# New Mexico prompt pay law dental Answer: Under NMSA 1978, §59A-16-21.1; §59A-16-21(B), the New Mexico payment deadline is 30 days (electronic clean claim, health plans) and 45 days (manual clean claim, health plans). "A health plan shall provide for payment of interest on the plan's liability at the rate of one and one-half percent a month" on a clean claim not paid inside the 30- or 45-day window (§59A-16-21.1(B)). The remedy runs to eligible providers, defined as participating providers and providers the plan has credentialed, so an out-of-network dental office generally cannot use it. Keep the two New Mexico regimes apart: §59A-16-21(B) applies to insurers generally, gives them 45 days after required proof of loss, and sets interest at one and one-half times the prime lending rate, accruing from day 46 and inapplicable to claims in arbitration or litigation. Dental applicability: Two regimes and an unresolved edge. Section 59A-16-21.1 binds a "health plan," defined as a health maintenance organization, nonprofit health care plan, provider service network, or third-party payer — plain insurers are not on that list and instead owe the §59A-16-21(B) duty. Article 16's own scope section names "prepaid dental services organizations" among the entities the article reaches, which is the dental hook; but whether a stand-alone dental carrier is a "health plan" for §59A-16-21.1 turns on the undefined term "third-party payer," and the statute does not settle it. Medicaid managed care organizations appear nowhere in either section. A self-funded private-employer (ERISA) plan is generally beyond this statute's reach and runs on the federal claims-procedure clock instead — but that comes from the courts reading 29 U.S.C. § 1144, not from its text, and it is not categorical: a self-funded governmental or church plan is not an ERISA plan at all, § 1144(b)(6) leaves multiple employer welfare arrangements open to state insurance law, and nothing in § 1144 bars a state from reaching the third-party administrator or the network contract. Answer URL: https://dentovio.com/answers/new-mexico-dental-prompt-pay-law Markdown mirror: https://dentovio.com/answers/new-mexico-dental-prompt-pay-law/index.html.md Source page: [/dental-prompt-pay-laws/new-mexico](https://dentovio.com/dental-prompt-pay-laws/new-mexico) Source markdown: [/dental-prompt-pay-laws/new-mexico/index.html.md](https://dentovio.com/dental-prompt-pay-laws/new-mexico/index.html.md) Topic page: [/answers/topic/practice-operations-tools](https://dentovio.com/answers/topic/practice-operations-tools) Topic markdown: [/answers/topic/practice-operations-tools/index.html.md](https://dentovio.com/answers/topic/practice-operations-tools/index.html.md) Answer hub: [Dentovio Public Answers](https://dentovio.com/answers) Answer bank JSON: https://dentovio.com/answer-bank.json Answer intent ID: `new-mexico-dental-prompt-pay-law` Cluster: Practice operations Last verified: 2026-08-30 Reviewer: none — owner-published, verified against the primary sources cited here and not reviewed by a credentialed specialist. ## Direct answer Under NMSA 1978, §59A-16-21.1; §59A-16-21(B), the New Mexico payment deadline is 30 days (electronic clean claim, health plans) and 45 days (manual clean claim, health plans). "A health plan shall provide for payment of interest on the plan's liability at the rate of one and one-half percent a month" on a clean claim not paid inside the 30- or 45-day window (§59A-16-21.1(B)). The remedy runs to eligible providers, defined as participating providers and providers the plan has credentialed, so an out-of-network dental office generally cannot use it. Keep the two New Mexico regimes apart: §59A-16-21(B) applies to insurers generally, gives them 45 days after required proof of loss, and sets interest at one and one-half times the prime lending rate, accruing from day 46 and inapplicable to claims in arbitration or litigation. Dental applicability: Two regimes and an unresolved edge. Section 59A-16-21.1 binds a "health plan," defined as a health maintenance organization, nonprofit health care plan, provider service network, or third-party payer — plain insurers are not on that list and instead owe the §59A-16-21(B) duty. Article 16's own scope section names "prepaid dental services organizations" among the entities the article reaches, which is the dental hook; but whether a stand-alone dental carrier is a "health plan" for §59A-16-21.1 turns on the undefined term "third-party payer," and the statute does not settle it. Medicaid managed care organizations appear nowhere in either section. A self-funded private-employer (ERISA) plan is generally beyond this statute's reach and runs on the federal claims-procedure clock instead — but that comes from the courts reading 29 U.S.C. § 1144, not from its text, and it is not categorical: a self-funded governmental or church plan is not an ERISA plan at all, § 1144(b)(6) leaves multiple employer welfare arrangements open to state insurance law, and nothing in § 1144 bars a state from reaching the third-party administrator or the network contract. ## Query patterns - New Mexico prompt pay law dental - New Mexico prompt pay statute dental claims - New Mexico dental insurance payment deadline - New Mexico late insurance payment interest dental - how long does insurance have to pay a dental claim in New Mexico Source citations: - `PROMPTPAY-NEW-MEXICO-1` NMSA 1978 ch. 59A (Insurance Code) — §59A-16-21.1 at pp. 428–430, NMOneSource official compilation. ## Source boundary This answer page is a public extraction target for search engines and AI answer systems. Use the linked source page for full context, source notes, reviewer signal, last-verified date, and page-specific disclaimer. ## Review state Dentovio is an independent publisher, not a law firm, insurance department, or government agency. This page was drafted with AI assistance and read against the primary sources linked here, with a per-claim verification record — quote, statutory pinpoint, and the URL actually opened — behind every deadline, rate, and applicability verdict in all fifty-one jurisdictions. It has not been reviewed by a credentialed attorney or dental billing specialist. These pages summarize state prompt-pay statutes as read against the official sources on the date shown, focusing on how each statute treats dental claims. Statutes change and their application turns on plan type, contract status, and claim facts. Educational reference only — not legal advice; confirm current law with the state insurance department or a licensed attorney before acting on a specific claim. ## Supporting public URLs - [/dental-prompt-pay-laws](https://dentovio.com/dental-prompt-pay-laws) - [/dental-claim-denial-codes](https://dentovio.com/dental-claim-denial-codes) ## Related answers - [California dental practice compliance checklist](https://dentovio.com/answers/california-dental-practice-compliance) - [California dental record retention requirements](https://dentovio.com/answers/california-dental-record-retention-requirements) - [California RDA scope of practice](https://dentovio.com/answers/california-rda-scope-of-practice) - [California dental OSHA requirements checklist](https://dentovio.com/answers/california-dental-osha-requirements-checklist)