# North Dakota prompt-pay law for dental claims

> What is the North Dakota prompt-pay deadline for dental claims, and what interest applies to late payment? Read against the statute text (N.D. Cent. Code §26.1-36-37.1).

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

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 N.D. Cent. Code §26.1-36-37.1, the North Dakota payment deadline is 15 business days (statute makes no format distinction). There is no interest remedy to report. Dental applicability: Dental is inside the section's own definition: "'health care service' means any service included in providing an individual with medical, dental, or hospital care or any service incident to providing medical, dental, or hospital care." The implementing rule reinforces it by naming the ADA uniform dental claim form for use by dentists. 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: 15 business days (statute makes no format distinction)
- Paper claims: 15 business days (statute makes no format distinction)

After receiving a health insurance proof of loss form, the insurer has fifteen business days to pay the claim or the portion that is not contested, deny the claim, or make an initial request for additional information. A second fifteen-business-day window then runs from receipt of the information initially requested, and that one allows only payment or denial — no further information requests. If the claim is contested, the insured or the insured's assignee must be notified in writing of the reasons, and that notice does not stop the insurer denying later on other grounds. The section draws no distinction by submission format.

## Interest and penalties on late payment

There is no interest remedy to report. The 1.5 percent per month figure that circulates for North Dakota is not in §26.1-36-37.1, not anywhere in chapter 26.1-36, and not in the administrative rules that implement it (N.D. Admin. Code chs. 45-06-03.1 and 45-06-07). A dental office in North Dakota has a deadline to point to and a regulator to complain to, not an accruing statutory interest claim.

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

Dental is inside the section's own definition: "'health care service' means any service included in providing an individual with medical, dental, or hospital care or any service incident to providing medical, dental, or hospital care." The implementing rule reinforces it by naming the ADA uniform dental claim form for use by dentists. Two caveats travel with that. The statute binds "the insurer" and never names health maintenance organizations — neighbouring sections of the same chapter name them expressly when they mean them — and HMOs are swept in only at the rule level, as "issuers" under the standardized claim-form chapter. And §26.1-36-01's scope clause says no section of the chapter applies to a blanket or group policy except where the section refers to one, which §26.1-36-37.1 does not do.

## 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

- The claim-form rule defines "issuer" broadly — insurance company, fraternal benefit society, health care service plan, health maintenance organization, third-party administrator, or any other entity reimbursing health care costs.
- The official Century Code chapter PDF carries no per-section history notes, so no last-amendment year is stated here; the chapter as published is current through the 2025 session.

## Sources (statute text)

- [N.D. Cent. Code ch. 26.1-36 — §26.1-36-37.1 at PDF p. 35 (North Dakota Legislative Branch)](https://ndlegis.gov/cencode/t26-1c36.pdf)
- [N.D. Admin. Code ch. 45-06-03.1 — standardized health claim form rule (ADA dental form)](https://ndlegis.gov/information/acdata/pdf/45-06-03.1.pdf)

## 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)