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

Dental scope unsettled · Last verified 2026-08-30

New York prompt-pay law for dental claims

New York'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.

N.Y. Ins. Law §3224-a

Read the statute text

Payment deadlines

Electronic claims: 30 days (internet or electronic mail)
Paper claims: 45 days (paper, facsimile, or other means)

Payment is due within 30 days of receipt of a claim or bill transmitted via the internet or electronic mail, or 45 days of one submitted by other means such as paper or facsimile. The duty carries a standing exception: it does not apply where the obligation to pay is not reasonably clear, or where there is a reasonable basis supported by specific information that the claim was submitted fraudulently. On a disputed claim the payer must pay the undisputed portion and, within 30 days, either deny in writing with specific reasons or request additional information (§3224-a(b)).

Interest and penalties

Late payment carries interest "of the greater of the rate equal to the rate set by the commissioner of taxation and finance for corporate taxes pursuant to paragraph one of subsection (e) of section one thousand ninety-six of the tax law or twelve percent per annum, to be computed from the date the claim or health care payment was required to be made" (§3224-a(c)(1)). Interest under two dollars is not payable. The 98 percent safe harbor at §3224-a(c)(2) shields an insurer from the superintendent's civil penalty in a superintendent-initiated investigation but expressly does not excuse paying the claim or the interest. New York courts have also recognised an implied private right of action for health care providers: Maimonides Med. Ctr. v. First United Am. Life Ins. Co., 116 AD3d 207 (2d Dep't 2014).

Does it apply to dental? Dental scope unsettled

Section 3224-a applies to "all health care claims submitted under contracts or agreements" and to "all bills for health care services rendered by health care providers pursuant to such contracts or agreements," and it binds an insurer or an organization or corporation licensed or certified under Insurance Law article 43 or 47 or Public Health Law article 44. The text names no dental inclusion and no dental exclusion, and the sources read here did not resolve whether a stand-alone dental carrier sits inside — so the question stays open rather than being answered by inference. Dental services billed under a covered medical contract 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 New York rule (N.Y. Ins. Law §3224-a). Estimate only — the statute's own accrual triggers control.

How the claim was submitted

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

Electronic— 30 days (internet or electronic mail)Paper— 45 days (paper, facsimile, or other means)

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 (30 days (internet or electronic mail)), not days since submission.

Estimated interest

$12.58

12% per year (simple)

12% is the floor, not the rate: the statute requires the greater of 12% per annum or the corporate-tax rate set by the commissioner of taxation and finance, computed from the date payment was required. No interest is owed where the amount due on a claim comes to less than two dollars.

How we calculate this

Formula: claim × 12% × days late ÷ 365, using simple (not compounded) interest as the statute states it. The rate and deadline come from N.Y. Ins. Law §3224-a, 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.

Nothing you type here leaves your browser — the results are computed locally on this page.

Also in the statute

The Maimonides holding is about health care providers generally — the plaintiff was a hospital — not about dentistry specifically.
The current text of §3224-a took effect September 19, 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)