Page tree
Skip to end of metadata
Go to start of metadata

Chair:  Robert DieterleViet NguyenAnupam Goel

Scribe:
 

Attendees

Present

Name

Affiliation

  •  
Enablecare
  •  
Stratametrics
  •  
Point of Care Partners
  •  
BCBSAL
  •  

Emily Calvert

CMS
  •  

Erica Ross

CMS
  •  
Heather McComasAMA
  •  
Optum
  •  

Kelly Anderson

BCBSAL
  •  
InterSystems
  •  

Mark Mundt

InterSystems
  •  
Megan SoccorsoCigna
  •  

Mike Funk

Humana
  •  
Nancy SpectorAMA
  •  
Terrence CunninghamAMA
  •  
Tori WillowsWellcare
  •  
BCBSFL
  •  
Aim/ Anthem
  •  

Marci Maisano

Cigna
  •  
Edifecs
  •  
Edifecs
  •  
United Healthcare
  •  
Anthem
  •  
Christy Dodson
  •  
BCBSAL
  •  
Laura Hoffman
  •  
WPS Health Solutions
  •  
Optum
  •  
Edifecs
  •  
CMS
  •  

  •  
CAQH
  •  
Raj
  •  
Ray WilkersonScope Info Tech
  •  
BCBST
  •  
Taha AnjarwallaCAQH
  •  
Tom
  •  
Sonja Ziegler
  •  
Intersystems
  •  
Nandini GangulyEMDI/ Scope Info Tech
  •  
BCBSM
  •  
Kasi
  •  
EMDI Team
  •  
Anthem
  •  
Bart CarlsonAzuba
  •  
Cambia
  •  
Duane WalkerBCBSM
  •  
InterSystems
  •  
Tibco
  •  
Louis BedorCognosante
  •  
Anthem
  •  
CMS
  •  
CMS
  •  
IBC
  •  
Anthem
  •  
Rian
  •  
Palmetto gba
  •  
Sandeep
  •  
Sreekanth PuramMettle Solutions
  •  
Allscripts
  •  
James Gallagher Jr.Premera
  •  
Joseph Figueroa
  •  
Tony LittleOptum
  •  
Pallavi TalekarEMDI/ Scope Info Tech
  •  
Thomas KesslerCMS
  •  
Todd Omundson
  •  
ZeOmega
  •  
Emily TenEyckCAQH
  •  
Mark Taylor
  •  
Julia SkapikCognitive Medicine
  •  
Michael BrodyCME Online
  •  
Michelle ZuttermanHumana
  •  
Surescripts
  •  
Laurie DarstMayo
  •  
Marianna SinghCAQH
  •  
Labcorp
  •  

  •  
Mariana SinghCAQH
  •  
Madhuri
  •  

  •  
Bob THompson
  •  
Ben LangleyMITRE
  •  
Michelle PriestAllscripts
  •  
Michael Hurley
  •  
Cedars-Sinai
  •  
Roland Gamache
  •  
Dave HCRT INC
  •  
Barbara WoodPNC
  •  

  •  
Padma KondaveetiMettles
  •  
Unknown User (meryl_bloomrosen)Premier
  •  
Cambia
  •  
Judy Williamson
  •  
Matthew Maurer
  •  
Smitha HarishMettles
  •  
BC Idaho
  •  
Michael LunzerAltegra Health
  •  
Rush
  •  
Shilesh NairGdit
  •  
Steve Favilla
  •  
Optum
  •  
Texas Health
  •  
Keya ShahCasnet
  •  
Epic
  •  
Josh Lamb
  •  

  •  
Edifecs
  •  
Max MD
  •  
Allen SaundersChange Healthcare
  •  
Molly Malavey
  •  
Rich BlochLumedic
  •  

  •  
Thomas GrannanAzuba
  •  
Beth ConnorCMS
  •  
MA Health Data
  •  
Kellie Ruff
  •  

