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

Dental expressly covered · Last verified 2026-08-29

Rhode Island prompt-pay law for dental claims

R.I. Gen. Laws §27-18-61 (parallel §§27-19-52, 27-20-47, 27-41-64)

Under R.I. Gen. Laws §27-18-61 (parallel §§27-19-52, 27-20-47, 27-41-64), the Rhode Island payment deadline is 30 calendar days (complete electronic claims) and 40 calendar days (complete written claims). Late payments accrue 12% per year from the 31st day (electronic) or 41st day (written) after receipt until payment issues, paid to the submitting provider or policyholder on top of the reimbursement. Dental applicability: Expressly covered: the statute's definition of "healthcare entity" names dental service corporations alongside insurers and HMOs, and "healthcare services" expressly includes dental. Self-funded (ERISA) plans are outside this statute — federal ERISA deadlines apply to them instead.

Read the statute text

Payment deadlines

Electronic claims: 30 calendar days (complete electronic claims)
Paper claims: 40 calendar days (complete written claims)

Healthcare entities must pay complete claims within 30 calendar days (electronic) or 40 calendar days (written), and must notify the provider within 30 days of all reasons for denying or pending a claim and what additional information is required — with no time limit allowed on submitting that information. Identical text repeats across the insurer, hospital/medical service corporation, and HMO chapters.

Interest and penalties

Late payments accrue 12% per year from the 31st day (electronic) or 41st day (written) after receipt until payment issues, paid to the submitting provider or policyholder on top of the reimbursement. A substantial-compliance finding (95% of claims on time) excuses interest, and a 90-day waiver exists for claims-system conversions.

Does it apply to dental? Dental expressly covered

Expressly covered: the statute's definition of "healthcare entity" names dental service corporations alongside insurers and HMOs, and "healthcare services" expressly includes dental. Rhode Island's dental-service-corporation chapter adds no separate prompt-pay rule (its §27-20.1-19 is an 18-month post-payment audit limit), so §27-18-61 is the operative deadline for dental claims. Contract terms inconsistent with the section are void.

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.

Estimate the late-payment interest

Uses the verified Rhode Island rule (R.I. Gen. Laws §27-18-61 (parallel §§27-19-52, 27-20-47, 27-41-64)). Estimate only — the statute's own accrual triggers control.

Claim amount (allowed)Interest statutes run on the payable claim amount, not billed charges.Days past the deadlineDays after the statutory deadline (30 calendar days (complete electronic claims)), not days since submission.

Estimated interest

$12.58

12% per year (simple)

From day 31 (electronic) or day 41 (written) until the payment is issued; no interest if the entity processed 95%+ of claims on time (substantial compliance).

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 R.I. Gen. Laws §27-18-61 (parallel §§27-19-52, 27-20-47, 27-41-64), verified against the statute text linked in the sources on this page (last verified 2026-08-29). 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.

Also in the statute

Claims first submitted more than 90 days after service (or resubmitted more than 90 days after a deficiency notice) fall outside the violation rule.
Payer recoupment audits and provider underpayment claims are both limited to 18 months (§27-20.1-19).

Payment deadlines

Interest and penalties

Does it apply to dental? Dental expressly covered

Estimate the late-payment interest

Also in the statute

Sources (statute text)