care plans shall pay clean claims and the uncontested portions of a contested claim... within 45 days of the licensed insurer's or managed care plan's receipt of the claim.
Clean-claim deadline: 45 days electronic. Interest: 10% per year. Penalty beyond interest: Interest is the statutory penalty; owed and payable within 30 days of the claim payment (31 Pa. Code §154.18(c)); amounts of $2 or less per claim are exempt. Enforcement: insurance department complaint. “Clean claim” is defined at 40 P.S. § 991.2102 (Act 68 definitions section); operationalized at 31 Pa. Code § 154.18, which requires insurers to give providers written disclosure of all data elements needed for a claim to qualify as clean.
Interest is the statutory penalty for late payment; per-claim amounts of $2 or less are exempt, and once the underlying clean claim is paid the insurer has a separate 30-day window to remit the interest itself (31 Pa. Code §154.18(c)).
Rhode Island · R.I. Gen. Laws § 27-41-64… Confirmed
A healthcare entity or health plan operating in the state shall pay all complete claims for covered healthcare services ... within forty (40) calendar days following the date of receipt of a complete written claim or within thirty (30) calendar days following the date of receipt of a complete electronic claim.
Clean-claim deadline: 30 days electronic, 40 days paper. Interest: 12% per year. Penalty beyond interest: Interest is the sole monetary remedy stated in the text; no separate fine/penalty found. Substantial-compliance safe harbor (95%+ of claims paid on time) exempts an entity from interest liability. Enforcement: not stated in the section. “Clean claim” is defined at R.I. Gen. Laws § 27-41-64(f) (definitions of 'claim,' 'healthcare entity,' 'healthcare provider' within the section itself).
A healthcare entity that pays 95%+ of its claims on time (the substantial-compliance safe harbor) is exempt from paying this interest at all -- it is not a guaranteed per-claim remedy.
South Carolina · S.C. Code Ann. §§ 38-59-210, 38-59-230, 38-59-240… Confirmed
An insurer shall direct the issuance of a check or an electronic funds transfer in payment for a clean claim that is submitted electronically within twenty business days ... or via paper within forty business days following the later of the insurer's receipt of the claim or [receipt of all required information].
Clean-claim deadline: 20 business days electronic, 40 business days paper. Interest: 8.75% per year. Penalty beyond interest: No separate penalty beyond interest for late clean-claim payment. Separately, converting an electronic claim to paper before submission is an unfair trade practice under Ch. 5, Title 39, giving providers/insurers a damages action under §39-5-140 — this is a different violation, not the late-payment interest provision. Enforcement: insurance department complaint or court action. “Clean claim” is defined at S.C. Code Ann. § 38-59-210(8).
Interest on a late clean claim in SC is a flat 8.75%/year, not a variable rate — the variable prime+4% rate in §34-31-20(B) applies only to court judgments.
South Dakota · S.D. Codified Laws §§ 58-12-19… Confirmed
'Clean claim' means a claim for which there is no need for additional information to determine eligibility or adjudicate the claim ... Each clean claim shall be paid to the person entitled thereto, denied, or settled within thirty calendar days after receipt by the carrier if submitted electronically and within forty-five calendar days after receipt by the carrier [if submitted other than electronically].
Clean-claim deadline: 30 days electronic, 45 days paper. Penalty beyond interest: Confirmed on the CURRENT codified text: SDCL §58-12-21 states 'Nothing in §§ 58-12-19 to 58-12-21, inclusive, grants a private right of action.' No interest or dollar penalty for late payment of a clean claim exists anywhere in §§58-12-19–21. Enforcement: insurance department complaint. “Clean claim” is defined at S.D. Codified Laws § 58-12-19.
SD sets 30/45-day deadlines but has no statutory interest penalty for late payment and no private right of action — the only recourse is a general DOI complaint.
