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

Dental scope unsettled · Last verified 2026-08-30

Tennessee prompt-pay law for dental claims

Tennessee'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.

Tenn. Code Ann. §56-7-109

Read the statute text

Payment deadlines

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

Tennessee's prompt-pay requirements under §56-7-109 require, in the Department of Commerce and Insurance's words, "that clean claims be paid no later than 30 calendar days after the date that an issuer receives a claim from a provider" (TDCI Bulletin, "Prompt Pay Provisions and the ACA Grace Period," April 2014). A shorter deadline for electronically submitted claims is widely reported for Tennessee, but the statutory subsection sits behind a CAPTCHA gate on the state's designated code host and could not be read on an official source — so this page publishes only the 30-day requirement and no shorter electronic figure. A clean claim is one "that requires no further information, adjustment or alteration by the provider of the services in order to be processed and paid by the health insurer," with no defect, impropriety, missing substantiating documentation, or circumstance requiring special treatment; duplicates are excluded.

Interest and penalties

The statute is described by the Department of Commerce and Insurance as carrying interest penalties and remediation requirements, and a related section (§56-7-1023(e)) refers to "the interest penalties and remediation requirements" under §56-7-109 — but the operative subsection could not be read on an official host, so this page states no rate. Everything else here comes from official Tennessee documents: the TDCI bulletin of April 2014 and Attorney General Opinion 09-157 (2009). Both are official but dated; they evidence the statutory language they quote, not the statute's 2026 currency, which was confirmed separately on the state's code host.

Does it apply to dental? Dental scope unsettled

The Attorney General quotes the definition: a "health insurance entity" is an entity subject to Tennessee insurance law or the commissioner's jurisdiction that contracts or offers to contract to provide health insurance coverage, "including, but not limited to, an insurance company, a health maintenance organization and a nonprofit hospital and medical service corporation" — an illustrative, not exclusive, list. The same opinion quotes the exclusions from "health insurance coverage": accident, credit, disability income, long-term care, hospital indemnity, Medicare supplement, specified disease, "other limited benefit health insurance," and automobile medical payment coverage. Dental is not named in that list, but whether a stand-alone dental policy is other limited benefit health insurance is settled by no authority read here. Two firmer limits: self-insured ERISA plans are not health insurance entities, and TennCare runs on a different regime entirely.

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 Tennessee rule (Tenn. Code Ann. §56-7-109). 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 for this claim (30 calendar days (clean claims)), not days since submission.

No published rate to apply

Tennessee's interest provision was not verifiable on an official source: the subsection sits behind a CAPTCHA on the state's designated code host, so no rate, accrual date, or payment mechanism is published here. Treat any figure you find elsewhere as unverified until the statutory text is read. Note also the trap on record — the 2002 bill as introduced carried a 12/18/21 percent schedule that never became law.

How we calculate this

The calculator does not show a payable amount for this result; the explanation above states the controlling limitation. The rate and deadline come from Tenn. Code Ann. §56-7-109, 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

TennCare claims are a separate regime: TDCI measures TennCare managed care organizations, pharmacy benefit managers, and dental benefit managers under Tenn. Code Ann. §56-32-126(b)(1) — 90% of claims processed and paid within 30 days and 99.5% within 60 days. A practice billing a TennCare dental benefit manager should not be quoted the commercial deadline.
TDCI treats claims pended for enrollees in months two and three of the ACA premium grace period as a circumstance requiring special treatment rather than a violation.
No 2024 or 2025 amendment to §56-7-109 was found; the 2024 public chapter sometimes cited amended a different section.
The state's designated code host requires accepting terms of use and clears automated access through a CAPTCHA — the statutory text is public, but a person has to open it.

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)