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Chair: Robert Dieterle

Scribe: Dana Marcelonis
 

Attendees

Present

Name

Affiliation

  •  
SureScripts
  •  
Regence
  •  
Optum
  •  
Michael BaillieUHC
  •  
Humana
  •  
BCBS AL
  •  
Rush
  •  
SureScripts
  •  
Rush
  •  
Cerner
  •  
Independence Blue Cross
  •  
Allscripts
  •  
Regence
  •  
InterSystems
  •  
BCBS IL
  •  
Allscripts
  •  
Cambia Health
  •  
Enable Care
  •  
Howard FollisJuxly
  •  
Reliant Medical Group
  •  
Lantana Consulting
  •  
SureScripts
  •  

  •  
Independence Blue Cross
  •  
NCQA
  •  
Optum
  •  
Jackie HardisonHumana
  •  
Cigna
  •  
HealthLX
  •  
ZeOmega
  •  
BCBSA
  •  
Point of Care Partners
  •  
Edifecs
  •  
Edifecs
  •  
BCBS AL
  •  
Stephen LaneSutter Health
  •  
InterSystems
  •  
Anthem
  •  
Erin MajderBCBS IL
  •  
Point of Care Partners
  •  
Cognosante
  •  
BCBS AL
  •  
Optum
  •  
Humana
  •  
MaxMD
  •  
Stratametrics
  •  
Sean ParsonsBCBS OK
  •  
BCBS AL
  •  
Allscripts
  •  
HealthLx
  •  
Optum
  •  
Regence
  •  
InterSystems
  •  
NewWave
  •  
NewWave
  •  
ZeOmega
  •  
Anne Marie SmithNCQA
  •  
InterSystems
  •  
UHC
  •  
Casenet
  •  
Cigna
  •  
HealthLX
  •  
Independence Blue Cross
  •  
Joel WalkerHealthLX
  •  
BCBS AL
  •  
Regence
  •  
Diameter Health
  •  
Cambia
  •  
NewWave
  •  
Edifecs
  •  
BCBST
  •  
Tracy FitzgibbonRegence
  •  
Chris JohnsonBCBSAL
  •  
Donna ZimmermanTibco
  •  
Veradigm
  •  
Allscripts
  •  
Optum
  •  
BCBSM
  •  

Allscripts

  •  
Allscripts
  •  
Nandini GangulyScope Infotech/ EMDI
  •  

  •  
Sarah Brown
  •  

  •  
Anthem
  •  
Allscripts
  •  
Regence
  •  
IMO
  •  
WPS Health Solutions
  •  
CMS
  •  
Bart CarlsonAzuba
  •  
CMS
  •  
Deepthi ReddyMettle Solutions
  •  
Sequoia Project
  •  
Emma JonesAllscripts
  •  
India DuncanOptum
  •  
Tibco
  •  

  •  
Manifest Medex
  •  
Christopher GraconIndependent Health
  •  
Mark Bellezza
  •  
Matthew MarkhamWolters Kluwer
  •  
Michael BrodyCME Online
  •  
Dave Foster
  •  
Eric Dimmel
  •  
Jeff BrownCigna
  •  

  •  
Mark Taylor
  •  
Matthew FLores
  •  
Phil SurineTista tech
  •  
CMS
  •  
Karen Waters
  •  
Matt DyerVyne
  •  
BCBSM
  •  
Centene
  •  
Marti
  •  
Health Share Exchange
  •  
Eddy NievesEpic
  •  
Katherine LuskChildrens
  •  
Eliot HellerMercy Health
  •  
Troy BergstrandBC Idaho
  •  
Lacy Hanson
  •  
Greta HoneycuttCoverMyMeds

Present

Name

Affiliation

  •  
Laura Burckhardt
  •  
EMDI TeamEMDI
  •  
Donna CampbellBCBSIL
  •  
Emily CalvertCMS/ CPI
  •  
Eric SullivanInovalon
  •  
Ralph Saint-PhardHealow
  •  
Sara WilliamsCAQH
  •  
Scott LawrenceCMS
  •  
Wanda Govan-JenkinsHHS
  •  
Cognizant
  •  
Mike NovalesBCBSIL
  •  
Sudhir NairAnthem
  •  
Julie MaasEMR Direct
  •  
Candrea SmithCMS
  •  
Edward Yurcisin
  •  
Christy DodsonMCG
  •  
Dawn PerreaultBCBSM
  •  
JP Systems
  •  
Gregory MagazuCasenet
  •  
Chris KlesgesMitre
  •  
Laurie WoodromeLabcorp
  •  
Maria MichaelsCDC
  •  
Anthem
  •  
Interopion
  •  
Ric LightHumana
  •  
Robert LatzTrinity Rehab Services
  •  
eClinicalWorks
  •  
Vannak Kan
  •  
Joint Commission
  •  
Aakash DeliwalaeClinicalWorks
  •  
Alison SchambachTCS
  •  
Magna HadleyTCS
  •  
Cindy MonarchBCBSM
  •  
Marcus WaltersInterfaceware
  •  
Megan Smith-HallingsheadRegence
  •  
Interfaceware
  •  
Patrick LeblancFallon Health
  •  

