Facilitator:  Durwin Day Russell Ott Christol Green

Scribe: Christol Green   


Agenda Topics

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

Decision Link
ManagementMinutes Approval 6/16Approved by Consensus

LOINC 2.68 and RELMA 7.1 are now available for download from the LOINC.org website

Outstanding discussion is how these updates are propagated to VSAC, if at all.

Pat TaylorPDEX/CDPDE diagram change

Final review

Per BCBSA legal advice, if a person changes coverage with the same payer, the coverages are per product and therefore two separate profiles.  Per the final rule, a payer is only required to show the current coverage.  It is at the payer's discretion to return data on both coverages.  The payer or third party app elects to link historical data.  The conversation was deferred when discussion of clinical data came up.  Pat made changes to the document for #8 and #11 personas.  Pat motions to approve document as complete, Laurie seconded.  Discussion - PIE asked by FM to review, so completed document will be sent to FM to determine if document will be included in the guide or kept separate as a link.

VOTE:  13-0-0 approved as compete by PIE workgroup.

Lisa motioned that PIE should recommend to FM to include in the guide, Laurie seconded.  Discussion - Laurie wanted to make it clear that PIE is merely making a recommendation to FM that the personas/use cases be included in the guide. 

VOTE:  13-0-0 approved to recommend adding to the guide.

CARIN BB Ballot Recon 2020 0610 PIE.docx

Not discussed this week - Pending discussion with SDWG:

Attachment control number (solicited or unsolicited). InFullfilment of.  would like to keep control number for solicited and unsolicited instructions OID 2.16.840.1.113883.17.4 Provider Attachment 

AllOpen floorPat had received several questions regarding Blue Button including clinical data. She shared a Powerpoint slide that shows the differences/overlaps between Da Vinci PDex (clinical data) vs Carin BB (claims/financial data).  IG included clinical, but the final rule came out and was expanded to include use cases.  rule does not specify if US Core or CDI.  Do not convert CPT to SNOMED.  PDex will accept whatever the provider has.  The goal is to provide data.  What will the App do with the data?  The apps could show minimum or maximum of data.  Lisa - Data provided by payers for EOBs will be Carin profile conformant with PDex.  Did data come from the clinical system or Payer?  Bhanu - There is a meeting this afternoon regarding overlapping resources between clinical document and claims data.  With PDex, coverage is current.  Carin is related to coverage at claim date of service.  Data elements are the same for PDex and Carin.  PDex will not link to date of service.  Lisa - If there are 4 procedures with 1&2 from clinical (richly populated) and 3&4 from claims (sparsely populated), how many responses will come back? PDex will get 4 responses.  The App must sort the data.     PDex vs CARIN BB v5.4.pptx
Meeting adjourned at 3:31 PM EST

Supporting Documents

Outline Reference

Supporting Document

Minute Approval

Action items