NDEDIC Task Group calls are open to any interested party that abides by NDEDIC's expected conduct rules and is willing to work together to solve industry problems. To learn more about how to join one of NDEDIC’s Task Groups please email email@example.com.
Pre-determination of Benefits Task Group
This task group is researching dental provider and payer perspectives for three types of inquiries:
The scope of the information requested and response received, the transactions being used, and commitment to the payer’s response are being discussed. In most cases, these are done in a batch mode, but payers are considering a migration to a real-time model. The task group’s goal is to develop a best practices guide on how these transactions should be completed.
Surveying Dental Providers Task Group
This task group has coordinated the development of a survey of dental providers to better understand their needs as dental payers are planning future system releases. Included are:
The survey seeks providers' views when these are completed in batch and real-time.
Frequency Limitations Task Group
This task group is researching how an eligibility and benefit response (271) should be coded to inform a provider that multiple procedures share a frequency limitation, that is only one of the procedures is a covered benefit for a period of time.
For example, Panoramic and full mouth are both radiograph procedures, and typically share a frequency. Example: Patient has a frequency of 3 years on both the panoramic radiograph and the full mouth series. However they can only have one of these procedures done in that time period. The frequency limit of 3 years is shared by both procedures.