Tennessee · Tenn. Code Ann. § 56-7-109… Confirmed
A claim is clean if it has no defect or impropriety, including any lack of any required substantiating documentation, or particular circumstance requiring special treatment that prevents timely payment from being made on the claim under this section;
Clean-claim deadline: 30 days (paper; the electronic deadline was not confirmed). Enforcement: insurance department complaint. “Clean claim” is defined at Tenn. Code Ann. § 56-7-109(a)(1)(A).
Only the 30-day paper-claim rule is confirmed against a free TN government document. The 21-day electronic deadline and 1%/month interest figure some secondary sources cite are unverified — confirm with TN DOI before relying on them.
Texas · Tex. Ins. Code § 1301.103… Unverified
not later than the 45th day after the date an insurer receives a clean claim from a preferred provider in a nonelectronic format or the 30th day after the date an insurer receives a clean claim from a preferred provider that is electronically submitted, the insurer shall make a determination of whether the claim is payable.
As quoted by a secondary source; not checked against the state's own statute text this cycle.
Clean-claim deadline: 30 days electronic, 45 days paper. Interest: 18% per year. Penalty beyond interest: Tiered billed-charges penalty (Tex. Ins. Code §1301.137 for PPO / §843.342 for HMO, near-identical text): if paid/denied late, insurer owes the contracted rate plus a penalty = lesser of (a) 50% of (billed charges minus contracted rate) or (b) $100,000, if paid within days 1-45 after the deadline. If paid on/after day 46 and before day 91 after the deadline, penalty rises to lesser of 100% of that difference or $200,000. If paid on/after day 91, that day-46-90 penalty amount plus 18% annual interest (accruing from the original due date) is owed. Same tiers apply to underpayments, computed on a pro-rata 'underpaid amount' formula (subsection (g)). Insurer not liable if a catastrophic event caused the delay, or if provider notifies of underpayment >270 days after receipt and insurer pays within 30 days of notice. Separately, an insurer/HMO that violates the deadline on >2% of clean claims is subject to a Chapter 84 administrative penalty up to $1,000/day per unpaid claim. Non-institutional providers get 100% of the penalty (interest goes to the Texas Health Insurance Risk Pool); institutional providers split 50/50 with the Risk Pool. Enforcement: insurance department complaint or court action. “Clean claim” is defined at Tex. Ins. Code §1301.131 (PPO 'Elements of Clean Claim' — CMS-1500/UB-92 or electronic ASC X12N 837 equivalents); analogous HMO definition set by TDI rule under Ch. 843.
This record's text was confirmed via an archived copy of the state's own page, not a live fetch — the current statutes.capitol.texas.gov site could not be reached by any automated tool as of 2026-09-20.
Utah · Utah Code § 31A-26-301.6… Confirmed
Except as provided in Subsection (4), within 30 days of the day on which the insurer receives a written claim, an insurer shall pay the claim; or deny the claim and provide a written explanation for the denial.
Clean-claim deadline: 30 days electronic, 30 days paper. Interest: Late fee = (total amount insurer is obligated to pay on the claim) x (number of days the response or payment is late) x 0.033% daily interest rate (Utah Code §31A-26-301.6(8)(b)); a computed late fee under $1 is not owed (subsection (8)(d)). Statute does not distinguish electronic vs. paper submission — the single 30-day clock in (3)(a) applies to any 'written claim'; 0.033%/day annualizes to roughly 12.05% simple (0.033% x 365), but the statute itself states a daily rate, not an annual one, so interestRateAnnualPct is left null rather than converted. Penalty beyond interest: No separate billed-charges penalty tier like Texas — the daily late fee formula above is the monetary remedy. Repeated/pattern violations (e.g., failing to maintain a payment process sufficient to comply, or using untimely payment to pressure a provider on an unrelated claim) are separately listed as 'unfair claim settlement practices' under §31A-26-301.6(10), subject to Commissioner examination and sanctions under (12)(a). Enforcement: insurance department complaint.
