# Indiana prompt-pay law for dental claims

> What is the Indiana prompt-pay deadline for dental claims, and what interest applies to late payment? Verified against the statute text (Ind. Code §27-8-5.7-6; §27-13-36.2-4).

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

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 Ind. Code §27-8-5.7-6; §27-13-36.2-4, the Indiana payment deadline is 30 days (electronic) and 45 days (paper). Interest accrues from day 31 (electronic) or day 46 (paper) until payment, at the same rate used for Medicaid late payments: the prior fiscal year's average state general-fund investment yield, rounded to a whole percent — roughly 1% in recent Department of Insurance bulletins, not the flat figures often quoted. Dental applicability: Covered on both tracks. Self-funded (ERISA) plans are outside this statute — federal ERISA deadlines apply to them instead.

## Payment deadlines

- Electronic claims: 30 days (electronic)
- Paper claims: 45 days (paper)

Clean claims must be paid or denied within 30 days when filed electronically and 45 days on paper — identical for insurers (IC 27-8-5.7-6) and HMOs (IC 27-13-36.2-4). Deficiency notices must go out within the same windows, and a payer that fails to send one establishes the submitted claim as clean.

## Interest and penalties on late payment

Interest accrues from day 31 (electronic) or day 46 (paper) until payment, at the same rate used for Medicaid late payments: the prior fiscal year's average state general-fund investment yield, rounded to a whole percent — roughly 1% in recent Department of Insurance bulletins, not the flat figures often quoted. The real teeth are the compliance penalties: an insurer paying under 95% of clean claims on time in a year faces up to $10,000; under 85%, $10,000–$100,000; under 60%, $100,000–$200,000.

## Does it apply to dental? Dental expressly covered

Covered on both tracks. The insurer chapter's definition of provider expressly includes dental services, and the statute names the ADA claim form as a permitted format. Dental-only HMOs are covered as limited service health maintenance organizations — "limited health services" starts with dental care services in the statute's own list.

## 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

- Clean-claim protections attach to policies issued in Indiana (IC 27-8-5.7-2).

## Sources (statute text)

- [Ind. Code 27-8-5.7 — accident and sickness insurance provider payment](https://iga.in.gov/laws/2025/ic/titles/27#27-8-5.7-6)
- [Ind. Code 27-13-36.2 — HMO provider payment](https://iga.in.gov/laws/2025/ic/titles/27#27-13-36.2-4)
- [IDOI Bulletin 248 — clean-claim interest rate announcement](https://www.in.gov/dA/5bf05298be/Bulletin-248-Indiana-Rate-for-Failure-to-Pay-a-Clean-Claim.pdf)

## 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)