Nevada tightened its prompt-pay rules with AB 52, effective January 1, 2026, for claims submitted on or after that date. Electronic claims now get 21 days and paper claims 30, with 10% annual interest replacing the old prime-plus-6% rate.
To see what a late Nevada payer owes on a specific claim, use the prompt pay interest calculator.
Nevada prompt pay at a glance
| Statute | NRS 689A.410, 689B.255, 689C.335, and 695G.340 |
|---|---|
| Electronic clean claim | Approve or deny, and pay, within 21 days of receipt |
| Paper clean claim | Approve or deny, and pay, within 30 days of receipt |
| Late payment | 10% per year |
| Regulator for complaints | Nevada Division of Insurance |
The statute
The same rule appears in each coverage chapter: NRS 689A.410 for individual plans, NRS 689B.255 for group plans, NRS 689C.335 for small employer carriers, and NRS 695G.340 for managed care organizations, including HMOs. Third-party administrators are covered by NRS 683A.0879.
AB 52 (2025, ch. 366) applies to claims submitted on or after January 1, 2026, and to policies as they renew. It repealed the old HMO section, NRS 695C.185.
Clean-claim payment deadlines
A payer must approve or deny a claim, and pay an approved claim, within 21 days of receipt for electronic claims and 30 days for paper (NRS 689A.410). The Division of Insurance’s AB 52 guidance reads these as calendar days.
If the payer needs more information, it must ask within 20 working days. Once the information arrives, it gets another 21 or 30 days.
Interest and penalties on late payment
Interest of 10% per year runs from the date payment was due until the claim is paid (NRS 689A.410). It can be waived only for an act of God or another cause beyond the payer’s control.
There is no separate dollar penalty owed to the provider. The Commissioner may fine a payer that has not approved, denied, or paid a claim within 60 working days.
Which payers the law covers
- Commercial fully insured plans: Covered under NRS 689A.410, 689B.255, and 689C.335.
- HMOs: Covered under NRS 695G.340.
- Medicaid managed care plans: Not covered. NRS 695G.090(3) excludes Medicaid and CHIP managed care organizations, which follow federal standards under 42 CFR 447.45 and 447.46 instead: 90% of clean claims paid within 30 days and 99% within 90 days.
- Self-funded ERISA plans: Generally not covered, because of ERISA ยง 514 preemption.
NRS 695G.090(4) also excludes managed care organizations serving the state Public Employees’ Benefits Program.
How to file a prompt-pay complaint
The Division of Insurance complaint page offers an online portal and a printable complaint form, and lists “improper denial or delay in settlement of a claim” among the issues it handles.
Medicaid managed care claims fall outside these statutes, so disputes go through the plan and Nevada Medicaid.
Not verified: whether the Division accepts prompt-pay complaints from providers. Its complaint page is written for consumers and does not mention providers. We also found no Nevada Medicaid provider complaint page for plan payment disputes.
How prompt pay interacts with timely filing
We found no Nevada statute setting a minimum filing window for commercial claims, so the deadline comes from the payer contract. The 21 or 30 day payment clock starts at the payer’s receipt, and AB 52 applies by claim submission date, so a claim for a 2025 service submitted after January 1, 2026 falls under the new deadlines and 10% rate. Compare payer windows in our 2026 timely filing guide.
What we could not verify
- Whether any Nevada rule sets a minimum filing window. We searched the relevant NRS chapters but not the Nevada Administrative Code.
- That the 21 and 30 day periods are calendar days. The statute says “days”; the calendar reading comes from the Division’s AB 52 guidance.
- Whether the Division accepts complaints from providers.
- Prompt-pay and interest terms in Nevada Medicaid managed care contracts.
- The reach of NRS 683A.0879 to administrators of self-funded ERISA plans.
Sources
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