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

Dental scope unsettled · Last verified 2026-08-30

Nevada prompt-pay law for dental claims

Nevada'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.

Nev. Rev. Stat. §689B.255; §695G.340; §686A.310

Read the statute text

Payment deadlines

Electronic claims: 21 days (submitted electronically)
Paper claims: 30 days (not submitted electronically)

An insurer must approve or deny a claim relating to a policy of group health insurance or blanket insurance within 21 days of receipt if the claim was submitted electronically, or 30 days if it was not — and if the claim is approved, pay it within the same period (§689B.255(1)). The insurer may request additional information within 20 working days, which restarts the clock. Managed care organizations run on the same 21/30-day schedule and the same interest rate under §695G.340, added in 2025; the old HMO section, §695C.185, was repealed effective January 1, 2026 and should not be cited.

Interest and penalties

Current law requires the insurer to "pay interest on the claim at a rate of 10 percent per annum" (§689B.255(1) as amended by ch. 366, Stats. 2025 — AB 52 — effective January 1, 2026 and applying to claims submitted on or after that date). AB 52 rewrote Nevada's whole prompt-pay family in parallel, so third-party administrators, individual policies, group policies, and managed care organizations all now run 21/30 days at 10 percent. Courts must award costs and attorney's fees to the prevailing party (§689B.255(5)), the Commissioner's substantial-compliance benchmark is 95 percent of approved claims and 90 percent of dollars paid on time, and fines and licence action back it up.

Does it apply to dental? Dental scope unsettled

Nevada's prompt-pay section keys on "a policy of group health insurance or blanket insurance," and chapter 689B applies only to group health and blanket accident and health contracts. Nothing in the chapter expressly includes or excludes a stand-alone dental plan at the §689B.255 level; the limited-scope dental exclusion appears only inside the separate HIPAA-portability definition at §689B.390(3). The code plainly treats stand-alone dental as its own category elsewhere — §686A.313 regulates coordination of a "stand-alone dental benefit" — which is a reason to ask, not an answer. Dental benefits inside a group health policy are the clearer case.

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 Nevada rule (Nev. Rev. Stat. §689B.255; §695G.340; §686A.310). Estimate only — the statute's own accrual triggers control.

How the claim was submitted

Nevada sets a different deadline for each, so this decides which day the field below counts from.

Electronic— 21 days (submitted electronically)Paper— 30 days (not submitted electronically)

Claim amount (allowed)Interest statutes run on the payable claim amount, not billed charges.Days past the deadlineDays after the statutory deadline for a electronic claim (21 days (submitted electronically)), not days since submission.

Estimated interest

$10.48

10% per year (simple)

10% per annum for claims submitted on or after January 1, 2026. Claims submitted before that date ran on the prior rate — the prime rate at Nevada's largest bank plus 6 points — so older tables are describing repealed law. Interest may be waived only where payment was delayed by an act of God or another cause beyond the insurer's control.

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 Nev. Rev. Stat. §689B.255; §695G.340; §686A.310, 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

Prompt-pay failures are per-se unfair practices under §686A.310(1) — Nevada's list has no "general business practice" threshold — and §686A.310(2) makes the insurer liable to its insured for damages resulting from any listed act.
Managed care organizations are covered by §695G.340 (21/30 days, 10% per annum); §695C.185 was repealed effective January 1, 2026.
Denial notices must go to insureds and providers within the same 21/30-day windows with reasons, criteria, and the appeal summary required by §687B.820.
Insurers owe the Commissioner an annual compliance report each February 1 (§689B.255(9), added 2025).

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)