State RegulationsNJ specificDifficulty 2/5
A New Jersey carrier receives a paper clean claim for a covered health service and neither pays nor denies it. Interest on the eventually late-paid claim begins accruing when?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Under N.J.S.A. 26:2J-8.1d and N.J.A.C. 11:22-1.6, paper clean claims are due within 40 calendar days, and late-payment interest begins accruing from the day after that window closes — day 41. The electronic track runs on the shorter 30-day window, so the submission mode controls both the deadline and the interest start date. The New Jersey Department of Banking and Insurance enforces these prompt-pay consequences in its market-conduct examinations.
Why the other options are wrong
- B) The 31st-day interest start applies to electronic claims; paper claims run on the 40-day window.
- C) The interest start date tracks the claim's own deadline; a paper claim is not measured against the electronic 30-day mark.
- D) The 10-day figure belongs to the individual health free-look period, an unrelated rule.
Memory hook
Paper pays in 40; interest shows up at 41.