# District of Columbia prompt-pay law for dental claims

> What is the District of Columbia prompt-pay deadline for dental claims, and what interest applies to late payment? Verified against the statute text (D.C. Code §31-3132; §31-3131).

URL: https://dentovio.com/dental-prompt-pay-laws/district-of-columbia

Last verified: 2026-08-29

Dentovio is an independent publisher, not a law firm, insurance department, or government agency. These pages summarize state prompt-pay statutes as verified against the legislature's published text on the last-verified date, 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.

## 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.

## Payment deadlines

- Electronic claims: 30 days (uniform)
- Paper claims: 30 days (uniform)

Health insurers must reimburse within 30 days of receiving a clean claim — a uniform deadline with no electronic/paper split (formats differ only in receipt presumptions: 24 hours for electronic, five business days for mail). Disputed claims require written reasons within 30 days and payment of any undisputed portion on time.

## Interest and penalties on late payment

Interest accrues automatically from day 31: 1.5% per month through day 60, 2% per month from day 61 through 120, and 2.5% per month after that (§31-3132(c)) — among the steepest prompt-pay rates in the country. But read the definitions first: the chapter does not reach dental-only insurance at all.

## Does it apply to dental? Standalone dental excluded

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.

## Self-funded (ERISA) plans

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.

## Also in the statute

- Providers must be allowed at least 180 days from the date of service to submit a claim (§31-3132(g)).

## Sources (statute text)

- [D.C. Code §31-3132 — prompt payment](https://code.dccouncil.gov/us/dc/council/code/sections/31-3132)
- [D.C. Code §31-3131 — definitions (dental-only exclusion)](https://code.dccouncil.gov/us/dc/council/code/sections/31-3131)

## Related

- [All state prompt-pay pages](https://dentovio.com/dental-prompt-pay-laws/index.html.md)
- [Dental claim denial codes](https://dentovio.com/dental-claim-denial-codes/index.html.md)
- [Payer documentation requirements](https://dentovio.com/dental-claim-documentation/index.html.md)