Chair: Paul Scribe:
This call is at 11 AM ET, 10 AM CT, 9 AM MT, 8 AM PT
Find your local number: https://us02web.zoom.us/u/kfWlHSVu3
Attendees - list maintained at the bottom of the meeting notes
Antitrust Statement (HL7 GOM §05.02):
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|Meeting Minutes from Discussion|
Remember the Antitrust Statement, see above
Weekly Call Minutes
Review & Approve Interim Meeting 2/14/2023
Agenda accepted by unanimous consent.
challenge: what is the correct payer/plan and how do we determine (define). No national source for a plan identifier
On the national level, national standard and there is only 1 instance. can always look it up.
Today there is no unique identifier for the payer/provider. There is no standard.
The system becomes the national directory. Becomes the national assigner of identities.
NAIC, is it unique? NAIC calls it a producer id. Producer Database (PDB) | NIPR
No national payer database
Digital Certificate ID - what happens when a new cert is issued?
Bob putting out block votes tonight, please put on agenda for next week vote.
HL7 GOM Updates
The following proposed revisions are attached for your review [RC2301 Proposed Revisions.zip]. Please submit any comments or suggestions using the attached peer review comment form. Submit a separate form for each proposed revision receiving comment.
The peer review period closes at midnight Eastern on Tuesday, 3/14/23.
Reviewed the changes,
Naming Convention: no suggested changes. see: https://confluence.hl7.org/display/TSC/GOM+Naming+Conventions+and+Product+Family+Management+Council+Feedback?focusedCommentId=144989839#comment-144989839
Suggest change. 10.03.02. A TSC member may run in the election to be a TSC member only during the second year of their first term.
Product & Service MGMT
no suggested change.
Da Vinci - Risk-Based Lists
4th Meeting of the month Agenda (regularly), 10-15 minutes for Risk-Based Lists:
Risk Adjustment - Da Vinci - Confluence (hl7.org)
PSS: PSS for Risk Based Contract Member Identification (Updated) - Financial Management - Confluence (hl7.org)
Tickets to review for R5
These are the tickets from the 10/11/2022 call:
For Co-Chair Call:
project = FHIR AND issuetype in ("Change Request", Comment, Question, "Technical Correction") AND "Resolution Vote" is not empty AND Specification = "FHIR Core (FHIR) [FHIR-core]" AND "Work Group" = fm and status not in ("Applied")
Resume at 22763
Jira Filter: Applied for R5 - Ballot
project = FHIR AND issuetype in ("Change Request", Comment, Question, "Technical Correction") AND status in (Applied) AND Specification = "FHIR Core (FHIR) [FHIR-core]" AND "Work Group" =
Needs Negative ballot vote
Start here 12/13/2022:
2/7/2023: the following tickets are complete with the exception of the code set/value system.
Start here 2/7/2023:
Start here 2/14/2023:
Need to create a ticket or negative ballot comment for this clarification:
R4 comments guidance and update for R5
2/21/2023: Added FHIR-40502
Definition: The date this resource was created
Requirements: Need to record a timestamp for used by both the recipient and the issuer
FHIR 29687 Motion to edit to definition and change short description. Vote: Mary Kay/Chris Cioffi 8– 0–0
Link following three tickets - FHIR 33201, FHIR 30337, FHIR-29687 Vote: Chris Cioffi/Mark Scrimshire 8–0–0
FHIR 23003 Motion to change ex-revenue codes to be made up values to remove infringement. Vote: Chris Cioffi/Mark Scrimshire seconded 8–0–0. Then motion to change ticket to non substantive. Vote: Mary Kay/Chris Cioffi 7-0-0
FHIR 22763 – No objection to change as applied.
FHIR 22689 – No objection to change as applied.
FHIR 22662 – Already looked at this ticket and agreed to the change.
FHIR 32762 (marked as duplicate of 22662 but that is not accurate)
Anyone in addition to Paul available to make changes to the standard? Need 1) full build software on machine, 2) access to github and 3) know how to make the changes.
What are the latest dates for R5?
SEE notes to the left for the tickets that were worked on under 1/10/2023 section.
2/7/2023, reviewed in call
See notes in-line to the left....
Applied - Reviewed - Complete:
Created FHIR-40502 (last item on the left). update definition and requirement for EOB.created.
14-Feb-23 -Chris still needs to create ticket
14-Feb-23 - See notes inline
VOCABULARY: New Code System needed for Surface Codes:
Existing: HL7.TERMINOLOGY\Surface Codes - FHIR v4.0.1
CREATE a new Code System
2. Create a US value set that inclues all except the "V"
3. Create a FDI value set that inclues all except the "F"
4. The existing code system will then be deprecated
5. will there need to be a naming system entry created? Question for Vocab
Create new Value Sets:
existing EXAMPLE VS: HL7.TERMINOLOGY\Surface Codes - FHIR v4.0.1 URL: http://terminology.hl7.org/ValueSet/surface urn:oid:2.16.840.1.113883.4.642.3.546
From ADA Standard No 1084_May2019.pdf: Surface Code (2.16.840.1.113883.4.642.1.316)
From the OID registry:
From the new V2+ web version:
HL7.TERMINOLOGY\bodySiteModifier - FHIR v4.0.1 Official URL: http://terminology.hl7.org/CodeSystem/v2-0495
See FHIR-33202. Another ADA code system (tooth identifying system). Add to THO
Jeff reaching out to Rick for an update.
