# Maryland prompt-pay law for dental claims

> What is the Maryland prompt-pay deadline for dental claims, and what interest applies to late payment? Read against the statute text (Md. Code Ann., Ins. §15-1005).

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

Last verified: 2026-08-30

Dentovio is an independent publisher, not a law firm, insurance department, or government agency. This page was drafted with AI assistance and read against the primary sources linked here, with a per-claim verification record — quote, statutory pinpoint, and the URL actually opened — behind every deadline, rate, and applicability verdict in all fifty-one jurisdictions. It has not been reviewed by a credentialed attorney or dental billing specialist. These pages summarize state prompt-pay statutes as read against the official sources on the date shown, 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 Md. Code Ann., Ins. §15-1005, the Maryland payment deadline is 30 days (pay or send a receipt-and-status notice). Maryland puts the rate in the statute, not in regulation: interest runs on the amount unpaid 30 days after receipt at the monthly rate of 1.5 percent from the 31st through the 60th day, 2 percent from the 61st through the 120th day, and 2.5 percent after the 120th day (§15-1005(g)(1)). Dental applicability: Covered by cross-reference rather than 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.

## Payment deadlines

- Electronic claims: 30 days (pay or send a receipt-and-status notice)
- Paper claims: 30 days (pay or send a receipt-and-status notice)

Within 30 days after receiving a claim for reimbursement, an insurer, nonprofit health service plan, or health maintenance organization must either mail or transmit payment or send a notice of receipt and status of the claim. Undisputed portions must still be paid within 30 days when part of a claim is contested, and after requested additional information arrives the payer gets a fresh 30 days. "Clean claim" itself is defined by Commissioner regulation under §15-1003 (COMAR 31.10.11), not in the statute.

## Interest and penalties on late payment

Maryland puts the rate in the statute, not in regulation: interest runs on the amount unpaid 30 days after receipt at the monthly rate of 1.5 percent from the 31st through the 60th day, 2 percent from the 61st through the 120th day, and 2.5 percent after the 120th day (§15-1005(g)(1)). It "shall be included in any late reimbursement without the necessity for the person that filed the original claim to make an additional claim for that interest." Administrative penalties are separate: up to $500 for each violation that is arbitrary and capricious, plus §4-113(d) penalties where the conduct is frequent enough to be a general business practice.

## Does it apply to dental? Dental covered, with caveats

Covered by cross-reference rather than by name. Section 15-1005(c) governs claims "from a person entitled to reimbursement under §15-701(a)," and §15-701(a) reaches any service within the lawful scope of practice of a health care provider licensed under the Health Occupations Article — dentists are Health Occupations Article licensees. The statute is provider-neutral and never says "dental." One correction worth carrying: Medicaid managed care organizations are nowhere in §15-1005, so do not use this section for an MCO claim.

## 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.

## Also in the statute

- Carriers must allow a provider at least 180 days from the date of service to submit a claim and at least 90 working days after a denial to appeal it (§15-1005(e)).
- A provider that notifies the carrier of a claims-processing error within one year of the denial forces reprocessing without resubmission and without regard to timely-filing deadlines (§15-1005(e)(3)).
- Credit-card and virtual-card payment fees require advance notice, a no-fee alternative, and the provider's election (§15-1005(d)).
- Provider prompt-pay complaints go to the Maryland Insurance Administration through its online complaint portal; the MIA asks for a representative sample of no more than ten claims against one carrier.
- The official statute viewer carries no amendment history, so no last-amendment date is stated here.

## Sources (statute text)

- [Md. Code Ann., Ins. §15-1005 — Maryland General Assembly statute viewer](https://mgaleg.maryland.gov/mgawebsite/laws/StatuteText?article=gin&section=15-1005)
- [Md. Code Ann., Ins. §15-701 — persons entitled to reimbursement](https://mgaleg.maryland.gov/mgawebsite/laws/StatuteText?article=gin&section=15-701)
- [Maryland Insurance Administration — file a complaint (provider prompt pay)](https://insurance.maryland.gov/Consumer/pages/fileacomplaint.aspx)

## 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)