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Section


Column


Present

Name

Affiliation

  •   
Robert DieterleEnablecare
  •   
Stratametrics
  •   
Nita ThingalayaIBC
  •   
Cambia Health Solutions
  •   
Duane WalkerBCBSM
  •   
Gregory MagazuCaseNet
  •   
Jeanie SmithBCBSFL
  •   
Corey SpearsInfor
  •   
Greg Linden
  •   
Joseph QuinnOptum
  •   
Ashley SteddingCMS
  •   
Barbara AntunaAIM Specialty Health/ Anthem
  •   
Mary Kay McDanielCognosante
  •   
Michael GouldIBC
  •   
Laurie BurckhardtWPS Health Systems
  •   
Serafina Versaggi
  •   
Sreenivas MallipeddiMCG Health
  •   
Susan BellileAvaility
  •   
Susan LangfordBCBST
  •   
Taha AnjarwallaCAQH
  •   
Tony BensonBCBSAL
  •   
Tracey McCutcheonKPMG
  •   
Brent WoodmanBCBSM
  •   
Sonja ZieglerOptum
  •   
Dawn PerreaultBCBSM
  •   
CMS
  •   
Anupam ThakurBCBS FL
  •   
Anthem
  •   
Allscripts
  •   
BCBSM
  •   
Chris JohnsonBCBSAL
  •   
MITRE
  •   
ZeOmega



Column


Present

Name

Affiliation

  •   
John BialowiczBCBSM
  •   
Nandini GangulyScope Info Tech/ EMDI
  •   
Peter Muir
  •   
CAQH
  •   
Pallavi TalekarScope Info Tech
  •   
Julia SkapikCognitive Medicine
  •   
Kelly TaylorCMS
  •   
Karen L. ZapataAnthem
  •   
Brandon RaabAnthem
  •   
Cindy MonarchBCBSM
  •   
Michael CabralCMS
  •   
Nick RadovUHC
  •   
Anne MeisheidCMS
  •   
Isaac VetterEpic
  •   
James Derrickson
  •   
Laurie WoodromeLabcorp
  •   
Ric LightHumana
  •   
Harvey KuangExpress Scripts
  •   
BCBS AL
  •   
Gevity
  •   
Julia ChanCW Global Consult
  •   
Ken Lord
  •   
Edifecs
  •   

  •   
Roland Gamache
  •   
Alberto S. LlanesAnthem
  •   
Mark ScrimshireNew Wave
  •   
EMR Direct
  •   
Patrick MurtaHumana
  •   
Ranjith KandurAnthem
  •   
Mitre
  •   
Joe Minieri
  •   
Dave Foster
  •   
Providence




Minutes Approved as Presented 

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Agenda Outline

Agenda Item

Meeting Minutes from Discussion

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


ManagementBallot and Connectathon Schedule
MarkVirtual Connectathon 
May and JuliaScenario and RI questions
  • Identifiers patient
    • Required?
    • HRex Coverage Profile does not require Member ID
    • HRex requires Subscriber ID
    • EHR situations where it doesn't know the Member ID, but could use member name and DOB instead
    • If Payer to Payer scenario, they'll always have the Member ID
    • US Core doesn't require DOB
      • If payer has it they have to put it in
    • http://build.fhir.org/ig/HL7/US-Core-R4/StructureDefinition-us-core-patient.html

      • States for US-Core Patient: "The following data-elements are mandatory (i.e data MUST be present) or must be supported if the data is present in the sending system (Must Support definition)."

  • Coverage – HREX or PAS versions-- PAS is referenced in PCDE-- will comment that HREX should be the profile referenced
  • Terminology
    • Procedures
      • CPT, HCPCS, and SNOMED
      • L codes
    • Meds
      • RX Norm as primary, but NDC as alternate
    • Devices
      • SNOMED as primary
      • Code for device itself, not the procedure - UDI
        • Not every payer has UDI
      • DI in codable concept
      • HCPCS could go into codable concept
    • Therapies
      • Behavioral
      • Allied
      • Care Mgmt

ManagementNext agenda



 Adjournment

Adjourned at at 2:56pm ET


Supporting Documents

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