AUC EXECUTIVE COMMITTEE AGENDA and Meeting Materials
Monday, May 2, 2016 8:30 a.m. – 10:30 a.m.
HealthPartners-Bloomington
8170 Building, 1W Walnut Room
*Teleconference and WebEx OPTION*
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Meeting Objectives:
Meeting materials contents (following this cover page):
I. Draft meeting agenda
II.
Discussion guide -- Old Business
a. Notes of previous meeting
b. Update – companion guide maintenance
III.
Discussion guide -- New Business
Adjourn
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Section I: April 4, 2016 Exec Meeting Agenda
5/2/16 Agenda item
A.
Meeting to order – Tony Rinkenberger
B.
Anti-trust statement
C.
Updates/Old business
D.
Notes
1. Review of notes from the previous meeting
The previous meeting (April 4, 2016) was canceled due
to a light agenda.
2. Update – companion guide maintenance
See table below
3. TAG and SBAR update
See table below
New Business
1. AUC response to X12 proposed TR3 for
reporting premium payment grace period
I will bring a copy to the meeting
2. EOB/Remit Educational Best Practice Example
I will bring a copy to the meeting
3. MDH community engagement
I will have background to discuss
4. Planning for next Ops meeting on June 14

Planning/discussion of survey of AUC
re. use of transactions and barriers

Other
E.
Other business
F.
Next meeting: June 6, 2016 8:30am - 10:30am
a. Health Partners 8170 Bldng, 1st Floor Walnut Room
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Section II: Old Business
2. Update -- Companion Guide maintenance (back to agenda)
Transaction Category
Eligibility
Transaction
Maintenance status
Health Care Eligibility Benefit Inquiry and
No updates at this time
Response (270/271) (PDF)
Health Care Claim: Professional (837)
(PDF)
Health Care Claim: Institutional (837)
(PDF)
Claims,
including applicable
medical coding
requirements
Health Care Claim: Dental (837) (PDF)
Pharmacy Claim Submission and
Response (NCPDP D.0) (PDF)
Notice of proposed changes/public
comment published January 11, 2016.
Public comment period ended Feb. 10,
2016. Medical Code TAG has been
addressing changes submitted by DHS.
Final versions will be voted on at the
next TAG meeting on May 12.
New version with proposed changes for
coding for “teledentistry” has been
prepared for Medical Code TAG vote.
No updates at this time
Pharmacy Reversal Submission and
Response (NCPDP D.0) (PDF)
Payment/Advice
One sentence addition re. DLI workers
Health Care Claim Payment/Advice (835)
compensation requirement in next
(PDF)
version
Health Care Claim Acknowledgment
(277CA) (PDF)
Acknowledgments
Implementation Acknowledgment for
Health Care Insurance (999) (PDF)
Final revised version (v12) will be
published in the May 23 State Register
Interchange Acknowledgment Segment
(TA1) (PDF)
Prescription Drug Minnesota Companion Guide Version 1.1
No changes
Prior Authorization for the Implementation of NCPDP
Electronic Prior Authorization (ePA)
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Section III: New Business
Transaction Category
Transaction
Maintenance status
Transactions [NCPDP SCRIPT Standard
version 2013101] (PDF)
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Section III: New Business
3. TAG and SBAR update (Back to agenda)
See summary of recent TAG activity in latest AUC monthly newsletter
We will have an SBAR status update at the Exec meeting.
Upcoming TAG activity:
TAGs
Eligibility
Focus-Improving particular administrative transactions/processes
Eligibility met on April 27 to complete its review of a draft implementation guide for a
new proposed X12 transaction, the ASC X12 Premium Payment Grace Period
Notification (271) (007030X344). The review was in response to an X12 solicitation for
public comments regarding the proposed implementation guide, due May 9. The TAG
will be voting on its proposed comments to X12, with the vote to be completed by
Monday, May 2. The TAG product will then be submitted to Ops for a vote before
being submitted to X12 by May 9.
Next meeting is scheduled for May 25.
Claims Data
Definition
The TAG was last scheduled to meet on April 6 but the meeting was canceled due to a
light agenda. The TAG is next scheduled to meet on June 1 but no agenda has been set
yet.
Next meeting is scheduled for June 1.
Medical Code
The MCT met on April 14 and reviewed proposed changes to the 837P and 837I
companion guides. The proposed changes are generally related to DHS updates and
clarifications. The TAG is meeting May 12 to vote on the revisions. If the TAG
approves, they will be forwarded for a vote by Ops.
The next MCT meeting is scheduled for May 12.
Explanation of
Benefits/
Remittance
Advice
Acknowledgments
Prescription Drug
Electronic Prior
Authorizations
The EOB/Remit TAG last met on April 18 to continue development of a best practice for
use of the 835 for recoupment of overpayment under a variety of scenarios. The TAG is
scheduled to next meet again on May 16, to complete work on the overpayment
recoupment best practices.
Next meeting is scheduled for May 16.
The TAG last met Jan. 25 and no further meetings of the TAG are scheduled at this time.
No meetings scheduled.
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Section III: New Business
TAGs
Focus-Improving particular administrative transactions/processes
ACO Data
Analytics
The TAG last met Jan. 14 and no further meetings are scheduled at this time.
Home Health
Prior
Authorization
Form
No further TAG meetings are planned at this time.
Legislative
No meetings planned.
Operations
The Ops Committee last met on March 8 to approve the ACO Data Analytics TAG
recommendations and the proposed changes to the Acknowledgment companion
guides.
Next regularly scheduled quarterly meeting is June 9.
Executive
Exec canceled its last meeting on April 4 due to a light agenda.
Exec is meeting next on June 6.
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