Effective 5/6/2026, Utah added a new provider protection unrelated to deadlines: insurers must let providers opt out of credit-card remittance and must accept paper checks (dental fee carve-out sunsets 7/1/2028).
Vermont · 18 V.S.A. § 9418… Confirmed
Not later than 30 days following receipt of a claim, a health plan, contracting entity, or payer shall do one of the following: (1) Pay or reimburse the claim.
Clean-claim deadline: 30 days electronic. Interest: 12% per year. Enforcement: insurance department complaint.
No dedicated complaint clause in this statute; enforcement runs through DFR's general investigation/penalty powers (8 V.S.A. §13), not a named prompt-pay complaint process.
Virginia · Va. Code §38.2-3407.15… Confirmed
A carrier shall pay any claim within 40 days of receipt of the claim except where the obligation of the carrier to pay a claim is not reasonably clear due to the existence of a reasonable basis...
Clean-claim deadline: 40 days electronic. Interest: 6% per year. Penalty beyond interest: Providers may sue for actual damages; if the trier of fact finds the carrier's violation/breach resulted from gross negligence and willful conduct, damages may be trebled (up to 3x actual damages), plus reasonable attorney fees and court costs (§38.2-3407.15(G)). Enforcement: insurance department complaint or court action. “Clean claim” is defined at Va. Code §38.2-3407.15(A).
Interest under Va. Code §38.2-3407.1 runs from 15 working days after the carrier's receipt of proof of loss, not from the 40-day clean-claim deadline; subsection (D) also carves out claims paid under a negotiated reimbursement arrangement with uniform/periodic interim payments (i.e., most standard in-network provider-contract claims), though §38.2-3407.15(B)(3) separately requires any interest owed under any applicable law or contract to be paid within 60 days of the claim payment.
Washington · WAC 284-170-431… Confirmed
Ninety-five percent of the monthly volume of clean claims shall be paid within thirty days of receipt by the responsible carrier or agent of the carrier.
Clean-claim deadline: 30 days electronic. Interest: 1% per month, simple interest, calculated monthly and prorated for any partial month, on undenied and unpaid clean claims more than 61 days old (WAC 284-170-431(2)(d)) — roughly equivalent to 12%/yr but the rule as written is monthly, not a stated flat annual rate. Enforcement: insurance department complaint. “Clean claim” is defined at WAC 284-170-431(3).
OIC enforces via general authority, not a claim-specific penalty statute; billers should use OIC's standard complaint form, not a specialized prompt-pay channel.
West Virginia · W. Va. Code §33-45-2… Confirmed
An insurer shall either pay or deny a clean claim within 40 days of receipt of the claim if submitted manually and within 30 days of receipt of the claim if submitted electronically.
Clean-claim deadline: 30 days electronic, 40 days paper. Interest: 10% per year. Penalty beyond interest: CORRECTED: §33-45-3's full body text provides only a private right of action for actual damages: 'Any provider who suffers loss as the result of an insurer's violation of any provision of this article or an insurer's breach of any provider contract provision required by this article is entitled to initiate an action to recover actual damages.' It does not provide for attorney fees or costs anywhere in its text — the section title's mention of 'attorney fees and costs' does not match the operative language, which the earlier pass had not independently read. Enforcement: insurance department complaint or court action. “Clean claim” is defined at W. Va. Code §33-45-1(2) — 'Clean claim' means a claim: (A) That has no material defect or impropriety... to determine eligibility or to adjudicate the claim; or (B) With respect to which an insurer has failed timely to notify the person submitting the claim of any such defect.
Interest under §33-45-2(a)(4) is pegged to the 40-day (manual) deadline regardless of submission channel -- for an electronically submitted clean claim (30-day deadline), interest does not begin until day 40, not day 30.
Wisconsin · Wis. Stat. §628.46… Confirmed
A claim shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of the loss. ... All overdue payments shall bear simple interest at the rate of 7.5 percent per year.
