Chair:  @PaulKnapp

Scribe: @MaryKay McDaniel

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Attendees - list maintained at the bottom of meeting notes.


Agenda Outline

Agenda Item

Meeting Minutes from Discussion
Weekly Call Minutes

Approve 4/10/2019/ 4/17/2019 5/1/2019 meeting minutes


Motion to approve:  



IG Review

PDex:

URL: 

http://build.fhir.org/ig/HL7/davinci-epdx/



Mark displayed and we reviewed the PDex draft.

Requires multiple passes. 1st is in context. Do we know you? can we identify you? THEN once id'd the conversation can continue. This is the magic number for the health plan to identify the patient. 

Questions: A way to 'not' share information (Behavioral health info/Substance Abuse). Scenario 1: out of scope for the IG.  Payers are already dealing with this today. We will add a statement about this in the IG. In the scenario where the member asks to move the data - the member should be in control. They should be able to have the final say, that is dependent on who writes the API for the request. 

What happens if claim information is sent to one provider and then the claim is adjusted. How does that adjusted information get sent out to those who already received it? Out of scope (push) in this situation. Also a query that says give me anything that has changed since this date. 

Read the conformance statement from the receiver (EMR) to determine what can be written into the EMR. If they don't allow it to be updated, it is written into a resource, placed in bundle and a the reference given. Smart on Fhir app allows the receiver to configure the items they want. The smart app will do the work of reading the capability statement. the requester is in control of the impacts to their system. the sender is only responding to the queries from the requester.

Mark will continue to build out the overview section.

Recognized that we need some additional information : MK: will start a ppt that starts with Mark's spreadsheet 

to advance the training documents. 


CCDA Payer Section Templates, 

Continuing Discussion

Moving to Wednesday's at 12ET, starting on 4/10.

Payer Section Templates CCDA - Linda Michaelsen

I would like to request time on your agenda to start talking about the Payer Section Templates.

 http://www.hl7.org/special/Committees/projman/searchableProjectIndex.cfm?action=edit&ProjectNumber=1437

 Collaborative CDA Template Review Process Pilot

Eventually FM will own/support 3 templates: THIS IS A PILOT. What does it mean for the WG to 'own'?

- C-CDA R2.1 Coverage Activity Entry
- C-CDA R2.1 Planned Coverage
- C-CDA R2.1 Policy Activity Entry

Keith Boone does a great job of outlining the RIM and where the information from an insurance card is placed in the CDA documents: 

http://motorcycleguy.blogspot.com/2012/10/where-do-they-go-insurance-id-cards-and.html

Reviewed the information found at:  Payer Section C-CDA



PPT:  Payer Section.pptx (located in documents), the spreadsheet contains the vocabulary:  https://confluence.hl7.org/download/attachments/30638450/Payer%20Section.xls.xlsx?api=v2


HOMEWORK from 4/10/2019: Review the ppt and the vocabulary to discuss next week.


Scenario:  

Johnny - child

Custodial Parent - Mom

Covered by Mom's Insurance

Biological Father is responsible for all remaining medical bills






Open Discussion




Next Agenda Items


Adjournment   Adjourned at 1:15pm ET

ATTENDEES: 

Present

Name

email

Affiliation

  •  
Alex Beckneralex.beckner@cerner.comCerner
  •  
Amol Vyasamol.vyas@cambiahealth.comCambia Health
  •  
Andy Gregorowiczandrewg@mitre.org

The MITRE Corporation

  •  
Andy Stechishin Co-Chairandy.stechishin@gmail.com
  •  
Benoit Schoeffler Co-Chairbenoit.schoeffler@almerys.comAlmerys
  •  
Celia Bowen

celia.bowen@va.gov

VA
  •  
Durwin Daydayd@bcbsil.com
  •  
Donna Campbell Donna_campbell@bcbsil.comBCBSIL
  •  
Joe QuinnJoseph.Quinn@optum.comOptum
  •  
Juana Romanoromemj01.gmail.com
  •  

Kathleen Connor, Co-chair

VA/Book Zurman
  •  
Katie Sullivankatie.sullivan@cognosante.comCognosante
  •  
Laurie Burckhardtlaurie.burckhardt@wpsic.comWPS
  •  
Larry Decellesldecelles@mitre.comMITRE
  •  
Linda Michaelsenlinda.michaelsen@optum.comOptum
  •  
Lisa NelsonLNelson@max.mdMax MD
  •  
Mark Scrimshiremark@ekivemark.comCMS/NewWave
  •  
Mary Lynn BushmanMary.Bushman@Anthem.comAnthem
  •  
MaryKay McDaniel, Co-chairmarykay.mcdaniel@cognosante.comCognosante
  •  
Michael Cabralmichael.cabral@cms.hhs.govCMS
  •  
Paul Knapp, Co-chairpknapp@pknapp.comKnapp Consulting Inc.
  •  
Patrick J LaRocqueplarocque@mitre.orgThe MITRE Corporation
  •  
Rachel FoersterRachel@rfa-edi.com
  •  
Ray Delanoray.delano@cerner.comCerner
  •  
Robert Dieterlerdieterle@enablecare.usEnableCare
  •  
Terrence Cunningham terrence.cunmingham@ama-assn.orgAMA
  •  
Tricia Chitwoodtricia.chitwood@cerner.comCerner
  •  
Tom Twaitttwait@cerner.comCerner
  •  
Serafina Versaggiserafina.versaggi@gmail.com
  •  
Sonja Ziegler

  •  
Susan LangfordSusan_Langford@bcbst.comBCBST
  •  
Terrence Cunninghamterrence.cunningham@ama-assn.orgAMA 
  •  
Michael Cliftonmclifton@epic.comEpic