  •  

  •  
Mark Fleming
  •  
Kumar Elubandi

Present

Name

Affiliation

  •  
Rachel GoldsteinCAQH
  •  
Ralph Saint-PhardHealow
  •  
Susan LestinaAHA
  •  
Briana BarnesScope Info Tech
  •  
Cerner
  •  
Cassandra Bell
  •  
Deepthi ReddyMettle Solutions
  •  
Cognosante
  •  
Humana
  •  
Prashanth Golconda
  •  
Rajesh GodavarthiMCG
  •  
Rim Cothren
  •  
Scott LawrenceCMS
  •  
Chris JonesHumana
  •  
Christina BorgLumeris
  •  
Julie MaasEMR Direct
  •  
Kathleen Connor
  •  
Matt ReidAMA
  •  
Mike BerkmanCoverMyMeds
  •  
Monse SerenilHumad
  •  
Rian RaineyCoverMyMeds
  •  
Sandra StuartKP
  •  
Sheryl TurneyAnthem
  •  
Wanda Govan-JenkinsHHS
  •  
Chris HutchinsonCoverMyMeds
  •  
Anna MeisheidCMS
  •  
Cyrus PeyrovianFastAuth
  •  
Janice BakosAetna
  •  
SureScripts
  •  
Gevity
  •  
Melanie JonesCMS
  •  
eClinicalWorks
  •  
Tammy SchreinerWPS Health Solutions
  •  
Amy PetersonHumana
  •  
Dave Trotter, MD
  •  
BCBSIL
  •  
Renee FullerIBX
  •  
Helina Gebremariam
  •  
Cambia
  •  
Intepro
  •  
Carradora
  •  

  •  

  •  
MaxMD
  •  
Cindy Monarch BCBSM
  •  
Dawn PerreaultBCBSM
  •  
Cognizant
  •  
Mitre
  •  

  •  
Missy BoserSurescripts
  •  
CAQH
  •  
Phranil MehtaeClinicalWorks
  •  
Dylan TuggleBCBST
  •  
JPSys
  •  
Mario JarrinChange Healthcare
  •  
Jim AdamsonArkansas Blue Cross
  •  
Brian PoteetBCBST
  •  
Tony LaurieNoridian
  •  
Optum
  •  
Bonnie SirottZeOmega
  •  
MCG
  •  
ESAC
  •  
Geeta KrishnanEdifecs
  •  
Katherine LuskChildrens
  •  
Michael NovalesBCBSIL
  •  
Tracey McCutcheonKPMG
  •  
Anupam ThakurBCBS FL
  •  
Cathy PlattnerKP
  •  
Srinivasarao EadaraesMD
  •  
Availity
  •  
ZeOmega
  •  
Dennis ZanettiNantHealth
  •  
Haris BegCambia
  •  
Kishore MetlaMettle Solutions
  •  
Sunitha Godavarthi
  •  

  •  
C-HIT
  •  
SriniesMD
  •  
Anthem
  •  
Kumar SourabhGRSI
  •  
Julia ChanCW Global Consult
  •  
Ric LightHumana
  •  
UHC
  •  
Anil VezendlaMCG
  •  
Ken LordBook Zurman
  •  

Scott Robertson


  •  
Christopher GraconIndependent Health
  •  
Gary GryanMitre
  •  
Mitre
  •  
Marty StaszakVoluware
  •  
Stephen ReckfordGRSI
  •  
Joe HamiltonUnity Point
  •  

  •  
Dave Foster
  •  
Betty SullivanAllscripts
  •  
Cigna
  •  
Juzer KhorakiwallaUHC
  •  
Unknown User (patricekuppe)Surescripts
  •  
Express-Scripts
  •  
Celine LefebvreAMA
  •  
Eshaa DhalleClinicalWorks
  •  

  •  
Aakash DeliwalaeClinicalWorks
  •  
Chris JohnsonBCBSAL
  •  
Megan RileyMITRE
  •  

  •  
Crystal HyattTransunion
  •  
Epic
  •  
AEGIS
  •  
BCBSM
  •  
Pawan RegmiRush
  •  
Rajesh GarlapatiRush
  •  
Rush
  •  
Scott HoltItiliti Health
  •  
Cigna
  •  
Cigna
  •  
UHC
  •  
Steve KirbyCoverMyMeds
  •  
Neena DakuaWPS Health
  •  
Evicore
  •  
Med Allies
  •  
Laurie Henson
  •  
Healow
  •  
Bapi Beshara
  •  
David Delano
  •  

