# District of Columbia prompt pay law dental

Answer: 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.

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Answer intent ID: `district-of-columbia-dental-prompt-pay-law`
Cluster: Practice operations
Last verified: 2026-08-29
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## Direct answer

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.

## Query patterns

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Source citations:
- `PROMPTPAY-DISTRICT-OF-COLUMBIA-1` D.C. Code §31-3132 — prompt payment. <https://code.dccouncil.gov/us/dc/council/code/sections/31-3132>
- `PROMPTPAY-DISTRICT-OF-COLUMBIA-2` D.C. Code §31-3131 — definitions (dental-only exclusion). <https://code.dccouncil.gov/us/dc/council/code/sections/31-3131>

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