Fourth Annual Claims Attachments Forum

July 17-18, 2007

Fairfax Marriott at Fair Oaks

Fairfax, Virginia

AGENDA

Tuesday, July 17

7:30 AM – 8:30 AM

The Garden Atrium

Registration and Continental Breakfast

8:30 AM – 8:45 AM

Potomac Ballroom, Salons A&B

Welcome and Introductions

Speakers:

Don Bechtel, AFECHT, Siemens, WEDI Board of Directors, and WEDI SNIP Co-chair

Maria Ward, WEDI Board of Directors, WEDI SNIP Claims Attachments Subworkgroup Co-chair, Co-chair HL7 Attachments SIG

8:45 AM – 9:45 AM

Potomac Ballroom, Salons A&B

Current Standards Initiatives

Speakers:

Mary Lynn Bushman, National Government Services, Empire Blue Cross Blue Shield, WEDI SNIP Claims Attachments Subworkgroup Co-chair

Maria Ward, HL7

  1. X12 –
  2. Status of the 275 Implementation Guide
  3. Is there another comment and voting period?
  4. Handling base64 encoding
  5. Acknowledgements
  6. HL7 –
  7. Ballot results and new CDA R2 specifications
  8. New attachments development, e.g. dental attachment
  9. Both –
  10. Status of joint SDO project to determine appropriate data placement (in claim or in attachment)
  11. Development of standards for PHR plan to plan exchange

9:45 AM – 10:15 AM

Potomac Ballroom, Salons A&B

Newest Claims Attachments Pilot Underway

Speaker to be announced

  • Participants
  • What’s being tested
  • Ease of implementing standards
  • Status, i.e. are files being exchanged yet?
  • Observations so far
  • Reduced provider DRO
  • Reduced health plan resources for review
  • Affect on appeals and denials

10:15 AM – 10:30 AM

The Garden Atrium

Refreshment Break

10:30 AM – 11:45 AM

Potomac Ballroom, Salons A&B

WEDI Claims Attachments SWG Progress and Status

Speakers:

MaryLynn Bushman, Empire

Catherine Schulten, Independent Consultant, WEDI SNIP Claims Attachments Subworkgroup Co-chair

Maria Ward, HL7

  • National Claims Attachments Pilot Resource Directory
  • National Implementation “Roll out” plan
  • Audience discussion / guidance
  • Interactive discussion with audience on needs and best approaches for education on claims attachments
  • What’s needed? Technical vs. business, both, etc
  • Best methods? Webcast vs. in person

11:45AM -1:00 PM

The Garden Atrium

Networking Plated Luncheon

1:00 PM – 2:30 PM

Potomac Ballroom, Salons A&B

Education on the HL7 CDA Release 2

Speakers:

Maria Ward, HL7

Keith Boone, GE Healthcare; Co Chair HL7 Structured Documents Technical Committee (SDTC)

2:30 PM – 2:45 PM

The Garden Atrium

Snack Break

2:45 PM – 4:15 PM

Potomac Ballroom, Salons A&B

Resume Education on the HL7 CDA Release 2

4:15 PM – 4:30 PM

Potomac Ballroom, Salons A&B

Wrap up and questions

Speaker:

Catherine Schulten, Independent Consultant

4:30 PM

Adjourn

Wednesday, July 18

8:00 AM – 8:30 AM

The Garden Atrium

Registration and Continental Breakfast

8:30 AM – 8:40 AM

Potomac Ballroom, Salons A&B

Introduction to Alternative uses for the Claims Attachment Standards

Speaker:

Catherine Schulten, Independent Consultant

8:40 AM - 9:00 AM

Potomac Ballroom, Salons A&B

X12 and HL7 Claims Attachments Standards for Other Uses

Speaker:

MaryLynn Bushman, Empire

  • Other Attachment types in development
  • Use of Attachments with the X12 278
  • Use of these standards for Plan to Plan PHR data exchange

9:00 AM – 10:30 AM

Potomac Ballroom, Salons A&B

Plan to Plan PHR Data exchange – Expert Panel

Speakers:

Maria Ward, WEDI Board of Directors & Co-chair WEDI Claims Attachment Subworkgroup, Co-chair HL7 Attachment SIG (Moderator)

Durwin Day, Health Care Service Corporation

Hayes Abrams, Health Care Service Corporation

Jeanette Thornton, Director of Health Informatics, America’s Health Insurance Plans

Additional Health Plan Representative to be announced

This panel will discuss how the use of a proprietary X12 275 and a “CDA-like” XML schema are currently being used to transport PHR information about a member when they move from one Health Plan to another. Panel participants represent Blue Cross and Blue Shield Plan(s) and America’s Health Insurance Plans (AHIP). Specifically, panelists will address:

  • The benefit to Health Plan members…what’s the value proposition?
  • Member response / feedback to this concept
  • Are there concerns, e.g. privacy?
  • Are members volunteering for this initiative?
  • What is the feedback to date?
  • Benefits to the Health Plan
  • Risks and rewards
  • Transitioning to the use of “standards” versus proprietary formats
  • X12 275 IG development underway
  • Discussions with HL7 for use of Continuity of Care Document (CCD) as the “payload” in the 275. (CCD is an implementation of the HL7 Clinical Document Architecture (CDA) which is the standard used for claims attachments
  • Timing
  • Other

10:30 AM – 10:45 AM

The Garden Atrium

Refreshment Break

10:45 AM – 11:00 AM

Potomac Ballroom, Salons A&B

HITSP recommended standards related to CDA

Speaker:

Don Bechtel

  • Recognition date and what it means
  • What this HITSP requirement might mean to the adoption of CDA (CCD) for Claims Attachments
  • Increased awareness and adoption

11:00 AM – 11:45 AM

Potomac Ballroom, Salons A&B

Meeting Wrap up

Meeting Facilitators

  • Audience feedback and questions
  • Action items for WEDI SNIP Claims Attachments Subworkgroup
  • Action items for SDO’s
  • Next Steps

11:45 AM

Adjourn

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