Page tree

Versions Compared

Key

  • This line was added.
  • This line was removed.
  • Formatting was changed.

...

Section


Column


Present

Name

Affiliation

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

Emily Calvert

CMS
  •   

Erica Ross

CMS
  •   
HeatherAMA
  •   
Optum
  •   

Kelly Anderson

BCBSAL
  •   
InterSystems
  •   

Mark Mundt

InterSystems
  •   
Megan SoccorsoCigna
  •   

Mike Funk

Humana
  •   
Nancy SpectorAMA
  •   
Terry 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
  •   

  •   

  •   
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
  •   
Michcelle ZuttermanHumana
  •   
Surescripts
  •   
Laurie DarstMayo
  •   
Marianna SinghCAQH
  •  
Labcorp
  •  

  •  
Mariana SinghCAQH



Column


Present

Name

Affiliation

  •   
Anthem
  •   
Rachel GoldsteinCAQH
  •   
Ralph Saint-PhardHealow
  •   
Susan LestinaAHA
  •   
Briana BarnesScope Info Tech
  •   
Cerner
  •   
Cassandra Bell
  •   
Deepthi ReddyMettle Solutions
  •   
Cognosante
  •   
Humana
  •   
Prashanth Golconda
  •   
Rajesh Godavarthi
  •   
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 Fuller
  •   
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 Eadara
  •   
Availity
  •   
ZeOmega
  •   
Dennis ZanettiNantHealth
  •   
Haris BegCambia
  •   
Kishore MetlaMettle Solutions
  •   
Sunitha Godavarthi
  •   

  •   
C-HIT
  •   
SriniesMD
  •  
Anthem
  •  
Kumar Sourabh




Agenda Topics

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

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



Milestones
  • Mitre will be developing Reference Implementation
  • Gevity/ Lloyd McKenzie will be lead to author Implementation Guide
  • September ballot cycle schedule
    • NIB - June 30
    • Sign up for ballot opens - July 8
    • Initial content due - July 14
    • QA period - July 21
    • Final Content due - August 4
    • Ballot opens - August 9
    • Ballot closes - September 9


Vocabulary Update (Mary Kay McDaniel

  • ~50 new value sets thus far, and work is not complete yet
  • Creating a code system that points to where it needs to point to at the X12 level (X12 5010 or X12 5010 278 loop/data element level)
    • Need to go back to the X12 implementation guide to know what value it's going to be
    • External X12 code sets - we'll point back to the external source in this case (e.g., revenue codes)
  • Are all code sets publicly available?
    • No, in some cases need to subscribe to particular standards organization
  • New code sets, or aggregating work that has already been done?
    • Need to create a FHIR code system along with the value sets that point to the appropriate values that can be used
    • Existing X12 code sets - pointing back to the subset of codes to be used in the specific implementation guide
    • Sometimes pointing back to base standard and sometimes pointing to specific transaction
  • Is there a visual that describes the end-state?
    • Yes, but can't post on Confluence due to IP issues
    • Folks can follow up with Mary Kay McDanieloffline if organization has X12 license and can access


Implementation Guide Review (Jean Duteau)

Link to Prior Authorization Support Implementation Guide for review: http://build.fhir.org/ig/HL7/davinci-pas/index.html

  • IG based on R4
  • No need to use US Core for 278 information
  • Clinical information in 275, wouldn't we want to based that on US Core?
    • Easy to do this if that's the direction we want to go - if we only need a few data elements, do we want to make organizations support the rest
      • Patient is one that we'd want to use US Core
        • We only need 5 patient fields - US Core is a superset
    • Leads should meet to discuss "pre-harmonization"
  • Use Case page in IG is still a 'to do' item
    • Business needs/rationale to be incorporated
    • Katherine Lusk (Children's) to send information to Robert Dieterle and/or Dana Marcelonis to be incorporated in IG development
  • Mapping, initial profiling are done
  • Vocabulary questions to be discussed between Jean Duteau, Lloyd McKenzie andMary Kay McDaniel
  • Asynchronous delivery results to be discussed


Workflow Review (Anupam Goel)

  • Question: different payers require a 'wet' signature (and not an electronic signature), which requires printing documentation and would be a barrier to a fully electronic process
    • Viet Nguyento follow up with Robert Dieterle
    • Narcotic control needs 2 factor authentication in the EHR - possibly could work towards eliminating the wet signature


Next agenda

 Adjournment
 Adjourned at at 3:50pm ET

Supporting Documents

Outline Reference

Supporting Document

Minute Approval

...