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

Under Iowa Admin. Code r. 191—15.32; Iowa Code §507B.4A, the Iowa payment deadline is 30 days (no format split). Interest accrues at 10 percent per annum "commencing on the thirty-first day after the insurer's receipt of all information necessary to establish a clean claim" (Iowa Admin. Dental applicability: Iowa never names dental. 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 scope unsettled · Last verified 2026-08-30

Iowa prompt-pay law for dental claims

Iowa's prompt-pay statute never names dental, and its definitions do not settle whether it reaches a stand-alone dental carrier. The deadlines are below.

Iowa Admin. Code r. 191—15.32; Iowa Code §507B.4A

Read the statute text

Payment deadlines

Electronic claims: 30 days (no format split)
Paper claims: 30 days (no format split)

The deadline is in the rule, not the statute: insurers subject to the subrule must accept and pay or deny a clean claim for health care benefits within 30 days after receipt (Iowa Admin. Code r. 191—15.32(2)(a)). The 30 days that appears in Iowa Code §507B.4A(1) is about responding to inquiries from the commissioner, not paying claims — cite the rule for the payment clock. Insurers get 30 days to request additional information, and a claim counts as paid on the date a check, draft, or other valid negotiable instrument is written. "Clean claim" excludes coordination-of-benefits and third-party-liability claims, preexisting-condition investigations, subrogation, and circumstances requiring special treatment such as suspected fraud, acts of God, or group non-payment of premium.

Interest and penalties

Interest accrues at 10 percent per annum "commencing on the thirty-first day after the insurer's receipt of all information necessary to establish a clean claim" (Iowa Admin. Code r. 191—15.32(2)(b)), with the same rate stated in Iowa Code §507B.4A(2)(d). Enforcement is administrative through the Iowa Insurance Division under chapter 507B — hearings, orders, and penalties — with no private right of action in §507B.4A.

Does it apply to dental? Dental scope unsettled

Iowa never names dental. The covered entities are "an insurer providing accident and sickness insurance under chapter 509, 514, or 514A; a health maintenance organization; or another entity providing health insurance or health benefits subject to state insurance regulation," and the exemption list runs to liability insurance, workers' compensation or similar insurance, automobile or homeowners' medical payment insurance, disability income, and long-term care. Dental appears on neither list. A dental carrier that is a state-regulated health-benefits entity reads as inside, but the statute and rule never say so, and no controlling Iowa source read here resolves it.

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.

Because this statute never names dental, whether it reaches your claim is unresolved. Treat anything below as the figure the statute would produce if it applies — read the applicability note above first.

Estimate the late-payment interest

Uses the verified Iowa rule (Iowa Admin. Code r. 191—15.32; Iowa Code §507B.4A). Estimate only — the statute's own accrual triggers control.

Claim amount (allowed)Interest statutes run on the payable claim amount, not billed charges.Days past the deadlineDays after the statutory deadline for this claim (30 days (no format split)), not days since submission.

Estimated interest

$10.48

10% per year (simple)

Accrual starts on the thirty-first day after the insurer receives all information necessary to establish a clean claim — an information request effectively restarts the clock, so count days from that receipt, not from first submission.

How we calculate this

Formula: claim × 10% × days late ÷ 365, using simple (not compounded) interest as the statute states it. The rate and deadline come from Iowa Admin. Code r. 191—15.32; Iowa Code §507B.4A, 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 rule applies to policies issued, issued for delivery, or renewed in Iowa; it says nothing about network status.
On a coordination-of-benefits claim, the insurer must comply once its liability is determined (r. 191—15.32(2)(d)).
Currency: Iowa Code 2026; the statute was last amended in 2017, and the rule was last amended effective April 24, 2024.

Payment deadlines

Interest and penalties

Does it apply to dental? Dental scope unsettled

Estimate the late-payment interest

Also in the statute

Sources (statute text)