What is the Hawaii prompt-pay deadline for dental claims, and what interest applies to late payment?

Under Haw. Rev. Stat. §431:13-108, the Hawaii payment deadline is 15 calendar days (filed electronically) and 30 calendar days (filed in writing). Interest runs at 15 percent a year — from the first calendar day after the 30-day period for a written claim, or after the 15-day period for an electronic one (§431:13-108(g)(1)). Dental applicability: Covered by name. 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.

Dental expressly covered · Last verified 2026-08-30

Hawaii prompt-pay law for dental claims

Hawaii's prompt-pay law covers dental claims. Clean claims must be paid or denied within 15 calendar days electronic, 30 calendar days paper; late payment accrues statutory interest.

Haw. Rev. Stat. §431:13-108

Read the statute text

Payment deadlines

Electronic claims: 15 calendar days (filed electronically)
Paper claims: 30 calendar days (filed in writing)

Unless a contract specifies shorter timeframes, an entity must reimburse a claim that is not contested or denied within 30 calendar days of receiving it in writing or 15 calendar days of receiving it electronically (§431:13-108(b)). To contest or deny, the entity must notify the provider within 15 calendar days for a written claim or 7 calendar days for an electronic one — unless it sends the provider a reimbursement report containing that information at least monthly. Payment is effective on the postmark date or the date of the electronic transfer.

Interest and penalties

Interest runs at 15 percent a year — from the first calendar day after the 30-day period for a written claim, or after the 15-day period for an electronic one (§431:13-108(g)(1)). Any interest that accrues in a sum of at least $2 on a delayed clean claim is automatically added by the entity to the amount of the unpaid claim due the provider (subsection (h)). The commissioner may suspend interest accrual for a major disaster or an unanticipated major computer-system failure, and penalties route through §431:13-201.

Does it apply to dental? Dental expressly covered

Covered by name. The section applies to accident and health or sickness insurers issuing comprehensive medical plans, mutual benefit societies, "dental service corporations under chapter 423," and health maintenance organizations — dental service corporations appear in the statute's own list of covered entities and again in its definition of "entity." The section also contemplates claims from non-contracted providers. The important limit is on the term "clean claim," which excludes self-insured employer groups, national participating provider network claims, Medicaid, Medicare, medigap and federally financed plans, and coordination-of-benefits, subrogation, preexisting-condition, and third-party-liability claims — those are outside the deadline and the interest.

Self-funded (ERISA) plans: A self-funded private-employer (ERISA) dental plan is generally beyond a state prompt-pay statute's reach: 29 U.S.C. § 1144(b)(2)(B) bars a state from deeming such a plan an insurer, and the courts have read that to keep state insurance regulation off it. The statute itself never uses the words self-funded or prompt pay, and the rule is not categorical — a self-funded governmental or church plan is not an ERISA plan at all, so state law can reach it; § 1144(b)(6) leaves multiple employer welfare arrangements open to state insurance law; and nothing in § 1144 addresses state enforcement against the third-party administrator or the network contract. Where the plan is a self-funded ERISA group health plan, the federal claims-procedure deadlines apply 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.

Estimate the late-payment interest

Uses the verified Hawaii rule (Haw. Rev. Stat. §431:13-108). Estimate only — the statute's own accrual triggers control.

How the claim was submitted

Hawaii sets a different deadline for each, so this decides which day the field below counts from.

Electronic— 15 calendar days (filed electronically)Paper— 30 calendar days (filed in writing)

Claim amount (allowed)Interest statutes run on the payable claim amount, not billed charges.Days past the deadlineDays after the statutory deadline for a electronic claim (15 calendar days (filed electronically)), not days since submission.

Estimated interest

$15.72

15% per year (simple)

Interest that accrues to at least $2 on a delayed clean claim is added to the unpaid claim automatically. The statute does not say smaller amounts are forfeited — only that the automatic-add duty attaches at $2. The commissioner may suspend accrual for a major disaster or an unanticipated major computer-system failure.

How we calculate this

Formula: claim × 15% × days late ÷ 365, using simple (not compounded) interest as the statute states it. The rate and deadline come from Haw. Rev. Stat. §431:13-108, read against the statute text linked in the sources on this page (last verified 2026-08-30). Accrual start dates, clean-claim status, safe harbors, and plan funding all affect the real figure — treat this as an estimate for the payer conversation, not a demandable amount.

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Also in the statute

The 15- and 30-day clocks run "unless shorter payment timeframes are otherwise specified in a contract" — in Hawaii a contract may only shorten them.
Recoupment or offset may not start more than 18 months after the initial claim payment was received; fraud or material misrepresentation extends that to 72 months, it does not remove the cap (§431:13-108(j)).
Any recoupment requires 30 days' written notice, and the provider has 60 days from that notice to appeal (§431:13-108(i)).
Last amended by L 2017, c 90, which clarified that acute care hospitals fall under the clean-claims statute.

Sources (statute text)

Haw. Rev. Stat. §431:13-108 — Hawaii State Legislature (current HRS)