Paul - we can do a better job for example codesets, especially in places where each country may have their own codeset. (IE Billing codes) where the codesets can vary widely.
We are working on value sets in improving definitions for interoperability. Targetting R6 for that cleanup.
Replacing the v3 ActCoverageTypeCode Value Set
***We have SEVERAL R5 tickets around this value set: 13024, 14127, 24916, 20361 (these are linked and in FMWG-Discussion Grouping)
C/N Working List of Definitions - Financial Management - Confluence (hl7.org)
See also JAN WGM work: 2022 01 20 Thurs Q3 - FM WGM Minutes - Financial Management - Confluence (hl7.org)
R5 Work - Clarification ADJ Category vs. ADJ Reason... what is the difference between Category and Reason use
PaymentReconciliation - add a ticket to request documentation addition to describe how to do a refund.
Category = Large Bucket
Reason = further description of why something ended up in the bucket
Category: Patient Responsibility / Reason: Deductible / Amount: 256.00
Category: Patient Responsibility / Reason: Co-Pay Amount / Amount: xx.xx
Category: Patient Responsibility / Reason: Co-Insurance Amount / Amount: xx.xx / Value: .20
Category: Patient Responsibility / Reason: Non-Par Provider
Category: Contractual / Reason: exceeds fee schedule / Amount: 27.00
Category: Contractual / Reason: exceeds plan contractual / Amount / 98.00
Category: Contractual / Reason: POS step down amount / Amount: 11.00
Category: Other / Reason: Tax Not Covered / Amount: 33.45
Category: Other / Reason:
Category: Constractual / Reason: exact dup claim/service
Category: Payer Initiated Reductions / Reason: Performance program proficiency requirements not met / Amount
01-Nov-22: The US has unique requirements. There's a desire to see how we can synchronize international code usage, as much as possible.
There are also situations where different jurisdictions have elements with the same name, but different meaninging.
supportingInfo Slices in existing IGs:
Do we need to add any of these to the base?
01-Nov-22: We might add to base is to guide IG authors in the best practice for adding this data.
CARIN made the design desicion to NOT use any extensions, and so they are using supportingInfo slices. Other IGs are using extensions for the same data elements. We'd like to simplify this for implementers with a standard.
|Patient/Related Person||Patient vs Related Person.pptx|
HL7 Antitrust Policy - Updated 10/2021
HL7 Code of Conduct
HL7 is a community where we can always ask searching questions about technical matters and how our decisions might impact our various communities and stakeholders, but HL7 and its participants are committed to a harassment-free environment for everyone, regardless of level of experience, professional background, gender, gender identity and expression, sexual orientation, disability, personal appearance, body size, race, ethnicity, age, religion, or nationality. Generally this should mean there is no reason for those subjects to come up with regard to any specific individual.
Co-chairs are asking our WG participants periodically review the HL7 Code of Conduct .
Human Services WG:
3/29/2022: Motion that FM be a co-sponsor. Approved. 16-0-0
Withdrawn (FM was sponsoring):
Meeting ID : 820 3100 5986 Topic : FM Full WG Weekly Conference Call User Email : email@example.com Duration (Minutes) : 126
Start Time : 2023-02-21 10:56:04 AM End Time : 2023-02-21 01:01:43 PM Participants : 15
|Name (Original Name)||User Email||Join Time||Leave Time||Duration|
|Guest||In Waiting Room|
Susan L Langford (BCBST)
|2023-02-21 10:56:04 AM||2023-02-21 12:59:41 PM||124||Yes||No|
Rachel Foerster (RFA Ltd)
|2023-02-21 10:56:32 AM||2023-02-21 01:01:38 PM||126||Yes||No|
Gheisha-Ly Rosario Diaz
|2023-02-21 10:59:48 AM||2023-02-21 11:00:02 AM||1||Yes||No|
Jeff Brown (Lantana)
|2023-02-21 11:00:11 AM||2023-02-21 11:59:22 AM||60||Yes||No|
MaryKay McDaniel (Financial Management Work Group)
|2023-02-21 11:00:42 AM||2023-02-21 01:01:43 PM||122||No||No|
Chris Cioffi (Elevance Health)
|2023-02-21 11:01:15 AM||2023-02-21 01:01:44 PM||121||Yes||No|
|2023-02-21 11:01:24 AM||2023-02-21 11:15:03 AM||14||Yes||No|
|2023-02-21 11:01:33 AM||2023-02-21 11:59:04 AM||58||Yes||No|
|2023-02-21 11:01:41 AM||2023-02-21 11:30:11 AM||29||Yes||No|
Gheisha-Ly Rosario Diaz
|2023-02-21 11:02:16 AM||2023-02-21 01:01:43 PM||120||Yes||No|
|2023-02-21 11:05:43 AM||2023-02-21 11:16:26 AM||11||Yes||No|
|2023-02-21 11:19:16 AM||2023-02-21 11:53:08 AM||34||Yes||No|
|2023-02-21 11:47:35 AM||2023-02-21 01:01:43 PM||75||Yes||No|
Chris Johnson - BCBSAL
|2023-02-21 11:48:55 AM||2023-02-21 01:01:43 PM||73||Yes||No|
Paul Knapp (Financial Management Work Group)
|2023-02-21 11:01:30 AM||2023-02-21 01:01:45 PM||121||No||No|