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This call is at 2:30 PM ET, 1:30 PM CT, 12:30 PM MT, 11:30 AM PT

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    Meeting ID: 933 7214 7617


  Agenda Outline

Recap


                                                                                                                                                            



Status of CARIN BB WG Ballot Reconciliation                                                                                                                                                                                              

Search Parameters; return of focal and reference resources (FHIR-26693)

  • Payers reviewed two options for payers to return reference resource data,
    • RESTful read / vread vs. RESTful $assemble.eob operation. 
    • The review occurred on calls and via a survey
  • Those surveyed represented commercial Blue and non-Blue payers and Medicaid Blue and non-Blue payers; CARIN Alliance and non CARIN Alliance members
  • Survey results recommend support for requiring the payer to support read / vread (versioned read) and _include to request the EOB and  reference resources
  • Highlight to payers that they shall use versioned references whenever they maintain point-in-time dataGo but may use versionless references when they do not maintain versioned data.

Continue review of tickets to be included in Block-Vote-2b

  • FHIR-26693 is the primary JIRA ticket with documentation attached.
  • Will add a note to implementers
  • The server SHALL support the following search parameters
    • Required search parameters:
      •  _id,
      • patient,
      • _lastUpdated*
        • A new logical CPCDS new data element, EOBLastUpdated,that defines the date the EOB was created or updated, whichever is later will be defined. The payer could choose how they want to map it to this CPCDS element. Map to meta.lastUpdated. Cardinality is 1..1. Search parameter uses the logical EOBLastUpdated field.
      • type (Claim Type)**
        • A search parameter will be defined: "name": "type", "type": "token", "description": "The category of claim", "expression": "ExplanationOfBenefit.type"
      • identifier (Business / Claim Identifier of EOB
      • service-date***
        •  A search parameter for service-date will be defined. The goal of service-date is to simplify the search, so that a client doesn't need to know that for inpatient and outpatient admission dates they need to search by billablePeriod.period.start, for a pharmacy by servicedDate, for professional services - by servicedPeriod.period.start. The cardinality of these data elements will be changed to 1..1. 
  • Recommend forwarding to Financial Management as Block-Vote-6 (search parameters)









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