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This call is at 11:00 am ET.

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    Meeting ID: 933 7214 7617


  Agenda Outline

Recap


                                                                                                                                                            



Status of CARIN BB WG Ballot Reconciliation

  • Block-vote-2b and Block-vote-6 were submitted for consideration last Tuesday. The vote will be held by e-vote as the FM WG will not be meeting for the next two weeks. When a link to the e-vote is made available, we will share it with the group.
  • The 49 terminology tickets will be grouped and then brought before the group for review.
    • We were given authorization to begin to build examples for these in case we are not able to arrange licensing agreements.
  • There are 25 tickets that remain that we have not discussed. These include:
    • Examples – which we expect to have soon and then will bring before the group soon.
    • Capabilities statements – we will look to discuss these on Monday

Vision Gap Analysis                

  • The purpose of the gap analysis was to identify if you could map the vision and dental elements to the current CPCDS.
  • The Lookup field for EXCD code/description was not able to be mapped
    • Will look at a way for this information to be mapped back to consumers            
  • Not able to map:
    • Identifying a group of members for billing purposes (not by groupid)
    • Insured Last Name (subscriber id is captured)
    • Insured First Name (subscriber id is captured)
    • Condition codes:
      • Vision exams and checks (diabetes, glaucoma, hyptertension, highcholosterol, amrd)
        • Used the same Diagnosis Code that exists
      • Exam IND, LENS DESC, FRAME IND
        • Used Procedure Code
  • Based on how these elements were mapped to the CPCDS, they found that there are two possible profiles for vision: professional (which captures most claims) or facility (many were outpatient facility)


Dental Gap Analysis    

  • Will be available in the next week or two and is quite different from the CPCDS.












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