  •  
Steve BrunnerDiameter Health
  •  
MaxMD
  •  
Michael CollierAnthem
  •  
Interopion
  •  
Nancy Lush
  •  
Samir Jain
  •  
Todd Johnson
  •  
Tony LaurieNoridian
  •  
V Herisse
  •  
Anupam ThakurBCBSFL
  •  
Cara BarryAvaility
  •  
Deryl Lam
  •  
Greg Linden
  •  
Laurie DarstMayo
  •  
MCG
  •  
Briana BarnesScope Info Tech
  •  
Justin MacdonaldLumeris
  •  
Praveer MathurWellcare
  •  
Michael Zurat
  •  
Nancy SpectorAMA
  •  
Pallavi TalekarScope Info Tech
  •  
Prashanth GolcondaLumeris
  •  
Rajesh Godavarthi
  •  
Sreekanth PuramMettle Solutions
  •  
Susan BellileAvaility
  •  
Anthem
  •  
Dani HochleutnerOptum
  •  
Duane WalkerBCBSM
  •  
Jagakarthikeyan KaruppiahInovalon
  •  
Melanie JonesCMS
  •  
CMS
  •  
Ken Lord
  •  
Kishore MetlaMettle Solutions
  •  
BCBSM
  •  
BCBST
  •  
AMA
  •  
Alise WidmerLumeris
  •  
Rim CothrenCA HIE
  •  
Sharon DavisBCBSTX
  •  
Yolanda VillanovaCMS
  •  
Gevity
  •  
Luis MaasEMR Direct
  •  
Michael HurleyBRYJ Healthcare
  •  
Summa Health
  •  

  •  
CMS
  •  
Tom WillisMoxe Health
  •  
Cristol GreenAnthem
  •  
Regence
  •  
BCBSFL
  •  
CMS
  •  
Tori WillowsWellcare
  •  
CAQH
  •  
BSBCMI
  •  
Greg Zeller
  •  

  •  
Tareq NabeelAEGIS
  •  
Sonja Zeigler
  •  
Aaron  KohnChorus
  •  
Kat RuizUNC Health
  •  
Sheryl TurneyAnthem
  •  
Healow
  •  
Ellen Stonner
  •  
Akshay RameshAccenture
  •  
Rhonda ScottConduent
  •  
Anthem
  •  
Carrie Denny
  •  
Mona ChandrapaleClinicalWorks
  •  

  •  
MIHIN
  •  
Stanley Nachimson
  •  
Padma KondaveetiMettle Solutions
  •  
Shilesh Nair


Minutes Approved as Presented 


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Agenda Topics

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

Decision Link(if not child)
ManagementReview ANSI Anti-Trust Policy



Calendar
  • Ballot voting ended July 21
  • Ballot reconciliation underway


Links

Ballot comment review

#21273

  • Remove reference to non XML
  • Persuasive with Mod

#23441

  • CDex Referrals and Orders use case
  • Actors should be described
  • Clarify role of payer

#23672

  • CDex Support Quality Management use case
  • Clinical exchange of data should keep these overarching concepts of data transparency in mind, but no direct change to the IG needed - other comments are more specific

#23673

  • If information request is for quality metrics reporting, be sure that you're requesting data specific to the quality metric
  • Often payer collects information for more than one quality metric at a time
  • Wouldn't be acceptable for the payer to request everything even if covering multiple metrics - should request specific data needed for the list of measures
  • Requests should be made in light of HIPAA regulations re: access to information for payment and operations 
  • Once we have a general section on payer access to data, we'll refer to it

#23674

  • General comment, nothing to specifically address in this IG
  • Will address in section re: general approach to payer data access as it relates to HIPAA regulations

#23675

  • CDex Improve Member Experience use case
  • Seemed to be a catch all so that if payer data request doesn't fit in another use case, we can use this as a reason
  • Example included in IG is that payers sending reminders that it's time for a mammogram - would be useful to know if patient had a mastectomy, so that they don't send that reminder - request for information is care related
  • Move example to care coordination use case and remove this use case, or re-write this use case - need to follow up with original author(s)

#23676

  • More relevant to Prior Auth Support IG
  • Comment withdrawn

ManagementNext agenda

Ballot comment review


 Adjournment
Adjourned at 12:56pm ET

Supporting Documents

Outline Reference

Supporting Document

Minute Approval


Action items


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