October 9, 2018 Financial Management Work Group Conference Call

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Conference Call Schedule

Freeconference - at online meetings tab select join meeting and enter fm4 Dial in 515 739 1538 Access Code 589967

Attendees

Member Name
Kathleen Connor Co-chair x
Beat Heggli Co-chair .
Paul Knapp Co-chair .
John Moehrke Security Co-Chair
Lorraine Constable .
Andy Stechishin x
Mark Scrimshire x
Grahame Grieve .
Corey Spears .
Mary Kay McDaniel x
Durwin Day .
Lenel James .
Reed Gelzer .
Julia Chan .
Jamie Mosteller .
Alec McLure .
Rachel Foerster x
Eric Ellsworth .
Pete Glibert .
Alex Beckner ,
Susan Langford x
Lou Bedor x
Tricia Chitwood .
Cloud Cray .

Agenda

  • Roll Call
  • Agenda Approval
  • V2-to-FHIR Mapping - See Meeting Materials
  • Add insurance to V2 ORU^R01? - See Meeting Materials
  • Review FM CR
  • Update FM FHIR Resources

Meeting Materials

V2-to-FHIR Mapping

Based on our discussions on the proposed V2-to-FHIR PSS, the resulting updates that have been made, we would like to get the confirmation of your workgroup that you will be a co-sponsor and provide us with the following information:

  • Date of vote
  • Choice of (one or more)
    • Request formal content review prior to ballot
    • Request periodic project updates. Specify period:
    • Other involvement. Specify details here:
    • Any named individuals (if already known) who want to be directly involved in aspects of the project, e.g., pursue a tooling approach, perform mappings, otherwise.
  • Latest version of the PSS

Add Insurance to V2 ORU^RO1?

From: Radov, Nick <fm@lists.hl7.org> Sent: Thursday, October 04, 2018 10:55 AM To: fm@lists.hl7.org Subject: [fm] Add insurance to V2 ORU^R01?

Would the OO work group support a V2 change request to enhance the ORU_R01 message structure with patient insurance segments? As a payer when a lab sends us results we would like verification that the lab thinks the patient is one of our plan members; for privacy reasons and quality analysis reasons we don’t want to receive data for any patient not currently on one of our plans. Currently we tell labs to stick the insurance plan member or subscriber number in PID-3 (along with the MRN as a field repetition), but that isn’t a great fit. The member number should really go in IN2-61, plus we’d like to have fields for other plan data such as group number, effective dates, etc.

I was thinking we could copy the existing ADT_A01 INSURANCE segment group and add it as an optional repeating group in ORU_R01 at the end of the PATIENT segment group. Does that make sense?

Nick Radov | Director, Int Standards & Compliance nradov@uhc.com | unitedhealthgroup.com

CompuBill manages patent accounts receivable and billing for physicians, group practices and medical centers. From our perspective your suggestion is good and, to us who submit claims, it does make sense.

Narender Reddy President CompuBill Inc.

Minutes

  • TBD chaired
  • Approval of Agenda
  • Review FM CR
  • Update FM FHIR Resources