State and federal laws require that most payors pay clean claims within specific timeframes. California law further requires health plans and insurers to pay interest on claims that are not paid within the required timeframe.
|Payor Type||Timeframe for Payment||Penalty|
|HMOs and their contracting medical groups/IPAs||45 working days||
|PPOs||30 working days||
|ERISA||30 calendar days||None|
|Medi-Cal||30 calendar days||0.25% of amount due per day|
|Medicare||30 calendar days||10.875% per annum (effective 4/23/2010)|
|Workers’ Comp||45 working days||Payment is increased by 15% + 10% per annum|