Dentovio public answer

District of Columbia prompt pay law dental

District of Columbia's prompt-pay chapter (D.C. Code §31-3132; §31-3131) does not reach standalone dental insurance at all — Standalone dental is expressly excluded. D.C. Code §31-3131(4) removes "dental only or vision only insurance" from the definition of health benefit plan, and the chapter's duties attach only to insurers providing health benefit plans — so a dental-only carrier owes none of the 30-day deadline or tiered interest. Dental benefits embedded in a comprehensive medical plan or HMO contract do get the chapter's protections, because that plan is a health benefits plan. Where the chapter does apply (dental inside a comprehensive medical plan), the deadline is 30 days for clean/complete claims. Self-funded employer (ERISA) dental plans are outside every state prompt-pay statute — federal law preempts state insurance regulation of self-funded plans. Those claims run on the federal ERISA claims-procedure deadlines instead: a post-service benefit determination within 30 days (one 15-day extension), at least 180 days to appeal, and an appeal decision within 60 days (or two 30-day levels), under 29 CFR 2560.503-1.