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

Dental expressly covered · Last verified 2026-08-29

Kentucky prompt-pay law for dental claims

KRS 304.17A-702; 304.17A-730; 304.17C-090

Under KRS 304.17A-702; 304.17A-730; 304.17C-090, the Kentucky payment deadline is 30 days for clean/complete claims. KRS 304.17A-730 sets one retroactive rate by how late the claim is ultimately paid: 12% per year if paid 1–30 days late, 18% if 31–60 days late, and 21% beyond 60 days — the top tier triggers at day 61, not day 90 as often misquoted. Dental applicability: Expressly covered by a dedicated bridge statute. Self-funded (ERISA) plans are outside this statute — federal ERISA deadlines apply to them instead.

Read the statute text

Payment deadlines

Electronic claims: 30 calendar days (all clean claims)
Paper claims: 30 calendar days (all clean claims)

Insurers must pay, deny, or contest a clean claim within 30 calendar days of receipt (60 days for organ-transplant claims). The payment deadline is format-neutral; only acknowledgment differs — 48 hours for electronic claims, 20 days for paper. For dental-only plans, KRS 304.17C-090 applies the whole prompt-pay run of statutes with one acceleration: 3 business days to respond to electronically submitted claims.

Interest and penalties

KRS 304.17A-730 sets one retroactive rate by how late the claim is ultimately paid: 12% per year if paid 1–30 days late, 18% if 31–60 days late, and 21% beyond 60 days — the top tier triggers at day 61, not day 90 as often misquoted. The insurer must add the interest without the provider asking. Separate department fines can reach $1,000 per day or 10% of the unpaid claim, whichever is greater (KRS 304.99-123).

Does it apply to dental? Dental expressly covered

Expressly covered by a dedicated bridge statute. Kentucky's general definitions exclude dental-only policies from "health benefit plan" — a trap for anyone reading only KRS 304.17A-005 — but KRS 304.17C-090 independently applies the prompt-pay statutes to limited health service benefit plans providing dental-only benefits, with three modifications (3-business-day electronic response, annual reporting, and the $5 interest floor). The clean-claim definition even specifies the ADA-approved form for dentists.

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.

Estimate the late-payment interest

Uses the verified Kentucky rule (KRS 304.17A-702; 304.17A-730; 304.17C-090). 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 (30 calendar days (all clean claims)), not days since submission.

Estimated interest

$18.86

18% per year (rate set by final lateness, applied retroactively from the due date)

A single rate chosen by final lateness, accruing retroactively from the due date. For dental-only plans, interest is owed only when it reaches at least $5 on the claim.

How we calculate this

Formula: claim × tier rate × days late ÷ 365, using simple (not compounded) interest as the statute states it. The rate and deadline come from KRS 304.17A-702; 304.17A-730; 304.17C-090, verified against the statute text linked in the sources on this page (last verified 2026-08-29). 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.

Also in the statute

Interest is excused when the failure is due to events beyond the insurer's control (acts of God, epidemics, strikes, war, facility disruptions).
Fines extend to Medicaid managed care organizations (KRS 304.99-123(3)).

Payment deadlines

Interest and penalties

Does it apply to dental? Dental expressly covered

Estimate the late-payment interest

Also in the statute

Sources (statute text)