# New Jersey prompt-pay law for dental claims

> What is the New Jersey prompt-pay deadline for dental claims, and what interest applies to late payment? Verified against the statute text (N.J.A.C. 11:22-1.5; N.J.S.A. 17B:30-26 to -34).

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

Last verified: 2026-08-29

Dentovio is an independent publisher, not a law firm, insurance department, or government agency. These pages summarize state prompt-pay statutes as verified against the legislature's published text on the last-verified date, 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 N.J.A.C. 11:22-1.5; N.J.S.A. 17B:30-26 to -34, the New Jersey payment deadline is 30 calendar days (clean claims) and 40 calendar days (clean claims). Late clean claims from dental plan organizations and dental service corporations accrue simple interest at 10% per year, added to the claim payment automatically (N.J.A.C. Dental applicability: Expressly covered, with a dental-specific interest rate. Self-funded (ERISA) plans are outside this statute — federal ERISA deadlines apply to them instead.

## Payment deadlines

- Electronic claims: 30 calendar days (clean claims)
- Paper claims: 40 calendar days (clean claims)

Clean claims must be paid within 30 calendar days when submitted electronically (or the federal Medicare time limit, whichever is earlier) and 40 calendar days on paper. The rule applies expressly to dental service corporations and dental plan organizations — N.J.A.C. 11:22-1.1(b) names them, and the enabling statute (N.J.S.A. 17B:30-26) defines "carrier" to include both.

## Interest and penalties on late payment

Late clean claims from dental plan organizations and dental service corporations accrue simple interest at 10% per year, added to the claim payment automatically (N.J.A.C. 11:22-1.5(e)). Health carriers — insurance companies, service corporations, HMOs — owe 12% per year under the same rule and N.J.S.A. 17B:27-44.2(d)(9). Interest starts at day 30/40 from receipt of all information required to process the claim.

## Does it apply to dental? Dental expressly covered

Expressly covered, with a dental-specific interest rate. New Jersey is unusual in naming dental entities directly: the prompt-pay subchapter applies to any dental service corporation or dental plan organization issuing dental plans in the state, and dental entities have their own internal and external appeal tracks (N.J.A.C. 11:22-1.11 and 1.12). The statute reaches insured plans only (N.J.S.A. 17B:30-27).

## 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.

## Also in the statute

- Capitation payments have their own rule: overdue if not remitted by the 5th business day after the due date, bearing 10% simple interest (N.J.S.A. 17B:30-32).

## Sources (statute text)

- [N.J.A.C. 11:22-1.5 — Prompt payment of claims](https://regulations.justia.com/states/new-jersey/title-11/chapter-22/subchapter-1/section-11-22-1-5/)
- [N.J.S.A. 17B:27-44.2 — health insurer deadlines and 12% interest](https://codes.findlaw.com/nj/title-17b-insurance/nj-st-sect-17b-27-44-2/)
- [N.J.S.A. 17B:30-26 — carrier definition including dental entities](https://codes.findlaw.com/nj/title-17b-insurance/nj-st-sect-17b-30-26/)

## 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)