Prompt Pay Act

The Kansas Health Care Prompt Payment Act establishes a framework for prompt payment of health insurance claims.

In general, an insurer has 30 days to pay a clean claim or send a notice to the provider stating why the payment has been delayed or denied. Failure to comply with this portion of the act results in the accrual of interest equal to 1% per month of the billed charges. The interest is payable to the provider, individual, or entity submitting the claim.

An insurer may request additional information on an unpaid claim but must do so within the first 30 days. When the additional information is received, the insurer has 15 days to pay or deny the claim. Again, failure to comply with this portion of the act results in the accrual of interest equal to 1% per month of the billed charges.

For more information:

Which Insurance Plans Are Covered

The law applies to fully insured health plans including plans offered by HMOs. Plans typically covered include individual or group major medical plans and hospital /surgical policies and dental plans. Organizations such as Third Party Administrators paying claims for fully insured plans must also comply with the act.

Which Insurance Plans Are NOT Covered

The law does not apply to any of the following types of health related medical claims. Some plans not covered:

When to Report slow payment

Providers or covered individuals will need to give companies at least 30 days to respond to a claim. During that time, the insurance company does have the right to request additional information regarding a claim. They are required to notify you of this action within the 30-day time period. If you do not receive payment or a notice of delay within 30 days the law allows you to file a written complaint.

If the insurance company requests additional information, it is allowed 15 days from the date it received the required information to pay or deny the claim. In situations where additional information is requested, we suggest that you check with the insurance company to determine if and when the additional information was received. Complaints can then be filed if you think the 15-day response time has expired.

How to Report a slow payment

To report a slow claim payment, send a written notice to the Kansas Insurance Department. The complaint checklist below tells you what information to include. You will be notified as soon as our Consumer Assistance Division begins to investigate the claim. You will also be notified of the results of the investigation.

Complaint Checklist

Submit complaint in writing. While no special form is required, it would help expedite the process to include the following information:

Mail to:
Kansas Insurance Department
Consumer Assistance Division
420 SW 9th St.
Topeka, KS 66612

If you have questions, contact the Consumer Assistance Division of the Kansas Insurance Department.
Toll-free: 800-432-2484
Email: commissioner@ksinsurance.org