ANSWERS · PAYERS

A payer is paying slowly — escalation paths that actually work.

When a payer sits on clean claims, escalate on the record and use the leverage that exists: prompt-pay law. Most states require payers to pay clean claims within about 30–45 days or owe interest, and a documented, specific escalation — claim numbers, submission dates, the statute — moves money faster than repeated status calls.

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Step by step

1
Confirm the claims are clean
Pull acknowledgment/277 status so you know the claims were accepted and the delay is on the payer.
2
Cite prompt-pay law
Reference your state's clean-claim payment deadline and interest provision in writing — this is your real leverage.
3
Escalate inside the payer
Move past the call center to a provider-relations rep or your network contract manager, with specific claim numbers and dates.
4
Claim the interest owed
If the payer blew the deadline, bill the statutory interest — it signals you're tracking and raises the cost of stalling.
5
File with the regulator
For patterns, a complaint to the state department of insurance (or Medicaid agency) often gets fast attention.

Common questions

How fast do payers legally have to pay?

Most states set a clean-claim deadline of about 30–45 days for electronic claims, with interest owed after that. Self-funded ERISA plans aren't bound by state prompt-pay law, so their timelines differ.

Does self-funded change my options?

Yes. Self-funded (ERISA) plans aren't subject to state prompt-pay statutes, so the leverage is the plan's own claims-procedure rules and the ERISA appeal timeline rather than a state deadline.

Where Volari fits: Slow-pay and the interest it owes tie into the same follow-up discipline Volari applies to denied and underpaid claims — the aged money that stalls when no one has time to chase it.

Related answers
How do I lower my practice's denial rate?How do I reduce days in A/R?How do I read an EOB or 835 remittance?How do I know if I'm being underpaid by insurers?In-house billing vs. outsourcing: which is right for my practice?How do I renegotiate payer contracts for better rates?

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