History and Impact

For many years, NDEDIC has been educating the dental industry and its various stakeholder groups on the value of electronic exchange of dental information, including increased efficiency, speed and accuracy of dental claims, reduced administrative costs, and ultimately, better patient service.

In recent years, NDEDIC, through the efforts of its members, has made significant progress toward standardizing the electronic exchange of dental eligibility and claims information and maximizing use of existing electronic transactions. Recent and ongoing efforts include:

• Identifying the top 56 (formerly top 50) data elements necessary for payers to provide an efficient electronic response (271 transaction) to a dental office request for patient eligibility and benefit information.
• Promoting payer use of the top 56 elements in the electronic exchange of information in order to minimize time consuming and expensive phone calls between dental offices and insurance companies.
• Recognizing payers who are using the top 56 elements in electronic transaction.
• Providing implementation guidance to help the dental community take full advantage of the HIPAA-compliant, healthcare industry standard for sending an electronic explanation of claims payment (Electronic Remittance Advice). This includes establishing a standard set of transaction codes (Claim Adjustment Reason Codes - CARCS and Remittance Advice Remark Codes - RARCS) that meet dental needs.