  •  
Vishnu


Agenda Topics

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

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



Upcoming conference call changes
  1. Burden Reduction (CRD/DTR/PAS) Implementer Support Call - Wednesday, DTR time slot (11at ET)
  2. Burden Reduction (CRD/DTR/PAS) Supplemental Examples - Friday, PAS time slot (3pm ET)
  3. Burden Reduction (CRD/DTR/PAS) IG Updates/Future Requirements - call to be scheduled, potentially Mondays at 1pm ET - group feedback?
    • Send email to Dana Marcelonis if any issues with the proposed 3rd call schedule
    • Targeting setting up this 3rd call around August timeframe


HL7 Patient Access API Implementation Event

Registration: https://www.hl7.org/events/fhir/implementation/2020/

  • Virtual, August 17-19
  • 1st day - kick-off, education
  • 2nd day - education
  • 3rd day - implementation day


HL7 Sept Connectathon

2020-09 Connectathon 25


  • Robert Dieterle to submit a change request for CRD to establish the linkage to DTR - need to add to this version of IG
    • App context is sent from CRD to DTR -that's the point of transfer - when you launch app, pass on that context (the questionnaire ID or the library to populate it)
    • Are we going to standardize those specific criteria that any app would need in that launch context - location of the questionnaire or the id of the questionnaire
      • You don't need to 
      • Full URL goes to that endpoint and the questionnaire
    • Is this clear in the IG?
      • Not clear, but it's customary
      • Original device request or service request - need to pass that on to the app
      • Even if you have questionnaire, you need the exact CPT or HCPCS code for the request that was made
      • MITRE RI used the device request ID or service request ID - saved in the EHR, but it's not usually the case
      • On DTR call discussed it - that can also be passed on as a part of the launch information - embedded in the launch and pushed into SMART on FHIR app
    • How do we standardize that content?
      • Every payer should give the same info in the same format in order for app to retrieve the data they need
      • Ability to support generic app that supports payer endpoint and questionnaire
    • Can we sort this out in the Connectathon? 
      • Start off by standardizing those launch parameters


CRD IG Update
  • Continuous Integration Build for CRD includes all applied changes
  • QA process in progress
  • Block vote is out for 6-10 items that were outstanding- scheduled to be approved on Tuesday FM call
  • Once done, reconciliation spreadhseet, withdrawal of negatives process
  • Then publication request


DTR IG Update
  • Working on Tasks and workflow
  • 3 outstanding items to be reconciled - a couple issues submitted recently, not part of ballot process
    • Outstanding vote on IG supporting R4 only
    • 2 triaged
    • 1 ready for vote
  • Address these items on Wednesday, 7/22 DTR call
  • MITRE team needs to update JIRA with items that have been applied


PAS IG Update
  • Vocabulary/ X12 mapping
    • Vocabulary mapping on hold until next week - new naming pattern for URLs, code sets and value sets to enable mapping to X12
    • Once vocabulary is done, mapping will be handed over to X12 for their process
  • When submitting X12 278 - supplement documentation in form of X12 275 after or before?
    • Could submit 275 and 278 at same time, or 278 first and 275 documentation following - depends on payer
    • Payers don't generally like getting unsolicited 275 (after the 278)
    • Typically submit 278, payer requests additional documentation, so provider sends solicited 275
  • PAS recommends sending entire FHIR bundle and sending to payer 
    • Payers would have everything they need in FHIR bundle and process request as FHIR and ignore 278 if want to
    • FHIR bundle sent to entity who translates to/from X12 - send entire bundle and 278 (if needed)
      • Can send 275, or send some other way because no attachments rule
      • Payer receives 278 and FHIR bundle, may get 275 or not
      • Payer can review in real-time, make determination, and respond (no pend)
    • 278 request and FHIR bundle sent to payer at same time
    • This model assumes a CRD/DTR happened first because provider knows what documentation to send, but PAS written in such a way that could be independent from CRD/DTR
      • If implementer wants to go straight to PAS - no exception process in guide re: documentation
      • Have to do documentation out of band in that case - lose value in doing questionnaire in advance
    • Clarify documentation, add some flows to address


Implementation/IG QuestionsNone today

Privacy/Security IG draft content

Celine Lefebvrewill get back to Robert Dieterle if there are any open issues



Next agenda
  • Presentation on DRLS - ~30 min
  • Identify workflow exceptions/gaps to address for production - Sreekanth - ~30 min
    • Start with an app and review where gaps are

 Adjournment

Adjourned at 3:56pm ET

Outline Reference

Supporting Document

Minute Approval



Tasks

  •