ADA data content standards available for comment

Deadline is Nov. 27

Two draft standards are available from the American Dental Association for review and comment until Nov. 27.

Proposed ANSI/ADA Standard No. 1120-1 for Dentistry — Data Content Standard: Dental Claim Status Verification: This document defines the structured data required for dental claim status inquiries, including patient, provider, claim and procedure details. It specifies the expected response from payers, detailing claim adjudication status, reasons for pending claims, payment processing updates and any additional required actions.  

This document does not prescribe or endorse any specific implementation methodology, implementation guide or technology standard for its adoption. In addition, it does not define or reference any operating rules but may refer to operating rule definitions associated with dental claim status inquiries, including patient, provider, claim and procedure details.

Proposed ANSI/ADA Standard No. 1120-2 for Dentistry — Data Content Standard: Dental Coordination of Benefits: This document defines the structured data required for coordination of benefits for dental claims, ensuring efficient communication between dental providers, payers and intermediaries. It specifies the essential data elements, including, but not limited to, patient demographics, provider information, interoperability requirements for data exchange between primary and secondary payers, claim level details, and adjudication data for dental claim coordination of benefits.  

This document does not prescribe or endorse any specific implementation methodology, implementation guide or technology standard for its adoption. In addition, it does not define or reference any operating rules associated with dental claim status inquiries, including patient, provider, claim and procedure details.

To obtain a copy of the draft documents, visit ADA.org/aipreview.

The ADA is an American National Standards Institute-Accredited Standards Developer and has been at the forefront of the development of dental standards since 1928. These standards establish requirements for safe and effective dental products and technologies through a consensus-based process.

The ADA Standards Program working groups that develop standards consist of a diverse group of expert volunteers representing dental practitioners, industry, government and academia. Involvement is open to anyone who would like to contribute their expertise.

To learn more about the standards program, visit ADA.org/dentalstandards.