Prompt pay law

Prompt pay laws put a clock on the payer, and the deadlines differ by state. New York gives insurers 30 days to pay a claim sent electronically and 45 days for one sent any other way, and 30 calendar days to deny it or ask for more information¹. Florida gives 20 days for electronic claims and 40 for paper, charges 12 percent simple interest a year on overdue payments, and turns a claim still neither paid nor denied 120 days after receipt, 140 for paper, into an obligation the insurer can no longer contest². For Original Medicare the clock is federal: a clean claim must be paid or denied no later than 30 days after receipt, and interest is owed after that³.

For A/R follow-up, these rules turn a slow payment into an obligation with interest attached, but only once the claim counts as received. Medicare does not treat a claim that fails basic format or completion requirements as received until it comes back corrected. Medicare also has a floor: it waits 13 days after receipt before paying a clean electronic claim and 26 days for paper, so the earliest an electronic claim can pay is day 14³.

The mistake is assuming the state law covers every commercial claim. It reaches the insurers and plans the state regulates, which can leave out self-funded employer plans, and Medicare and Medicaid follow their own rules. When a regulated plan pays late, cite the statute and the receipt date in writing, and check that the interest arrives with the payment.