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.
Planning to ballot an artifact in the September 2019 cycle? PMO and Project Number BEFORE TSC approval of the PSS by April 7th.
Meeting Minutes from Discussion
|Decision Link(if not child)|
Approve previous Minutes
2019 JAN WGM Meeting Notes, not yet ready for approval
Ballot Reconciliation, Coverage Requirements Discovery
0) v2.9 FM Reconciliation Spreadsheet needs approval - already late
See changes/updates made in Spreadsheet.
Motion to approve: Kathleen Connor, Mark Scrimshire 2nd. 13-0-1 (Linda M.)
1) Harmonization Proposals
Thanks to everyone who participated today. We did have to table two proposals for decisions and completion by FM, which will happen on
Row 75 (FM Reconciliation spreadsheet see above), Fix table. Motion to approve: Kathleen Connor, Craig Newman. 13-0-1 (Linda M.)
2) email/Questions from Frank/Outstanding Harmonization Proposal, need to review for 12:00 Harmonization meeting Today
From: Frank Oemig <firstname.lastname@example.org>
Motion to approve with the changes: Laurie Burkhardt, Kathleen Connor: 9-0-0
Motion to approve with the changes: Kathleen Connor, Laurie Burkhardt. 13-0-0
4 fields to be added. Made changes to the harmonization /table values. Split error codes into error table, left success codes in 1st table. Updates made to the word documents and returned to Harmonization meeting.
Motion to approve with the changes: Kathleen Connor, Laurie Burkhardt 11-0-0
1.5) FM Interest in C-CDA R2.1 Update PSS
get FM to weigh in on whether they would want to be a co-sponsor or an interested party on the PSS for doing an update to C-CDA R2.1?
Here is the PSS:
We need to Vote on this PSS in SDWG on Thursday.
Interested party and updated at WGMs - we will define time for the updates...
Kathleen Connor, Laurie Burkhardt. 11-0-0
3) Review New Proposed Da Vinci PSS
WG reviewed the PSS.
Motion to approve, with the intent that when work begins on the PSS the WG will again review the work in depth.
Mark Scrimshire/Laurie Burkhardt: 8-0-0
4) Vocabulary Facilitator, email from Heather Graham
5) Proposal to enhance balance, statement and payment adjustment data. JAN WGM and HIMSS follow-up.
From the recent discussions at the WGM on proposing enhancements to FHIR to address Balance, Statement, Payment, and Adjustment data that to some started to sound like regular banking transactions rather than transactions specific to “patient/guarantor accounts” that actually already are available through HL7 V2 as well, it seems we landed that we should be able to move forward, but do not necessarily need a separate/new PSS. In talking with Grahame Grieve at HIMSS he further clarified that while in Australia some of this could be managed through generic banking transactions, in other parts of the globe that would not necessarily be true. So he would not stand in the way of moving forward, although like anybody, he may provide feedback as specific proposal flow through. Considering though the questions about project and scope, we’d like to suggest an update to the current FHIR PSS for FM to root the discussions more clearly without surprises down the road.
Billable Service Invoice, Patient/Guarantor Accounts (including Balance, and Statement data), Claim, Explanation of Benefit, Remittance Advice, Reversals, PaymentReconciliation (including Payment and Adjustment data), Pre-Authorization/Pre-Determination, Coverage, Eligibility, and other resource corollaries of current HL7 standards supporting these concept such as existing HL7 V3 CMETs and HL7 V2 FT1 segment.
4) Review changes we made for Bill type
5) Insurance type spreadsheet
6) 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
**) 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.
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
**)Need to discuss Harmonization Process within the WG.
Tuesday, March 19, 2019 at 11:00 - 12:30 ET
|Adjournment||Adjourned at 12:30 ET|
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|Paul Knappemail@example.com||Knapp Consulting Inc.|
The MITRE Corporation
|Patrick J LaRocquefirstname.lastname@example.org||The MITRE Corporation|