esMD+PPA+UC2+Harmonization+Meeting+Minutes+5-9-2012

**Time: 1:30 PM EST**
Reviewed Changes to Data Model
 * Changed Date/Time elements to “Date of…” to make it clearer.
 * Updated ‘Provider Organization’ and ‘Individual Provider’ Objects to better address cardinality.
 * Recommend making similar changes to ‘Structured Content eMDR General Request Info’ Tab.

SC eMDR General Request Tab SC eMDR Audit Specific Information Tab SC eMDR Contents of eMDR Tab
 * Can a non NPI Provider have multiple alternate ID’s?
 * If so would we need an element that identifies the issuer of the alternate id?
 * The alternate id is intended to be for providers that are not eligible for an NPI.
 * E.g. an individual needs a ramp built at home for a wheelchair. They are not eligible for an NPI, but are eligible to bill.
 * Added comment: “Suggestion that this be a ‘Tax ID’, however will need more industry input before we can decide this can only be a Tax ID”.
 * Also added comment: “Alternate ID may include an ‘Issuing Organization’ and may take the form of an OID”.
 * Decision to reuse objects in the transaction and adjust the cardinality of the objects. Depnding upon the transaction the cardinality will/can change.
 * ‘Cover Letter Text’
 * Datatype can be a PDF in addition to a string.
 * Cardinality is 0,1
 * ‘Program’
 * Datatype is String
 * Cardinality is 0,1
 * ‘Person / Role / Department’
 * Added definition: “Contact would include a person or department or role or some combination of the three”.
 * Cardinality is 0,1
 * ‘URL’
 * Datatype is URI
 * ‘Scope or Type of Audit’
 * Datatype is ‘String’
 * Cardinality is 1
 * Need codeset
 * ‘Unique Claim Reference Identifier’
 * Datatype is ‘String’
 * Cardinality is 1
 * ‘Unique Case Reference Identifier’
 * Datatype is ‘String’
 * Cardinality is 0,1
 * Added ‘Provider Directory ID’ element
 * ‘Return Method’ Object
 * Cardinality is 1..n
 * ‘Processor Information
 * Datatype is String
 * Cardinality is 0,1
 * ‘Beneficiary Name’
 * Datatype is an Object (the individual name)
 * Cardinality is 1
 * 'Date of Birth'
 * Datatype is Date
 * Cardinality is 0,1
 * ‘Account Number’
 * Datatype is String
 * Cardinality is 0,1
 * ‘Medical Record Number’
 * Datatype is String
 * Cardinality is 0,1
 * ‘Payer Identifier for the Policy Holder’
 * Datatype is String
 * Cardinality is 0,1
 * Comment added: “this field will be populated if the holder of the policy and beneficiary are different”.
 * ‘Payer Identifier for Beneficiary’
 * Datatype is String
 * Cardinality is 0,1
 * Changed ‘Claim Date’ to ‘Date Claim Received’
 * Definition: “The date the claim for which this eMDR is requesting documentation is received by the claim processor entity”.
 * Datatype is Date
 * Cardinality is 1
 * ‘Date(s) of Service’
 * Datatype is Date (2). Because there are 2 dates.
 * Cardinality is 1,2. Because at least one of the dates is required.
 * Discussion about whether this should be one data element or split into two elements, ‘Start Date of Service’ and ‘End Date of Service’.
 * This will be determined by the standard.
 * Decision to leave as is for now.
 * ‘Type of Bill’
 * Datatype is String
 * Cardinality is 1
 * Standard Format/Vocab is “National Uniform Billing Committee in Form Locator 04”
 * ‘Diagnosis Code(s)
 * Datatype is String
 * Cardinality is 1...n
 * Standard Format/Vocab is “ICD 9, ICD 9CM, ICD 9PSC, ICD 10, ICD 10CM or ICD 10PSC”.
 * ‘Diagnosis Code Set’
 * Datatype is String
 * Cardinality is 1
 * Comment added: “Supported values are ICD 9, ICD 10”
 * ‘Diagnosis Related Group Code’
 * Datatype is String
 * Cardinality is 0,1, but needs to be reviewed by Dan.
 * Comment added: “Code is as determined by Grouper software”.