Clean-claim deadline: 30 days electronic. Interest: 7.5% per year. Enforcement: not stated in the section.
The 7.5%/yr rate has been stable since 2017 (it was previously 12% before that amendment) — no near-term change expected.
Wyoming · Wyo. Stat. §26-15-124… Confirmed
Claims for benefits under a life, accident or health insurance policy shall be rejected or accepted and paid by the insurer or its agent designated to receive the claims within forty-five (45) days after receipt of the proofs of loss and supporting evidence.
Clean-claim deadline: 45 days electronic. Interest: 10% per year. Penalty beyond interest: If a court determines the insurer's refusal to pay the full amount of a covered loss was 'unreasonable or without cause,' the court may award the claimant a reasonable attorney's fee IN ADDITION TO the 10%/yr interest (§26-15-124(c)). This is the only interest/penalty mechanism in §26-15-124 — it is judicially awarded upon a finding of unreasonable refusal, not an automatic administrative accrual on every late clean claim like most other states in this batch. Enforcement: insurance department complaint or court action.
For medical claims WY has no automatic prompt-pay interest — a biller must go to court and win a finding of unreasonable refusal to get the 10%/attorney fee. Pharmacy claims differ: automatic 18%/yr, no court needed.
Frequently asked
- What makes a claim "clean"?
- A claim with no defect or missing information that would keep the payer from adjudicating it — correct codes, units, modifiers, NPI, member ID and any required attachments. Each state defines it in its own statute (cited in the state entries above), and most let the payer stop the clock by requesting records within the deadline. Sending the claim clean the first time is the whole game.
- Do I have to ask for the interest?
- In most states the statute says the payer "shall" pay interest, so it is owed without a request. In practice it is rarely added unless the provider notices and bills for it. Put the computation and the section in the reconsideration; if the payer refuses, the state insurance department is the enforcement path.
- Does prompt-pay apply to Medicare Advantage or Medicaid?
- Not through the state statute. Medicare Advantage plans follow the federal prompt-payment rule (clean claims from non-contracted providers within 30 days, 42 CFR §422.520). Medicaid managed care is reached by some states' statutes and not others — the "reaches" column records what each statute says.
- Why is the table missing a figure for my state?
- Because the statute we opened does not set one. Some states set no interest rate, some set a rate only a court can award, and some set a percentage-of-claims standard instead of a per-claim deadline. The state entry gives the rule as written. If we could not open the primary text at all, the row is marked Unverified and left out of the calculator.
- Is a late payment the same as an underpayment?
- No. Prompt-pay is about timing; the amount is set by your contract. A claim paid on time at the wrong rate is a contract dispute, and the remedy is the contract's dispute clause, not the prompt-pay statute.
Related references
Send the claim clean, then hold the payer to the clock
Claim Check runs the NCCI pair, MUE and JW/JZ edits on the drug and administration lines before the claim goes out — so the clean-claim date is the date you sent it.
Open Claim CheckSources & how this is maintained
- What this table is
- Each state's clean-claim payment deadline and late-payment interest for state-regulated health plans, with the section that sets it.
- How each row was verified
- A row is marked Confirmed only when we opened the state's own statute or regulation text and copied the operative sentence into the "statute text" section above. Law-firm summaries, association tables and trackers were used to find citations, never as the source of a number. Unverified rows are ones where the primary text could not be opened this cycle; they are excluded from any calculation on this page.
- Coverage
- 51 jurisdictions (50 states + DC); 44 confirmed, 7 unverified as of September 20, 2026.
- What can be wrong
- Statutes are amended; some rows carry an effective date or amendment in 2026 or later. A state may also have a regulation, bulletin or contract standard that adds to the statute. This is a reference for a billing office, not legal advice — cite the primary text, not this page.
- Corrections
- Send one with the statute section and we will re-verify against the primary text.