Blue Button+ Initiative Payer Workgroup Meeting January 3, 2014.
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Blue Button+ Initiative Payer Workgroup Meeting January 3, 2014
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Transcript of Blue Button+ Initiative Payer Workgroup Meeting January 3, 2014.
Blue Button+ InitiativePayer Workgroup Meeting
January 3, 2014
Meeting Etiquette
• Remember: If you are not speaking, please keep your phone on mute
• Do not put your phone on hold. If you need to take a call, hang up and dial in again when finished with your other call o Hold = Elevator Music = frustrated speakers and participants
• This meeting is being recordedo Another reason to keep your phone on mute when not
speaking• Use the “Chat” feature for questions, comments and items you
would like the moderator or other participants to know.o Send comments to All Panelists so they can be addressed
publically in the chat, or discussed in the meeting (as appropriate). From S&I Framework to Participants:
Hi everyone: remember to keep your phone on mute ☺
All Panelists
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Agenda
Topic Time Allotted
Welcome & Announcements 5 minutes
Pharmacy, Dental, Missing Fields 10 minutes
Implementation & Pilot Brainstorm 20 minutes
Next Steps / Reminders 5 minutes
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Announcements and Reminders
• Meeting Reminders– The next Meeting will be held on Friday, January 10, 2014. – Meeting information is on the Blue Button Wiki Page:
• http://wiki.siframework.org/BlueButton+Plus+Initiative
• Payer WG Wiki– View the Draft Project Charter, Meeting information and other materials on
the Payor Workgroup Wiki Page– http://wiki.siframework.org/BlueButton+Plus+-++Payers+Workgroup
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Week TargetDate Payor WG Meeting Tasks / Deliverables Homework
due Fridays COB
1 11/1 Kickoff and Project Charter Review Review: Project Charter Comment: Project Charter
2 11/8 Project Charter Final Review & ConsensusFinalize: Project CharterReview: Use cases
Consensus Vote: Project Charter Comment: Use cases
3 11/15 Discussion on WEDI Survey ResultsFinalize: Use casesReview: Summary of survey results
Comment: Summary of survey resultsAnalyze: Sample EOBs received
4 11/22 Discussion on Data FieldsFinalize: Finalize use casesReview: Blue Button Draft Spec
Comment: Blue Button Draft SpecUpload: Collection of samples received
5 11/29 CANCELLED Open: Open:
6 12/6 User Feedback on Data FieldsFinalize: User feedbackReview: Data fields
Review:
7 12/13 Discussion on Draft SpecFinalize: Data fieldsReview: Draft spec, format(s)
Review:
8 12/20 ImplementationFinalize: Draft spec, format(s)Review: Implementation guidance
Review:
9 12/27 CANCELLED Open: Open:
10 1/3 ImplementationFinalize: Implementation guidanceReview: Pilot plan, participant outreach
Review:
11 1/10 Begin PilotsFinalize: Pilot plan, outreachReview:
Review:
12 1/17 Continue PilotsFinalize: Review: Progress
Review:
Payor Content Workgroup
Proposed Timeline
Payor Content Workgroup
Pharmacy Fields – X12 270
NCPDP Field Name NCPDP Use Size X12 270 Segment ID X12 Field- Qualifier Used X12 270- Field X12 270- Field X12 270- Field
Issuer ID (80840) HIPAA Plan ID TBD Loop 2100A NM1 Information Source NameLoop 2100A NM108 ="XV"- HCFA National Plan ID Loop 2100A NM109
Cardholder ID
Member ID and Person Code (Separated by space) 20
Loop 2100C NM1-Subscriber Name OR 2100D NM1- Dependent Name
NM108="MI"- Member Identification Number
Loop 2100C or 2100D- NM109
Cardholder Name First MI Last 12,1,15Loop 2100C NM1-Subscriber Name OR 2100D NM1- Dependent Name No Qualifier Field
Loop 2100C or 2100D- NM 104= First Name
Loop 2100C or 2100D NM105 = Middle Initial
Loop 2100C or 2100D NM 103 = Last Name
Rx BIN ANSI IIN for routing 6Loop 2100B NM1- Information Receiver Name
Loop 2100B NM108="PP"- Pharmacy Processor Number Loop 2100B- NM109
Rx PCN PCN 10Loop 2100B REF- Information Receiver Additional Identification
REF01= "JD"- User Identification? Or New Code. Loop 2100B- REF02
RxGrp Group ID 15 REF 01= "1L" Group or policy number
Loop 2100 C or 2100 D- REF02
Payer Content Workgroup
Dental Fields – X12 837D
Payer Content Workgroup
Project Charter Updates
•http://bit.ly/bbcharter • also embedded on the S&I Payer wiki
Implementation
Pilots
• Brainstorm– Denied claims, customer service use cases– App and other electronic delivery methods– APIs for data access and analysis– Managing multiple family claims expenses– Download access via portal
• Formats• Presentation layer
Next Steps & Reminders
• Next Meeting 1/10• Help fill in any missing elements or X12 mappings
on the charter wiki or Google doc.• Submit pull requests to XML, JSON versions to
reflect changes• https://github.com/blue-button/claims
• Contact Nayan or Durwin directly to discuss pilot opportunities and implementation support.
Contact Information
• For questions, please contact your support leads– Presidential Innovation Fellow
• Nayan Jain ([email protected]) – Community Lead
• Durwin Day ([email protected]) – Project Manager
• Jennifer Brush ([email protected])– Project Support
• Lauren Caruso ([email protected])– S&I Admin
• Ali Khan ([email protected])
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