# Georgia prompt-pay law for dental claims

> What is the Georgia prompt-pay deadline for dental claims, and what interest applies to late payment? Verified against the statute text (O.C.G.A. §33-24-59.5; §33-24-59.14).

URL: https://dentovio.com/dental-prompt-pay-laws/georgia

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

Under O.C.G.A. §33-24-59.5; §33-24-59.14, the Georgia payment deadline is 15 working days (electronic) and 30 calendar days (paper). Late payments owe interest at 12% per year (§33-24-59.5(c); §33-24-59.14(c)) — mandatory and owed to the claimant. Dental applicability: Expressly covered: Georgia's definition of "health benefit plan" includes "any dental or vision care plan or policy" (§33-24-59.5(a)(2), incorporated by §33-24-59.14). Self-funded (ERISA) plans are outside this statute — federal ERISA deadlines apply to them instead.

## Payment deadlines

- Electronic claims: 15 working days (electronic)
- Paper claims: 30 calendar days (paper)

Insurers and administrators must pay or send a denial/deficiency notice within 15 working days for electronic claims or 30 calendar days for paper claims — §33-24-59.14 for claims payable to the provider, §33-24-59.5 for claims payable to the member. When requested documentation arrives, a fresh identical period runs. Undisputed portions must be paid on time.

## Interest and penalties on late payment

Late payments owe interest at 12% per year (§33-24-59.5(c); §33-24-59.14(c)) — mandatory and owed to the claimant. Many billing references still quote 18% and a flat 15-working-day deadline; that was the 1999 version of the law, replaced in 2011. The Commissioner can add administrative penalties only for systemic non-compliance (processing under 95% of claims on time in a quarter).

## Does it apply to dental? Dental expressly covered

Expressly covered: Georgia's definition of "health benefit plan" includes "any dental or vision care plan or policy" (§33-24-59.5(a)(2), incorporated by §33-24-59.14). The provider-claims section's limited-benefit exclusion names accident-only, CHAMPUS supplement, disability income, fixed indemnity, long-term care, and specified disease — dental is not on the list. Both sections apply only to fully insured business and TPA business; the Eleventh Circuit held the 2011 amendments preempted as applied to self-funded ERISA plans (AHIP v. Hudgens).

## 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

- For claims a dental office submits for payment to itself, the operative section is §33-24-59.14; §33-24-59.5 governs claims paid to the patient.

## Sources (statute text)

- [O.C.G.A. §33-24-59.14 — provider claims (2025 Code)](https://law.justia.com/codes/georgia/title-33/chapter-24/article-1/section-33-24-59-14/)
- [O.C.G.A. §33-24-59.5 — member claims (2025 Code)](https://law.justia.com/codes/georgia/title-33/chapter-24/article-1/section-33-24-59-5/)

## 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)