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Section

Attendees

Column


Present

Name

Affiliation

  •   
SureScripts
  •   
Regence
  •   
Optum
  •   
Michael BaillieUHC
  •   
Humana
  •   
BCBS AL
  •   
Rush
  •   
SureScripts
  •   
Rush
  •   
Cerner
  •   
Laurie BurckhardtWPS Health Solutions
  •   
Lindee ChinEdifecs
  •   
Independence Blue Cross
  •   
Allscripts
  •   
Regence
  •   
Sequoia
  •   
InterSystems
  •   
BCBS IL
  •   
Allscripts
  •   
Cambia Health
  •   
Enablecare
  •   
David DodgeCambia Health
  •   
Rachel Foerster & Associates
  •   
Howard FollisJuxly
  •   
Reliant Medical Group
  •   
Lantana Consulting
  •   
SureScripts
  •   

  •   
Independence Blue Cross
  •   
GunjitZeOmega
  •   
Kenneth Hall
  •   
NCQA
  •   
Optum
  •   
Jackie HardisonHumana
  •   
Cigna
  •   
HealthLX
  •   
ZeOmega
  •   
BCBSA
  •   
Point of Care Partners
  •   
Edifecs
  •   
Heather KennedyBCBST
  •   
Edifecs
  •   
Sathaya KrishnasamyAnthem
  •   
BCBS AL
  •   
Stephen LaneSutter Health
  •   
InterSystems
  •   
Anthem
  •   
Luis MaasEMR Direct
  •   
Erin MajderBCBS IL
  •   
Point of Care Partners
  •   
Cognosante
  •   
BCBS AL
  •   
Lloyd McKenzieGevity
  •   
Optum
  •   
Humana
  •   
MaxMD
  •   
Stratametrics
  •   
Sean ParsonsBCBS OK
  •   
Scott Parsons
  •   
BCBS AL
  •   
Allscripts
  •   
HealthLx
  •   
Optum
  •   
Optum
  •   
Regence
  •   
InterSystems
  •   
NewWave
  •   
NewWave
  •   
ZeOmega
  •   
Anne Marie SmithNCQA
  •   
InterSystems
  •   
UHC
  •   
Casenet
  •   
Cigna
  •   
HealthLX
  •   
Independence Blue Cross
  •   
Joel WalkerHealthLX
  •   
Holly WeeksRegence
  •   
BCBS AL
  •   
Darrell Woelk
  •   
Cambia
  •   
Brent Woodman
  •   
Diameter Health
  •   
Cambia
  •   
NewWave
  •   
Edifecs
  •   

  •   

  •   
YuriyHealthLX
  •   
Stephen MacVicarMITRE
  •   
Anna MeisheidCMS
  •   
Epic
  •   
Paul Knapp
  •   
Dave FosterEdifecs
  •   
John FeloExpress Scripts
  •   
Ken Lord
  •   
Roland GamacheAHRQ
  •   
Epic
  •   
Jennifer Joe
  •   
Stephen McVicarMitre
  •   
Joe HamiltonUnity Point
  •   
Matthew FloresAdvent Advisory Group
  •   
Providence
  •   

  •   
EMR Direct
  •   
Barbara WoodPNC
  •   
Eshaa DhalleClinicalWorks
  •   
Katherine RuizUNC Health
  •   
Zach Heath
  •   
Centene
  •   
Veradigm
  •   
Kenneth Foster
  •   
Cigna
  •   
Christopher StehnoCorepoint Health
  •   

Neena Dakua


  •   
MD Partners
  •   
Joe Miller
  •   
Gevity
  •   
Thomas GrannanAzuba
  •   
Mike SabinMedica
  •   
Clay Rogers
  •   
Thomas GrannanAzuba
  •   
Matthew Hoesch
  •   
Vijaya ShivgandUPMC
  •   
Lauri ShockArkansas Blue Cross Blue Shield
  •   
Zanub MalikUPMC
  •   
Vishnu
  •   
Erin GosneyHumana
  •   
Summer DumanRegence
  •   
Sonya MayOptum
  •   
MITRE
  •   
POCP
  •   
MA Health Data
  •   

  •   

  •  
Colin Barry
  •  
Anoop Mohemmed



Column


PresentNameAffiliation
  •   
Tibco
  •   
Aim Specialty Health
  •   
Christy Dodson
  •   
BCBSM
  •   
Allscripts
  •   
BCBSFL
  •   
BCBSM
  •   
CMS
  •   
Mike HurleyBRYJ Healthcare
  •   

  •   
Tori WillowsWellcare
  •   

  •   
Nandini GangulyEMDI - Scope Info Tech
  •   
Moxe Health
  •   
Jim McKinleyMedicaid Alabama
  •   
BCBST
  •   
Bart CarlsonAzuba
  •   
Deepthi ReddyMettle Solutions
  •   
Allscripts
  •   
Eric SullivanInovalon
  •   
MITRE
  •   
Pallavi TalekarScope Info Tech
  •   
Ralph Saint-PhardHealow
  •   
Scott SwihartSumma Health
  •   
India DuncanOptum
  •   
Jason CassidyMoxe Health
  •   
Praveer MathurWellcare
  •   
Megan Soccorso

