Louisiana insurance law requires prompt payment of clean claims and imposes automatic compensation for late payments. Understanding these requirements helps you secure timely reimbursement and collect earned adjustments.
Louisiana R.S. §22:1821 Payment Deadline
Louisiana R.S. §22:1821 mandates that health insurers must pay or deny clean claims within 30 days of receipt, regardless of whether the claim was submitted electronically or by paper. This 30-day period begins when the insurer receives the claim, not when it is processed.
Late Payment Adjustment in Louisiana
When an insurer fails to pay a clean claim within 30 days, Louisiana law automatically imposes a late payment adjustment equal to 1% of the claim amount. This adjustment applies whether or not you request it—the insurer must calculate and include it in the payment without additional demand.
Electronic vs. Paper Claims Deadline
Louisiana applies the same 30-day payment deadline to both electronic and paper claims. There is no distinction between submission methods—both are treated identically for timing purposes.
Incomplete Claims and Resubmission
If a claim is incomplete, the insurer must request the missing information within 10 business days of receipt. Once you resubmit with complete information, a new 30-day payment period begins, resetting the clock for both payment and late adjustment calculations.
Louisiana Department of Insurance Enforcement
The Louisiana Department of Insurance (LDI) enforces prompt pay requirements. You can file a complaint at ldi.la.gov if an insurer violates timely filing rules or fails to apply the required late payment adjustment.
How to Recover Late Payment Adjustment in Louisiana
- Confirm the submission date and insurer receipt of the clean claim.
- Calculate the 1% late payment adjustment on any underpaid or unpaid portion of the claim after day 30.
- Send a written demand to the insurer citing Louisiana R.S. §22:1821 and stating the adjustment amount owed.
- File an LDI complaint if the insurer refuses the adjustment within 15 business days.
Altair automatically tracks Louisiana late payment adjustments and ensures you receive every dollar owed.
Frequently Asked Questions
What late payment adjustment does Louisiana require?
Louisiana R.S. §22:1821 requires a 1% late payment adjustment on the claim amount for any clean claim not paid within 30 days. This adjustment applies automatically and must be included in the final payment.
Is there a complaint process for Louisiana prompt pay violations?
Yes, the Louisiana Department of Insurance (LDI) accepts complaints at ldi.la.gov. File a complaint if an insurer violates the 30-day deadline or refuses to pay the required 1% late adjustment.
How long can Louisiana insurers take to request missing claim information?
Insurers must request missing information within 10 business days. Once you resubmit the complete claim, a new 30-day period begins for both payment and late adjustment purposes.
Related Louisiana Insurance Topics
- Louisiana Balance Billing Protections
- Louisiana Surprise Billing Protections
- Louisiana Prior Authorization Rules
- All State Billing Laws