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This call is at 2:30 PM ET, 1:30 PM CT, 12:30 PM MT, 11:30 AM PT

Join using: https://leavittpartners.zoom.us/j/461256971Meeting ID: 461 256 971

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Meeting ID: 461 256 971


  Agenda Outline

Agenda Item


    
                           

Profile-Related Issues






                                                                                                                                                                                                                                                    


Action Items

EOB.careteam.provider – what should it reference? FHIR-26629

  • Include language in the IG to explain what is and is not required for careteam members.

EOB*.insurance – Slicing and Semantics FHIR-26816 and FHIR-25605

  • Include language to explain the various scenarios in the IG.

Recap


Inpatient content in OutpatientEOB? FHIR-26819

  • NUBC requires for both inpatient and outpatient admissions.
  • Names are incorrect and will be updated with the correct NUBC valuesets
  • This will be updated in the Jira ticket and the mapping spec


EOB.provider – what should it reference? FHIR-26790 and FHIR 26627

  • Aligning with US Core for nearly all profiles
  • Party responsible for claim depends on the type of EOB


EOB.careteam.provider – what should it reference? FHIR-26629

  • No change is proposed
  • Each of the referenced types is appropriate for certain types of careteam members
  • Clear rules for when each type of reference should be included will be provided in the narrative of the CarinBB EOB


Patient identifiers, why 3 required? FHIR-25685

  • 3 slices are identied MemberID, MedRecNum, and PatAcctNum
  • MemberID is the only required element
  • A fourth slice will capture the unique identifier or “belly button” identifier for the patient


EOB*.insurance – Slicing and Semantics FHIR-26816 and FHIR-25605

  • Key question: Do you have to provide primary or secondary insurance information?
  • Can the secondary payer populate just the insurance slice and not worry about the primary or secondary insurance information?
  • The primary insurance will be the focal
  • Tertiary insurance is not covered by this IG









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