# Michigan prompt-pay law for dental claims

> What is the Michigan prompt-pay deadline for dental claims, and what interest applies to late payment? Read against the statute text (MCL 500.2006).

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

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 MCL 500.2006, the Michigan payment deadline is 45 days (no format split). "A clean claim that is not paid within 45 days bears simple interest at a rate of 12% per annum" (MCL 500.2006(8)(a)). Dental applicability: Covered, and dental is written into the section twice. 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: 45 days (no format split)
- Paper claims: 45 days (no format split)

A clean claim must be paid within 45 days after the health plan receives it (MCL 500.2006(8)(a)). The plan has 30 days to notify the provider of a defect, and the 45-day clock is tolled from that defect notice until the provider responds — so the deadline only bites on an untolled clean claim. A claim must be billed within one year of the date of service to be a clean claim at all, and the plan must pay the payable line items rather than denying an entire claim over one defective service.

## Interest and penalties on late payment

"A clean claim that is not paid within 45 days bears simple interest at a rate of 12% per annum" (MCL 500.2006(8)(a)). Providers may file a complaint with the Department of Insurance and Financial Services on its Non-Medicaid Provider Clean Claim Report (form FIS 0284); the director may impose a civil fine of up to $1,000 per violation, capped at $10,000 in the aggregate, and court action is expressly preserved alongside the DIFS complaint.

## Does it apply to dental? Dental expressly covered

Covered, and dental is written into the section twice. The "health plan" definition includes an insurer providing benefits under a health insurance policy "including … an expense-incurred vision or dental policy," and subsection (15) adds: "After December 31, 2017, this section applies to a nonprofit dental care corporation operating under 1963 PA 125, MCL 550.351 to 550.373." The statute names the corporation type, not any company. The material exclusion is on the other side: administrative-services-only and cost-plus arrangements are expressly outside the definition, so a self-funded employer plan's administrator is not bound, and Medicaid claims run under MCL 400.111i instead.

## 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

- Administrative-services-only and cost-plus arrangements are expressly excluded from "health plan" (MCL 500.2006(14)(c)).
- A claim must be billed within one year of the date of service to qualify as a clean claim (MCL 500.2006(8)(f)).
- Medicaid provider clean-claim complaints use a different DIFS form (FIS 0278) and a different statute.
- The statute draws no in-network / out-of-network distinction, and subsection (7) preserves plans' freedom to set contract terms other than as provided in the section for timely payment.
- Currency: Michigan Compiled Laws complete through PA 91 of 2026; last amended by 2017 PA 223.

## Sources (statute text)

- [MCL 500.2006 — Michigan Legislature](https://www.legislature.mi.gov/Laws/MCL?objectName=mcl-500-2006)
- [DIFS — how to file a complaint (provider clean claim report FIS 0284)](https://www.michigan.gov/difs/consumers/complaint)

## 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)