Stream: CARIN IG for Blue Button®
Topic: Coverage.Type
Jason Teeple (Jul 24 2020 at 15:23):
What is the expected mapping for Coverage.type? The codeset has mixed concepts - medical has sub types like HMO, PPO, POS, etc... And those subtypes can be broken down into lower level such as a subsidy (SUBSIDIZ), and those subtytpes can be broken down if an account has a health spending account (HSAPOL). At what level should we be expected to map?
Josh Lamb (Jul 27 2020 at 19:26):
Anything with a 0..1 card without must support would be outside of scope of IG. Is Coverage.type included in CPCDS?
Jason Teeple (Jul 28 2020 at 14:00):
Coverage.type does not have a must support flag. Are you saying the IG expects payors to not provide the information? We know the coverage, just depends on the hierarchy expectation.
Lloyd McKenzie (Jul 28 2020 at 14:13):
You're allowed to provide content that isn't mustSupport, just not expected to do so. The IG provides no guidance on mapping because it's not trying to create interoperability on that element - presumably because it's not necessary for the use-case that defines the scope for the IG.
Last updated: Apr 12 2022 at 19:14 UTC
