Work Group 1 - Eligibility and Benefits (WG1 Eligibility Benefits)
Through a consensus building process, this work group is responsible for advancing the growth and adoption of electronic eligibility benefit inquiries submitted via the ANSI ASC X12 270/271 transactions.
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Work Group 2 - Remittance (WG2 Remittance)
Through a consensus building process, this work group is responsible for advancing the adoption of electronic remittance primarily through the creation of best practice guidelines for the ANSI ASC X12 835D transactions.
Expedited remittance information and faster payment are key benefits of using an electronic version of an Explanation of Benefits (EOB) document. The ASC X12 835 Claim Payment /Advice transaction enables dental providers and payers to exchange enhanced EOB information electronically. This includes information on charges experienced during a patient encounter, amount the payer is remitting to the provider, contractual adjustments, and any reasons the charges might have been denied.
The ASC X12 835 was developed for use in healthcare overall. NDEDIC is working to make the ASC X12 835 optimally useful for the dental industry, thereby also increasing adoption.
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