Group Minutes X12N TG2 WG15 Provider Information October 2-6, 2011 Pittsburgh, PA

Transcription

1 Group Minutes X12N TG2 WG15 Provider Information October 2-6, 2011 Pittsburgh, PA ASC X12N/TG2/WG15/ Group Leadership Chair Name Company Term End Date Phone Gail Kocher BCBSA Appointed Secretary Name Company Term End Date Phone Quorum Requirement Statement (Check appropriate statement for your group) This group enforces quorum requirements for group voting items. This group does not enforce quorum requirements for group voting items. X Work Products and Status (e.g. Transaction Sets Implementation Guides, etc.) Work Product Name Work Product Status Work Product ID # (opt) Health Care Provider Information Published X103 Health Care Provider Directory Published X109 Health Care Provider Inquiry and Information Published X185 Response Health Care Provider Directory In development TR X207 Health Care Provider Information Development on hold TR X206 Health Care Provider Directory Published XSD Schema Scheduled Meetings Type of Meeting Date Location/Call in Contact Agenda (high level items to be covered full agendas should be posted prior to the meeting) Current Meeting Continue development work on the X207 Next Standing Meeting Oct 2-6, 2011 Jan 29 Feb 2, 2012 Omni William Penn Hotel Pittsburgh, PA Hyatt Regency Tampa Tampa FL Gail Kocher Gail Kocher Interim Meeting TBD TBD Gail Kocher Management N/A Meeting Continue work with ONC S&I Framework ASC X12 representative on Provider Directories Continue development work on the X207 Continue work with SCO ASC X12 representative on Provider Directories As needed Revised 3/2011 Page 1 of 3

2 ASC X12N/TG2/WG15/ Chair Elections (Copy table for each election held) Candidate(s) Made by 2 nd By Approve Disapprove Abstain Nomination 1 st nd (add more as needed) 2 Discussion Nominations tabled until the January Standing Meeting Results <Elected person; record vote tally or state by acclamation> Voting Items (Copy table for each election held) Type Issue Description <(Work Product, DM, HIR, DSMO, Project Proposal for new TR3 for S&I Framework Initiative Provider Electronic Service Information Discovery etc. Include # if applicable> Vote Motion Made by 2 nd By Approve Disapprove Abstain Motion to approve project proposal Appendix A Don Dan Unanimous Discussion None Voting Items (Copy table for each election held) Type Issue Description <(Work Product, DM, HIR, DSMO, Data maintenance to the standard for ERA/EFT enrollment data and digital certificate needs. etc. Include # if applicable> Vote Motion Made by 2 nd By Approve Disapprove Abstain Motion to approve DM as developed with TG8 Appendix C Margaret Don Unanimous Discussion None consulted with TG8 prior WG15 agreed with solution as coordinated with TG8 Key Discussion Item (Add rows as necessary to capture discussion items) Discussion Decisions Revised 3/2011 Page 2 of 3

3 Discussed the S&I Framework Provider Directory initiative, including the first use ASC X12N/TG2/WG15/ Reviewed use case 2 and discussed various approaches to meeting needs, including preparing for digital certificates. Informational Forum or Joint Meeting Notes (Copy table for each meeting held - Attendance Roster should be submitted along with the minutes) Topic Date/Time DM Request Review with TG8 October 6 Notes Reviewed DM with TG8 to finalize. See Appendix C Attendance listed in Appendix B Additional Group Minutes (This section should be used for detail minutes by the group but should not be included in the formal minutes that are placed on the ASC X12 Web Site. Revised 3/2011 Page 3 of 3

4 Appendix A S&I Framework Provider Directory Project Proposal ASC X12N Implementation Guide Project Proposal Form New TR3 - With data element dictionary - With object descriptors Document Identification Set ID: 274 Version/Release: Owning Group: WG15 Name: Provider Electronic Service Information Discovery Contact Identification Project Delegate: Gail Kocher, BCBSA, , gail.kocher@bcbsa.com Project Alternate: Margaret Weiker, HP, , margaret.weiker@hp.com Project Identification Purpose/Scope The Provider Electronic Service Information Discovery Technical Report Type 3 describes the use of the ANSI ASC X12 Provider Information (274) transaction set, version for the following business usage: To enable a system to query Provider Directories for Electronic Service Information (including electronic address and any required security information). The Electronic Service Information (including electronic address and security information) obtained from the query will facilitate secure exchange of health information. Trading Partners: Trading partners may include but are not limited to: Providers, e.g. clinicians, laboratories, pharmacies, facilities Patients who have access to a Personal Health Record (PHR) Federal or State Agencies Health Information Exchanges (HIE)/Health Information Organizations (HIO) Health Plans Health Associations Health Information Service Providers (HISP) Exceptions The use of the Provider Electronic Service Information Discovery Technical Report Type 3 is limited to electronic service directory information about a health care provider and does not include all information for use in: Provider credentialing Provider application Other Provider business functions References The Health Care Provider Information X253 and the Health Care Provider Directory X109.

