# Utah prompt-pay law for dental claims

> What is the Utah prompt-pay deadline for dental claims, and what interest applies to late payment? Read against the statute text (Utah Code §31A-26-301.6).

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

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 Utah Code §31A-26-301.6, the Utah payment deadline is 30 days (no format split). Utah calls it a late fee, not interest, and computes it daily: the total amount the insurer is obliged to pay, times the number of days the response or the payment is late, times a 0.033 percent daily interest rate (§31A-26-301.6(8)(b)). Dental applicability: Covered. "Health care provider" means a person licensed to provide health care under Title 26B, Chapter 2, Part 2 or under Title 58, Occupations and Professions — and dentists are licensed under Title 58, Chapter 69, the Dentist and Dental Hygienist Practice Act. 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: 30 days (no format split)
- Paper claims: 30 days (no format split)

Within 30 days of receiving a written claim, an insurer must pay it or deny it with a written explanation (§31A-26-301.6(3)(a)). The 30 days is not unconditional: a 15-day extension is available for matters beyond the insurer's control with written notice, income-replacement claims run on a separate 45-day track, and once requested information arrives the insurer has 20 days to pay or deny. Insurer-provider contracts may impose more stringent terms than the section.

## Interest and penalties on late payment

Utah calls it a late fee, not interest, and computes it daily: the total amount the insurer is obliged to pay, times the number of days the response or the payment is late, times a 0.033 percent daily interest rate (§31A-26-301.6(8)(b)). Annualised that is roughly 12 percent. Fees below one dollar are not owed. The fee is symmetrical — subsection (8)(a)(ii) imposes it on a provider that fails to provide timely information on a claim. The section may not be the basis for a bad-faith insurance claim, but untimely payment used as leverage or retaliation is an enumerated unfair claim settlement practice the commissioner can act on.

## Does it apply to dental? Dental expressly covered

Covered. "Health care provider" means a person licensed to provide health care under Title 26B, Chapter 2, Part 2 or under Title 58, Occupations and Professions — and dentists are licensed under Title 58, Chapter 69, the Dentist and Dental Hygienist Practice Act. The section also speaks of "a dental insurer" directly in subsection (16)(e). "Insurer" covers admitted or authorised insurers including health maintenance organizations and third-party administrators subject to the title. The Medicaid carve-out that circulates for Utah is narrow: it applies only to the subsection (7) explanation-of-benefits duties, not to the section as a whole.

## 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

- Dental-specific 2026 additions: before July 1, 2028 a dental insurer may not impose a fee for paying with a tangible check, and providers get opt-out rights from credit-card remittance (§31A-26-301.6(16)(e)).
- Currency: effective May 6, 2026, as amended by Chapter 45 of the 2026 General Session.

## Sources (statute text)

- [Utah Code §31A-26-301.6 — health care claims practices (official Utah Code)](https://le.utah.gov/xcode/Title31A/Chapter26/31A-26-s301.6.html)
- [Utah Code Title 58 ch. 69 — Dentist and Dental Hygienist Practice Act](https://le.utah.gov/xcode/Title58/Chapter69/58-69.html)

## 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)