State RegulationsNJ specificDifficulty 1/5
A New Jersey carrier receives a paper clean claim for covered health services. Within how many calendar days must the carrier pay the claim under the prompt-pay deadlines?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
Under N.J.S.A. 26:2J-8.1d and N.J.A.C. 11:22-1.6, paper clean claims must be paid within 40 calendar days, while electronic clean claims enjoy the shorter 30-day window. The New Jersey Department of Banking and Insurance enforces both deadlines. The 41-day mark is when interest begins on an unpaid paper claim — after the deadline, not at it — so the deadline itself is the 40-day figure.
Why the other options are wrong
- A) 30 calendar days is the electronic-claim deadline; paper claims receive the longer window.
- C) Day 41 is when late-payment interest starts accruing on an unpaid paper claim; the payment deadline is day 40.
- D) 7 days is not the paper-claim deadline; it appears in unrelated New Jersey timing rules.
Memory hook
Paper plods: 40 days to pay, interest knocking at 41.