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Chair:  @Paul Knapp

Scribe: @MaryKay McDaniel

Call Logistics:  This call is at 11 AM ET, 10 AM CT, 9 MT, 8 AM PT, join using https://join.freeconferencecall.com/fm4

Attendees - list maintained at the bottom of meeting notes.

REMINDER:

Planning to ballot an artifact in the September 2019 cycle? PMO and Project Number BEFORE TSC approval of the PSS by April 7th.

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

Decision Link(if not child)

Approve previous Minutes

2019-02-19 FM Interim Meeting Minutes

2019 JAN WGM Meeting Notes, not yet ready for approval




Proposed Agenda,

Ballot Reconciliation, Coverage Requirements Discovery

1) email/Questions from Frank

From: Frank Oemig <fm@lists.hl7.org>
Sent: Monday, February 25, 2019 3:51 AM
To: fm@lists.hl7.org
Subject: [fm] online verification of Insurance Information using v2.x

hello all,

in Germany we do have the requirement to verify insurance information
via an online service. We are now checking/searching for suitable fields
in v2.x:

Date/Time of online verification:
-> IN3-6 Certification Date/Time

Result of online verification:
-> new field?

error code for online verification:
-> new field, eventually using a specific table in combination with the
previous information?

check-digit of online verification:
-> new field?

2) Review changes we made for Bill type


3) Insurance type speadsheet

*** Future meetings

3/26/2019 - 30 minutes

Payer Section Templates CCDA - Linda Michaelsen

 I would like to request time on your agenda to start talking about the Payer Section Templates.

 http://www.hl7.org/special/Committees/projman/searchableProjectIndex.cfm?action=edit&ProjectNumber=1437

 Collaborative CDA Template Review Process Pilot

Eventually FM will own/support 3 templates: THIS IS A PILOT. What does it mean for the WG to 'own'?

- C-CDA R2.1 Coverage Activity Entry
- C-CDA R2.1 Planned Coverage
- C-CDA R2.1 Policy Activity Entry

Hospice Indicator.

** Linda will create a tracker. What more does the FM WG need to do?

Paul: Will create the extension in Coverage. Will add into current build. There is no US Core for Coverage (Core was a project).

Tracker 20361, added for R5

Need for indicators for Hospice, LTC, Disability and ESRD.  There is a need to have an indicator when a particular coverage type was invoked. 

There is a monthly file between Medicare (IDR).  Need code to indicate the type of coverage and span for when it applies.

Benoit perhaps had possible business case as well. 

Going to add something to COVERAGE at least a dated data element.  Complex element to be a code and date.  For the US, will need a US CORE code set.  Need code set to ID the types of subplan.  If putting into coverage, will need to be included in any coverage for which it has been invoked.  Will only be for the actual coverage it has been invoked.  It isn’t a status about the person.  It won’t be able to be used for things like pregnancy indicator.  There are other things other than hospice and it must be invoked by the patient (or whatever the process is).   

There are some coverage and other member alerts that limit or impact coverage (high use individual limited to a single pharmacy).  There might be other alerts that would be in a clinical sense, but that wouldn’t necessarily be in coverage.    This new thing is specific to patient invoked rather than limitations imposed on coverage by someone else.   When will change in coverage resource be made so the Da Vinci project, when will it be available for use (R5 in 2 years), but extension can be used in the interim. FM would develop the universal extension.

Anesthesia Billing Outreach update - MK

No update.



Methodology

Added Items


Ballot Reconciliation



Vo

TrackerIDSummaryOutcome

Moved/

Seconder

VoteComment


















 


Management Next agenda

Tuesday, March 5, 2019 at 11:00 - 12:30 ET


 Adjournment
 Adjourned at 12:30 ET

Supporting Documents

Outline Reference

Supporting Document

Minute Approval


Action items



ATTENDEES: 

Present

Name

email

Affiliation

  •  
Kathleen Connor
  •  
Paul Knapppknapp@pknapp.comKnapp Consulting Inc.
  •  
MaryKay McDanielmarykay.mcdaniel@cognosante.comCognosante
  •  
Benoit Schoefflerbenoit.schoeffler@almerys.comAlmerys
  •  
Alex Beckneralex.beckner@cerner.comCerner
  •  
Lou BedorLouis.Bedor@cognosante.comCognosante
  •  
Laurie Burckhardtlaurie.burckhardt@wpsic.comWPS
  •  
Tricia Chitwoodtricia.chitwood@cerner.comCerner
  •  
Rachel FoersterRachel@rfa-edi.com
  •  
Susan LangfordSusan_Langford@bcbst.comBCBST
  •  
Linda Michaelsenlinda.michaelsen@optum.comOptum
  •  
Joe QuinnJoseph.Quinn@optum.comOptum
  •  
Mark Scrimshiremark@ekivemark.comCMS/NewWave
  •  
Najee Shafinajee.shafi@cognosante.comCognosante
  •  
Andy Stechishinandy.stechishin@gmail.com
  •  
Katie Sullivankatie.sullivan@cognosante.comCognosante
  •  
Andy Gregorowiczandrewg@mitre.org

The MITRE Corporation

  •  
Patrick J LaRocqueplarocque@mitre.orgThe MITRE Corporation
  •  
Ray Delanoray.delano@cerner.comCerner
  •  
Larry Decellesldecelles@mitre.comMITRE
  •  
Robert Dieterlerdieterle@enablecare.usEnableCare
  •  
Ben Hamlinhamlin@ncqa.orgNCQA
  •  
Julia Chanjchan@cwglobalconsult.com