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2018-02-14 PA Call Minutes

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Patient Administration Call

Meeting Information

PA Work Group Conference Call

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Meeting Information

PA Work Group Conference Call

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Date: Tuesday, Februar 14, 2017

Time: 12:00 PM (US Pacific Time, GMT -7)
Quorum Met (Chair+2, Yes/No)? Yes

Facilitator Brian Postlethwaite Scribe Brian Postlethwaite
Attendee Name Affiliation
X Brian Postlethwaite Telstra Health, AU
X Simone Heckmann Gefyra, GE
X Line Saele Nasjonal IKT HF, NO
X Louis Bedor Cognasante, US
X Cooper Thompson Epic, US
X Alex de Leon Kaiser Permanente, US
X MaryKay McDaniel Cognasante, US
X Paul Knapp Knapp Consulting, US
X Liz Murrans Careuvation, US
X Andrew Torres Cerner, US


Agenda Topics
Joint with Financial Management

  1. SelfPay

Supporting Documents



FM indicates that they don’t like the 2 categories of self-pay

  1. Who is solely responsible for account (guarantor?)
  1. Patient agreed service(s) – extras (TV/single room)

Paul: If the coverage says “self-pay” how does the billing engine understand what to charge?

Brian: Expect that this information would be in the Contract(s) that are referenced from the coverage?

Simon: Each of the self-pay parts would be in a separate Coverage instance, using the coverage.type=”pay” (self-pay)

Brian: can do 1. Self-pay tv/singleroom, 2. Private insurance, 3. Govt insurance

Simone: this is different to the guarantor use case

MaryKay: Who is sending the transaction/message processing?

MaryKay: describes the admission processing/entering the data, keying the data

As going through the data, will do checks to ensure that will be ok.

Cooper: This exchange would be going through the admission and the billing system

MaryKay: our back end system doesn’t understand these differentiations

Paul: The system may split these out, and then request the items to insurance for pre-approval (and doesn’t need to send the stuff that was approved)

Simone: Inpatient scenario, do you want extras? (select and sign contract)

This is entered into admin system (as noted by MaryKay)

Next the insurance part could be checked

MaryKay: Isn’t this just Contract?

Cooper: Suggests that they may not use the contract resource itself, but just a type on coverage

Brian: Could you use the co-pay backbone element?


Coverage.copay,type = tv/single room

Coverage.contract = the signed PDF

MaryKay: could list of contracts (contained) for all of these?

Paul: could use the Coverage.Contract.Identifier as the code value for the items

Coverage.Contract.Reference = Contract/42

Coverage.Contract.Identifier = 12

Paul: describes flow of processing (not necessarily messaging)

Cooper: Payment information doesn’t belong in the coverage resource. (e.g. bank account number) a local extension might be fine.

Paul: Agrees that this seems to make sense.

Brian: Asked if there was a thought of a datatype for bank account (Name, BSB, Account no, branch etc)

Cooper: How can we determine which bank account to process things with multiple coverages?

Cooper: Payment Bank Account stuff will remain off the todo list for now.

Paul moves motion that we re-open the FM decision regarding the removal of self-pay, seconded by Louis Bedor, 9-0-0

Paul Knapp moves to retain the self-pay in the coverage resource, Simone Heckmann seconded, 9-0-0


(out of time)

Next Meeting/Preliminary Agenda Items
  • Next telecom meeting: Wednesday 21. Feb 2018


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