Cigna

  •   
Prashanth GolcandaLumeris
  •   
Rajesh Godavarthi
  •   
Availity
  •   
Susan LestinaAHA
  •   
Bob BowmanCAQH
  •   
Thomas KesslerCMS
  •   
Patrick Edwards
  •   
Briana BarnesScope Info Tech
  •   
Kishore MetlaMettle Solutions
  •   
John DonnellyInterpro
  •   
Lorraine DooCMS
  •   
Melanie JonesCMS
  •   
Rim Cothren
  •   
Yolanda VillanovaCMS
  •   
Kathleen Connor
  •   
Manoj KumarBCBSFL
  •   
Saul KravitzMITRE
  •   
Srinivas KonchadaCentene Corporation
  •   
Sheryl TurneyAnthem
  •   
Helina Gebremariam
  •   
Mike NovalesBCBSIL
  •   
Ric LightHumana
  •   
Ann GallagherOptum
  •   
Chris KlesgesMitre
  •   
Adam GronskyHealth Fidelity
  •   
CaseNet
  •   
Anthem
  •   
CMS
  •   
eClinicalWorks
  •   
Healow
  •   
Interfaceware
  •   
Mark RucciSpectramedix
  •   
Carie HammondAEGIS
  •   
Anthem
  •   
Cindy MonarchBCBSM
  •   
ONC
  •   
Dawn PerreaultBCBSM
  •   
Kyle ZumsteinAvaility
  •   
Nancy SpectorAMA
  •   
Bruce WilkinsonBenmedica
  •   
Avality
  •   

Chris Johnson

BCBSAL
  •   
Duane WalkerBCBSM
  •   

  •   
Greg LindenLinden Tech Advisors
  •   
Mario JarrinChange Healthcare
  •   
Megan Smith-HallingsheadRegence
  •   
Patrice KuppeSurescripts
  •   

  •   
MCG
  •   
ONC
  •   
Surescripts
  •   
NCPDP
  •   
Anupam ThakurBCBSFL
  •   
Jonathan HutchinsBCBST
  •   
Anthem
  •   
Sunitha Godavarthi
  •   
Christopher GraconIndependent Health
  •   
Labcorp
  •   

  •   
James DerricksonIntersystems
  •   
Douglas DeShazoCognizant
  •   
Neetha JosephCognizant
  •   

  •   
MITRE
  •   
Rutika
  •   
Ashley H. MaplesExpress Scripts
  •   
Brody BrodockAllscripts
  •   
Michael BrodyCME Online
  •   
Theressa BaumannBCBS AL
  •   
Mona ChandrapaleClinicalWorks
  •   
Optum
  •   
Aakash DeliwalaeClinicalWorks
  •   
Mayo
  •   
Eddy Hernandez-NievesEpic
  •   
Shaheer
  •   
Stanley Nachimson
  •   
Anthony SmithUNC Health
  •   
Howard Cohen
  •   
Minaei BehnazFDA
  •   
BCBSA
  •   
Shilesh Nairgdit
  •   
NewWave
  •   
MaxMD
  •   
BC Idaho
  •   
Edward CastagnaAltarum
  •   
Andrea KentCoverMyMeds
  •   
Carrie Denny
  •   
Kim Pham
  •   
Celine LefebvreAMA
  •   
Edifecs
  •   
Josh LambUPMC
  •   
Keya ShahCasenet
  •   
Gevity
  •   
MITRE
  •   
Mrugen MehtaeClinicalWorks
  •   
Revathi Jayakumuar
  •   
Supriya
  •   
Bapi Behera
  •   
Matt DyerVyne
  •   
Sree Vijetha VegiC-HIT
  •   
BCBSA
  •   
Rich BlochLumedic
  •   
Cigna
  •   
Michael Kim



...

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

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



HL7 Virtual Connectathon 

HL7 Virtual Connectathon - May 13-15

PDex Connectathon Track Briefing: PDexConnectationPrep.pptx

Da Vinci Track Schedule



PDex

Next Agenda Adjournment
Adjourned at 
  • HL7 Da Vinci PDex $member-match
    • Follow up from last week
      • Payers are only required to obtain data from payers that the patient requests
      • Only payers to whom the patient is currently a member, needs to have a Patient API available for that patient to access data
    • CMS email inbox re: questions for CMS Interoperability and Patient Access rule
Provider Directory 
  • Update on value sets and code systems
      • Da Vinci is assembling a set of questions that have come out of various presentations/meetings - Da Vinci will submit list of questions to CMS next week
      • Will bring it back to this group for review
    • If you send a patient record to old payer, is there a mechanism in place for how they should handle it? Should they assume ID is correct, other data is correct?
    • Should we send old payer's member demographic record back to new payer?
      • No 
      • Intent - new payer has declaration re: old payer identifier; new payer reaches out to old payer and finds out if they do in fact have that match
        • They either have a match, or they don't have a match
        • No intent to reconcile demographics 
      • Plan is to update new payer's system old payer member ID to be used
    • Is there any need to return the old payer coverage record since it's no longer being updated anyway?
      • As new payer, don't want to take in more information than you need
      • Don't need to return coverage record to return the dates, planning to return the dates anyway
    • Return the Patient record and the new payer's coverage record (echo it back)
    • Is there example of using unique patient ID to query the old payer?


Provider Directory 
  • Qualification extensions on PractitionerRole, Organization, OrganizationAffiliation
    • Team is developing use cases and examples to bring back to this group for review
  • HealthcareService.category code sets/value sets
    • Team working on draft definitions and will bring back to this group for review


Next AgendaNo meeting next week (5/15) due to Connectathon
 Adjournment

Adjourned at 12:48pm ET



Outline Reference

Supporting Document

Minute Approval
Meeting Presentation 4/10/20
PDex Companion GuidesPDex IG Companion Guide List




...