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Date: 2022 01 20


Quarter: Q2


Minutes Approved as Presented 


This is to approve minutes via general consent. "You have received the minutes. Are there any corrections to the minutes? (pause) Hearing none, if there are no objections, the minutes are approved as printed."

Goals

Set goals, objectives or some context for this meeting.

Discussion items

TimeItemWhoNotes

FM Meeting

Welcome

R5 Ticket Review

Paul



FHIR-22661 - Claim.type has an extensible binding and is a limited value set TRIAGED  


Linked tickets: FHIR-28591, FHIR-27118, 

Jean, see FHIR-28591 which is updates to the descriptions. These new descriptions will eliminate the issues he had. 

He will withdraw this ticket.

Make ticket not persuasive. Due to the updates in FHIR-28591 not longer an issue. Motion by Jean Duteau / Jeff Brown. 9-0-0


FHIR-22660 - ClaimResponse.outcome has a required binding but is quite limiting TRIAGED


Paul: the outcome is not intended to convey what the result of the review, it is to represent the processing. 

Jean: right out of outcome there is a definition, there is no place to put a code.

Paul: no, there is no thing in the claim to describe the outcome and what the payer needs to do. You can send a communication request and get it back, or you could send them a claim response that says I've reveiw and the claim and you need to send me information back. We'll take it and pend it, ask for more stuff, and then wait for more stuff to arrive.

Jean: propose adding a new attribute on the claim response. 

claim.outcome = add more descriptive language clarifying what it is (outcome of the claim PROCESSING - not the claim decision)

claim.responseOutcome or claim.adjudication.outcome or claim.adjudication.decision (or something like it) = complete/denied/pended, etc. Convey the adjudication decision.

Motion to approve changes in FHIR-22660. Jean Duteau / Jeff Brown. 8-0-1

Action items