5 Appendix A Coordination Office of the National Coordinator Standards & Interoperability Framework Initiative SDO Charter Organization Approval Signatures: Guide ID: X297

6 X12N TG2 WG21 Provider Information Work Group ASC X12N/TG2/WG15/ Appendix B FULL_NAME COMPANY Mon Wed THurs Oct 3 Oct 5 Oct 6 Gail S. Kocher Blue Cross and Blue Shield Association x x x Don Bechtel Siemens x x x* Margaret F. Weiker HP x x Dan Kazzaz Secure Exchange Solutions, Inc x Walter Suarez Kaiser Permanente Debbie Meisner Emdeon Steve Bass Washington Publishing Company Stefan Fromm Central Washington Hospital * virtual attendance

7 ASC X12N INSURANCE SUBCOMMITTEE X TECHNICAL REPORT TYPE 3 STANDARD 274 Healthcare Provider Information Functional Group ID: PW This X12 Transaction Set contains the format and establishes the data contents of the Healthcare Provider Information Transaction Set (274) for use within the context of an Electronic Data Interchange (EDI) environment. This standard can be used to exchange demographic and educational/professional qualifications about healthcare providers between providers, provider networks or any other entity that maintains or verifies healthcare provider information. Such exchanges include the transmitting, inquirying, or responding to an inquiry. Healthcare provider information is routinely exchanged for the purpose of 1) maintaining provider data bases for claim adjudication, provider directories, patient referrals, and reporting provider information, 2) submitting an application to join a provider organization or provider network such as, but not limited to, a hospital, preferred provider organization (PPO) or health maintenance organization (HMO), and 3) verifying credentials such as educational/professional qualifications, licenses, and malpractice coverage/history. Table 1 - Header PAGE # POS. # SEG. ID NAME REQ. DES. MAX USE LOOP REPEAT 0100 ST Transaction Set Header M BHT Beginning of Hierarchical Transaction M DTM Date/Time Reference O PER Administrative Communications Contact O 1 Table 2 - Detail PAGE # POS. # SEG. ID NAME REQ. DES. MAX USE LOOP REPEAT LOOP ID > HL Hierarchical Level M TRN Trace O AAA Request Validation O 1 LOOP ID > NM1 Individual or Organizational Name M N2 Additional Name Information O > PER Administrative Communications Contact O > DMG Demographic Information O AMT Monetary Amount Information O API Activity or Process Information O > DEG Degree Record O IND Additional Individual Demographic Information O LUI Language Use O DTP Date or Time or Period O AAA Request Validation O MTX Text O > QTY Quantity Information O WS Work Schedule O CRC Conditions Indicator O HSD Health Care Services Delivery O BCI Basic Claim Information O PDI Practice Detail Information O 1 32 SEPTEMBER 2011 ROUGH DRAFT

8 ASC X12N INSURANCE SUBCOMMITTEE TECHNICAL REPORT TYPE X HAD Hospital Affiliation Detail O 1 LOOP ID > NX1 Property or Entity Identification O N2 Additional Name Information O N3 Party Location O N4 Geographic Location O PER Administrative Communications Contact O 1 LOOP ID > LQ Industry Code Identification O N1 Party Identification O TPB Business Professional Title O > DTP Date or Time or Period O QTY Quantity Information O YNQ Yes/No Question O > AAA Request Validation O 1 LOOP ID HPL Health Care Provider License O DTP Date or Time or Period O > AAA Request Validation O 1 LOOP ID > REF Reference Information O DTP Date or Time or Period O AAA Request Validation O 1 LOOP ID EMS Employment Position O DTP Date or Time or Period O SE Transaction Set Trailer M 1 NOTES: 1/0400 The PER segment is used to supply the sender s point of contact to the receiver. 2/0100 Valid hierarchical level codes for this transaction set are information source, information receiver, provider, group and site of service. 2/0200 The TRN segment is used to identify trace numbers that provide an electronic link between this transaction and other transactions. 2/0300 The NM1 segment is used to identify individuals and entities related to the hierarchical level identified by HL03. 2/2100 Loop 2110 provides multiple addresses related to the entity identified in the NM1 segment. The NX1 segment provides the type of address for each iteration of the loop. For instance, billing service or place of business. SEPTEMBER 2011 ROUGH DRAFT 33