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    Meeting ID: 933 7214 7617


  Agenda Outline

Recap


                                                                                                                                                            



The group began a review of 10 Jira tickets that we would like to include in Block-Vote-2b. The below 4 Jira tickets were reviewed and the proposed dispositions were updated based on group discussions. On Monday 8/3 will continue to review the remaining tickets. These 4 tickets will be added to Block-Vote-2b.


  1. FHIR-28135 Define supervising as a careTeam role; add attending as a careTeam role for OP
  • Supervising will be defined as a careTeam role on the Inpatient Institutional and Outpatient Institutional profiles.  CPCDS data elements will be defined and mapped like that which is defined for the other careTeam members.
  • Attending will be added as a careTeam role to the Outpatient Institutional profile.
  • The needed codes will be defined in HL7 code system and used in the appropriate value sets. See (FHIR-27013).


2. FHIR-26741 See attached document titled "CARIN Mapping to FHIR" submitted through the ballot site separately

  • Mapping worksheet will be updated with the 05-13-2020 interim attached to the ticket.  In response to other JIRA tickets, changes are being made to the mapping worksheet.  The worksheet will continue to be periodically updated in the CI IG. The document will be located on a separate website with a link in the IG. The document will be located in an separate website with a link in the IG the document link in the Addendum (FHIR-25705) will identify a specific version of the mapping worksheet. The website where the worksheet is hosted will be maintained with version control.


3. FHIR-25705 add mappings to structuredefinition

  • These mappings are already reflected as part of the Profiles StructureDefinitions. The mapping worksheet and .ppt explaining how to use it will be moved to an Addendum.


4. FHIR-25682 Coverage Profile - add at least introductory text

Introductory Narrative will be added as follows:

Coverage:  Data that reflect a payer's coverage that was effective as of the date of service  or the date of admission of the claim will be added to the Coverage Profile overview.  

CARIN BB EOB:  Abstract parent profile that includes constraints that are common to the four specific ExplanationOfBenefit (EOB) profiles defined in this Implementation Guide. All EOB instances should be from one of the four non-abstract EOB profiles defined in this Implementation Guide: Inpatient, Outpatient, Pharmacy, and Professional/NonClinician

CARIN BB EOB Inpatient Facility:  The profile is used for Explanation of Benefits (EOBs) based on claims submitted by clinics, hospitals, skilled nursing facilities and other institutions for inpatient services, which may include the use of equipment and supplies, laboratory services, radiology services and other charges. Inpatient claims are submitted for services rendered at a facility as part of an overnight stay. The claims data is based on the institutional claim format UB-04, standards adopted by the Department of Health and Human Services.

CARIN BB EOB Outpatient Facility:  The profile is used for Explanation of Benefits (EOBs) based on claims submitted by clinics, hospitals, skilled nursing facilities and other institutions for outpatient services, which may include including the use of equipment and supplies, laboratory services, radiology services and other charges. Outpatient claims are submitted for services rendered at a facility that are not part of an overnight stay. The claims data is based on the institutional claim form UB-04, standards adopted by the Department of Health and Human Services.

CARIN BB EOB Professional and NonClinician:  This profile is used for Explanation of Benefits (EOBs) based on claims submitted by physicians, suppliers and other non-institutional providers for professional services. These services may be rendered in inpatient or outpatient, including office locations. The claims data is based on the professional claim form CMS-1500.

CARIN BB EOB Pharmacy: The profile is used for Explanation of Benefits (EOBs) based on claims submitted by retail pharmacies. The claims data is based on submission standards adopted by the Department of Health and Human Services defined by NCPDP (National Council for Prescription Drug Program).

CARIN BB Location:  This profile may be removed pending the resolution of FHIR-26705. This profile is used to convey the location where the services reported on a Professional and NonClinician claim were rendered when the location is not part of the Billing Provider of the physician or nonclinician.  

CARIN BB Organization:  This profile builds upon the US Core Organization profile. It is used to convey a payer or provider organization may be updated to include service facility pending resolution of FHIR-26705.

CARIN BB Patient:  This profile builds upon the US Core Organization profile. It is used to convey patient information about the patient who received the services described on the claim. 

CARIN BB Practioner:  This profile builds upon the US Core Organization profile. It is used to convey practioner information who provided the services to the patient.

CARIN BB PractionerRole:  This provider builds upon the US Core Organization profile. It is used to convey the provider's role and taxonomy.   

                                                                                                                                                                                    











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