Arizona splits payment into two steps: 30 days to decide a clean claim, then 30 more days to pay the approved amount. One statute covers insurers, service corporations, and HMOs for contracted and noncontracted providers alike.
To see what a late Arizona payer owes on a specific claim, use the prompt pay interest calculator.
Arizona prompt pay at a glance
| Statute | A.R.S. § 20-3102, with definitions in § 20-3101 |
|---|---|
| Electronic clean claim | Adjudicate within 30 days of receipt, then pay within 30 days |
| Paper clean claim | Same as electronic. The statute does not distinguish them. |
| Late payment | Interest at Arizona’s legal rate |
| Regulator for complaints | Department of Insurance and Financial Institutions (DIFI) |
The statute
A.R.S. § 20-3102 sets claim timeliness for every “health care insurer,” which § 20-3101 defines to include disability insurers, hospital and medical service corporations, and health care services organizations (Arizona’s term for HMOs).
Laws 2024, chapter 72 broadened the definition of “grievance” to include payment delays and added DIFI reporting. It did not change the payment timelines.
Clean-claim payment deadlines
An insurer has 30 days from receipt of a clean claim to adjudicate it, and 30 more days to pay the approved portion, unless an express written contract sets different periods (§ 20-3102(A)). The statute sets one rule for electronic and paper claims.
If a claim is not clean, the insurer must request the missing information in writing within 30 days, stating all specific reasons. After everything arrives, it has 30 days to adjudicate and pay. Neither side may adjust a paid or denied claim more than one year later, with limited exceptions.
Not verified: the statute says “days” without specifying calendar or business days.
Interest and penalties on late payment
A late payment carries interest “at a rate that is equal to the legal rate,” running from the date payment was due (§ 20-3102(A)). There are no penalty tiers.
Not verified: the numeric rate. Arizona’s general legal rate under § 44-1201(A)(2) is 10% a year, but § 20-3102 does not cite that subsection, and the 2022 medical debt cap in § 44-1201(A)(1) creates ambiguity. We have not stated a percentage for that reason.
Which payers the law covers
- Commercial fully insured plans: Covered, for contracted and noncontracted providers. Surprise out-of-network billing claims are handled under a separate article and excluded by § 20-3102(N).
- HMOs: Covered. Health care services organizations are named in the § 20-3101 definition.
- Medicaid managed care plans: Governed by AHCCCS law and contracts rather than DIFI. A.R.S. § 36-2904(G) sets the AHCCCS filing limits, and its statutory quick-pay schedule applies to hospital claims only.
- Self-funded ERISA plans: Not covered. They are not state-licensed health care insurers, and state regulation of them is generally preempted by ERISA § 514. We found no opt-in.
How to file a prompt-pay complaint
Providers first use the insurer’s internal provider grievance process, which § 20-3102(F) requires every insurer to offer. If the insurer does not resolve it, the provider can file a grievance with DIFI.
AHCCCS claim disputes follow a separate path described on the AHCCCS claim disputes page. Disputes go to the member’s health plan, or for fee-for-service members to the AHCCCS Office of the General Counsel, within the later of 12 months from service, 12 months from eligibility posting, or 60 days from denial of a timely claim.
Not verified: DIFI’s provider grievance page and form. The DIFI site blocked every automated request, so the filing steps come from search results only. Confirm them on the DIFI site before filing.
How prompt pay interacts with timely filing
We found no Arizona statute that sets a minimum filing window for commercial claims, so it comes from the provider contract or plan terms, while AHCCCS requires the initial claim within 6 months and a clean claim within 12 months of the later of the date of service or eligibility posting (§ 36-2904(G)). The § 20-3102 adjudication clock starts only when a clean claim is received, so a claim missing information does not start the 30 days even as any contract filing window keeps running. Our 2026 timely filing guide compares windows by payer.
What we could not verify
- All DIFI content, including the provider grievance page, the Provider Grievance form, and DIFI’s list of plans it does not handle. The site blocked automated access.
- The numeric interest rate behind “the legal rate”.
- Day type for the 30-day periods.
- AHCCCS payment and interest rules for physician claims, which sit in an operations manual we could not extract.
- Whether § 20-3102 reaches AHCCCS plans that hold HMO licenses.
- Treatment of the state employee plan (ADOA Benefit Options).
Sources
Billing for a practice with more than one location? See how we report denials and A/R by location.
A-Z was built inside a four-location practice. The free tools on this site are the ones we use ourselves.