ADA Opens Proposed Dental EOB and Prior Authorization Standards for Comment

Edited by Dentaltown staff

The ADA Standards Program has opened two proposed administrative data standards for public review, one governing dental explanations of benefits and one covering electronic prior authorization and predetermination. Comments on both are due Aug. 21.

Proposed ANSI/ADA Standard No. 1120-4, “Dentistry – Data Content Standard: Dental Explanation of Benefits,” specifies the elements required to generate a comprehensive dental EOB. It also identifies the information that should pass between providers and payers so that adjudicated claim details are exchanged transparently.

The companion proposal, No. 1120-5, “Dentistry – Data Content Standard – Part 5: Prior Authorization and Predetermination,” outlines a uniform approach to electronic predetermination and prior authorization. It references X12 278 TR3 prior authorization formats and HL7 FHIR R4.

Both proposals belong to the ADA’s 1120 series of dental data content standards.

ADA Standards Working Group 11.15 developed the explanation of benefits proposal in collaboration with Working Group 11.10, which developed the prior authorization proposal in collaboration with 11.15. Comments go to standards@ada.org.

The two data content proposals remain drafts. The public review period is the stage at which practices, payers, and software developers can submit comment before the standards are finalized.

Sources:
American Dental Association, Standards Available for Public Review: ada.org/resources/practice/dental-standards/aip-review
ADA News, “Proposed ADA standard specifies requirements for comprehensive, consistent dental EOBs,” July 24, 2026: adanews.ada.org/2026/july/proposed-ada-standard-dental-eobs