2018-02-14 PA Call Minutes
Patient Administration Call
|PA Work Group Conference Call
FM indicates that they don’t like the 2 categories of self-pay
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: 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
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)
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