2018-02-14 PA Call Minutes

Patient Administration Call

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Meeting Information

PA Work Group Conference Call Minutes GoToMeeting Local numbers sent to list Return to PA Main Page Meeting Information PA Work Group Conference Call Minutes Gotomeeting - see pafm@lists.hl7.org HL7 Conference Call phone number 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 Agenda Topics Agenda Joint with Financial Management SelfPay Supporting Documents Minutes SelfPay FM indicates that they don’t like the 2 categories of self-pay Who is solely responsible for account (guarantor?) 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.type=pay 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 Invoice? (out of time)

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

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