Georgia gives insurers 15 working days to pay an electronic claim and 30 calendar days for paper, with 12% annual interest when they miss it. One caution applies to this whole page: the official Georgia Code is hosted on a LexisNexis portal we could not load, so the statute text below was read from unofficial copies.
To see what a late Georgia payer owes on a specific claim, use the prompt pay interest calculator.
Georgia prompt pay at a glance
| Statute | O.C.G.A. § 33-24-59.14 (payments to providers) and § 33-24-59.5 |
|---|---|
| Electronic clean claim | Pay, or send reasons for nonpayment, within 15 working days of receipt |
| Paper clean claim | Pay, or send reasons for nonpayment, within 30 calendar days of receipt |
| Late payment | 12% per year |
| Regulator for complaints | Office of Commissioner of Insurance and Safety Fire (OCI) |
The statute
O.C.G.A. § 33-24-59.14 governs payment to facilities and health care providers, and § 33-24-59.5 governs timely payment of benefits generally. Both define “insurer” to include HMOs. Medicaid care management organizations are governed separately by § 33-21A-7.
OCI Bulletin 21-EX-2 names §§ 33-24-59.5 and 33-24-59.14 as Georgia’s prompt-pay statutes. We found no amendment to either section in 2025 or 2026.
Clean-claim payment deadlines
An insurer must pay an electronic claim within 15 working days of receipt, or send the provider its reasons for not paying along with an itemized list of the documents it needs (§ 33-24-59.14(b)). Paper claims get 30 calendar days. Receipt by the insurer’s claims processor counts as receipt by the insurer.
Once the requested documents arrive, a fresh 15 working day or 30 calendar day period applies. The undisputed part of a partly disputed claim must be paid on time.
Interest and penalties on late payment
An insurer that misses the deadline owes the provider interest at “12 percent per annum” (§ 33-24-59.14(c)). The statute does not say whether the interest is simple or compound. Older versions of § 33-24-59.5 stated 18%, a figure that still circulates online and is out of date.
OCI can impose an administrative penalty only when an insurer pays fewer than 95% of its claims on time in a quarter (§ 33-24-59.14(d)). For Medicaid care management organizations, claims first denied or underpaid and later found owed carry 20% annual interest, counted from 15 days after submission and paid automatically (§ 33-21A-7(c)).
Which payers the law covers
- Commercial fully insured plans: Covered, including an insurer’s third-party administrator business. Limited-benefit policies such as accident-only and fixed indemnity are excluded (§ 33-24-59.14(f)).
- HMOs: Covered. HMOs fall within the statutory definition of insurer.
- Medicaid managed care plans: Governed by O.C.G.A. Chapter 33-21A, which requires care management organizations to follow the claim timeframes the Department of Community Health uses for its own claims.
- Self-funded ERISA plans: Not covered. OCI states that federal law exempts self-insured employer plans and that it has no jurisdiction over them.
The State Health Benefit Plan is named in both sections, but OCI’s complaint page lists the state employee plan as outside its jurisdiction.
How to file a prompt-pay complaint
Providers file with the OCI Consumer Services Division, which handles claim problems between providers and insurers. OCI describes its online Consumer Complaint Portal as the “preferred and quickest” route, and the portal requires an account.
OCI does not handle Medicaid. For a care management organization, § 33-21A-7(b) lets a provider who has exhausted the plan’s internal appeals choose administrative review or binding arbitration through the Department of Community Health.
Not verified: we did not find a Department of Community Health page for provider late-payment complaints.
How prompt pay interacts with timely filing
We found no Georgia statute that sets a minimum timely filing window for commercial claims, so the deadline comes from the payer contract or plan terms. The prompt-pay clock is separate and starts when the insurer or its claims processor receives the claim, so a claim filed on the last day of a contract window still gets the full 15 working days or 30 calendar days. Current windows for each major payer are in our 2026 timely filing guide.
What we could not verify
- All Georgia statute text on this page, which was read from unofficial copies (onecle, FindLaw, and a managed care legal database). The official LexisNexis code could not be loaded.
- Any 2025 or 2026 amendment to §§ 33-24-59.5 or 33-24-59.14. We found no amending bill, but could not search the 2026 session summary.
- Simple or compound treatment of the 12% interest.
- The care management organization interest rule and DCH claim timeframes, which rest on FindLaw’s copy of § 33-21A-7 alone.
- A DCH contact for provider Medicaid late-payment complaints.
- The 180-day Medicaid filing limit that appears in secondary sources.
- How far the third-party administrator language reaches administrators of self-funded plans.
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.