Maryland Insurance Code §15-1005 requires insurers to pay clean claims within 30 calendar days of receipt or issue a written denial. This statute establishes clear deadlines and imposes tiered interest penalties for late payments.
Maryland's 30-Day Payment Requirement
Insurers operating in Maryland must process clean claims on a standardized timeline. A clean claim is one that contains all necessary information for adjudication. Once submitted, the 30-day clock begins immediately. Electronic submissions are treated identically to paper claims.
Incomplete claims trigger a separate process: the insurer must identify deficiencies within 30 days of receipt. The 30-day payment clock then restarts upon submission of the corrected claim, not from the original submission date.
Tiered Interest Penalty Structure
Maryland's interest structure escalates based on payment delay:
| Days Overdue | Interest Rate |
|---|---|
| 31-60 days | 1.5% per month |
| 61-120 days | 2% per month |
| 121+ days | 2.5% per month |
Interest accrues separately and must be itemized from the claim payment. Providers can demand interest as a separate line item on remittance.
Enforcement and Penalties
The Maryland Insurance Administration (MIA) enforces timely filing requirements. Insurers that violate the statute face regulatory sanctions. Maryland Insurance Code §4-113 permits fines up to $500 per violation for arbitrary or capricious denial. Pattern violations trigger market conduct examinations.
How to Claim Interest on Late Payments
Document the original submission date, calculate accrued interest at the applicable tier, and submit a written demand to the insurer. If the insurer does not respond within 15 days, escalate to the MIA with copies of all correspondence and proof of submission.
Track timely filing compliance and recover late payment interest with Altair's claim management tools.
Frequently Asked Questions
What interest rate applies to a Maryland late claim?
Maryland insurers owe tiered interest on unpaid clean claims: 1.5% per month for days 31-60, 2% per month for days 61-120, and 2.5% per month after day 120.
How do I file a complaint with the Maryland Insurance Administration?
File complaints with MIA at mia.maryland.gov. Include claim EOB, denial letter, and payment history. MIA investigates pattern violations and can impose fines up to $500 per violation.
Does Maryland's timely filing rule apply to electronic claims?
Yes. Electronic submissions are subject to the same 30-day payment or denial requirement as paper claims under Maryland Insurance Code §15-1005.
Related Resources
- Maryland Balance Billing Law
- Maryland Surprise Billing Protection Act
- All State Billing Laws
- Clean Claim Standards Overview