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Objective:

The goal of this use case is to give providers real-time access to payer approval requirements, documentation, and rules at point of service to reduce provider burden and support treatment planning.

Sponsoring Workgroup: Financial Management Home

Coverage Requirements Discovery (CRD) Implementation Guide:

STU1 Ballot Reconciliation (May 2019):

Zulip Stream

Project Milestones

Milestone

Timeframe

Published STU1Dec 2020
Implementer Feedback and SupportQ1 2021
Requirements Q2 / Q3 2021
DesignQ3 / Q4 2021
IG and RI DevelopmentQ3 / Q4 2021
Ballot of STU1.1 (early May cycle)Feb - Mar 2022
Ballot ReconciliationMar 2022 - TBD
Publish STU1.1TBD

Conference Call Sign Up

HL7 Conference Call Center

Da Vinci Conference Call Sign Up Instructions


Conference Call Schedule & Dial-Ins

See Weekly Meeting Schedule for Burden Reduction Wednesday at 11am Eastern and Friday at 3pm Eastern call information.

Ballot Milestones

Milestone

May Ballot Deadlines

Ballot Voting Starts

Feb 2022

Ballot Voting Ends

March 23rd, 2022

Ballot Reconciliation Starts

March 30th, 2022
Ballot Reconciliation CompleteTBD

Team:

RoleName OrganizationEmail 
Project Co-LeadRobert (Bob) Dieterle EnableCarerdieterle@enablecare.us
Project Co-Lead (Ven)Rajesh (Raj) GodavarthiMCGrajesh.godavarthi@mcg.com
Project Co-Lead (Prov)Anna TaylorMultiCare Connected Careataylor@multicare.org
Project Co-Lead (Pay)David DeGandiCambiaDavid.Degandi@cambiahealth.com
Project Co-Lead (Ven)Ben GoldChange Healthcare Ben.Gold@changehealthcare.com
Business Process SMERobert (Bob) Dieterle EnableCarerdieterle@enablecare.us
Clinical Process SME Dr. Viet NguyenStratametrics vietnguyen@stratametrics.com 
RI Lead Jeff Brown MITREjeffbrown@mitre.org
IG LeadLloyd McKenzie Gevity
Project ManagerVanessa CandeloraPoint of Care Partners 

vanessa.candelora@pocp.com 

Testing LeadRichard EttemaAEGIS.net, Inc.

richard.ettema@aegis.net

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