on 12/11/2020 at 8:04 PM

Withdrawn - IRR CLM915 Additional Benefit Change Reason Codes for SROI CA and CB


From: Gregg Lutz

User Posts: 472 - Intermediate User

Download Attachment IRR CLM915 – Additional Benefit Change Reason Codes for SROI CA and CB (Original IRR).pdf 89.06 kB 22 downloads
Download Attachment IRR CLM915 – Additional Benefit Change Reason Codes for SROI CA and CB (Proposed... 70.21 kB 29 downloads

Business Requirement / Issue: Additional Benefit Change Reason Codes for SROI CA and CB.

Requester's Proposed Resolution: NYSIF has proposed six additional Benefit Change Reason Codes (see attached).

233 people saw this online 129 people saw this by email
on 8/30/2021 at 6:27 PM

From: Gregg Lutz

User Posts: 472 - Intermediate User

This IRR was withdrawn by NYSIF.

on 5/17/2021 at 4:02 PM

From: Candace Gray

User Posts: 28 - New User

Good morning all,

We have received information back from NYSIF with questions on a few scenarios and are waiting on the State of NY to review and provide input.  The workgroup will continue to follow up and provide information as it becomes available. 

Thank you,

Candace

Bryan Connors wrote:

Hi. Regarding the possible meeting on 5/4/21, it doesn't appear that we need it at this time, but our IT department is still trying determine whether or not there would be any major issues with making the suggested changes that would be necessary to avoid adding additional reasons. It's still possible that we may need an additional meeting at some point, but there's no need for a meeting on 5/4.



on 5/4/2021 at 1:29 AM

From: Bryan Connors

User Posts: 1 - New User

Hi. Regarding the possible meeting on 5/4/21, it doesn't appear that we need it at this time, but our IT department is still trying determine whether or not there would be any major issues with making the suggested changes that would be necessary to avoid adding additional reasons. It's still possible that we may need an additional meeting at some point, but there's no need for a meeting on 5/4.

on 4/13/2021 at 3:56 PM

From: Candace Gray

User Posts: 28 - New User

Download Attachment IRR 915 workgroup_20210413Meeting.docx 50.93 kB 5 downloads

Good afternoon,

Today's meeting ironed out additional Business Scenarios for one of the examples previously discussed.  NYSIF believes they may have a solution for each of the scenarios and ones that still have questions would likely need to be determined/discussed with NY on a case by case basis to determine which values would be considered acceptable.  NYSIF may withdraw this IRR; will let the group know by the end of the month if that's the case.  If not, next meeting would not be until May 4, 2021 at 10am CST. 

Attached are notes related to the life of this IRR including today's meeting. 

Candace Gray

Candace Gray wrote:

Good afternoon all,

The workgroup for this IRR met last on 4/6/2021 and believes they have provided solutions to each of the examples presented in this IRR, in addition to adding one example that wasn't previously included.  Business Scenarios for that example (2d) were captured with solutions provided to NYSIF to meet their needs.  With this, NYSIF is going to further determine if all of their examples have their needs met prior to tomorrow's scheduled meeting (Tuesday, April 13, 2021 at 10am CST).  If no additional Business Scenarios can be provided, NYSIF will consider withdrawing their IRR.  It is the request of the workgroup to have a conclusion to this IRR on or before 4/13/2021, as our next available meeting would not be until May 4, 2021.  

The notes from the last meeting, as well as the life of this IRR, are attached as well as the original PDF submitted by NYSIF, with comments included.  

Thanks,

Candace Gray

Candace Gray wrote:

Gregg Lutz wrote:

Business Requirement / Issue: Additional Benefit Change Reason Codes for SROI CA and CB.

Requester's Proposed Resolution: NYSIF has proposed six additional Benefit Change Reason Codes (see attached).



















on 4/12/2021 at 4:11 PM

From: Candace Gray

User Posts: 28 - New User

Download Attachment IRR 915 workgroup_20210406Meeting.docx 48.81 kB 3 downloads
Download Attachment IRR CLM915 Additional BCRC for SROI CA and CB_updated 202000406pdf.pdf 80.33 kB 3 downloads

Good afternoon all,

The workgroup for this IRR met last on 4/6/2021 and believes they have provided solutions to each of the examples presented in this IRR, in addition to adding one example that wasn't previously included.  Business Scenarios for that example (2d) were captured with solutions provided to NYSIF to meet their needs.  With this, NYSIF is going to further determine if all of their examples have their needs met prior to tomorrow's scheduled meeting (Tuesday, April 13, 2021 at 10am CST).  If no additional Business Scenarios can be provided, NYSIF will consider withdrawing their IRR.  It is the request of the workgroup to have a conclusion to this IRR on or before 4/13/2021, as our next available meeting would not be until May 4, 2021.  

The notes from the last meeting, as well as the life of this IRR, are attached as well as the original PDF submitted by NYSIF, with comments included.  

Thanks,

Candace Gray

Candace Gray wrote:

Good morning,

The workgroup for this IRR met last on 3/16/2021.  Some of the values originally presented in this IRR were ruled out as not being true CA/CB scenarios.  Of the remaining that do meet the need for a CA/CB to be submitted, additional business scenarios have been requested so the group may have a better understanding of the need for these additional Benefit Change Reason Codes. 

A recommendation was made that the mandatory reporting of the change reason code when benefits are modified should be taken to the Claims Implementation Team.  It was suggested that any Trading Partners that may have concerns may want to attend the meetings on this to express any concerns.  

Meeting notes are attached, as well as the originally proposed values for this IRR and their examples.

Our next meeting will be this morning, Tuesday April 6, 2021 at 11am EST.  

Thanks, 

Candace Gray

Candace Gray wrote:

Gregg Lutz wrote:

Business Requirement / Issue: Additional Benefit Change Reason Codes for SROI CA and CB.

Requester's Proposed Resolution: NYSIF has proposed six additional Benefit Change Reason Codes (see attached).

















on 4/6/2021 at 4:43 AM

From: Candace Gray

User Posts: 28 - New User

Download Attachment IRR 915 workgroup_20210316Meeting.docx 45.85 kB 3 downloads
Download Attachment IRR CLM915 Additional BCRC for SROI CA and CB_updated 20200309.pdf 86.35 kB 1 downloads

Good morning,

The workgroup for this IRR met last on 3/16/2021.  Some of the values originally presented in this IRR were ruled out as not being true CA/CB scenarios.  Of the remaining that do meet the need for a CA/CB to be submitted, additional business scenarios have been requested so the group may have a better understanding of the need for these additional Benefit Change Reason Codes. 

A recommendation was made that the mandatory reporting of the change reason code when benefits are modified should be taken to the Claims Implementation Team.  It was suggested that any Trading Partners that may have concerns may want to attend the meetings on this to express any concerns.  

Meeting notes are attached, as well as the originally proposed values for this IRR and their examples.

Our next meeting will be this morning, Tuesday April 6, 2021 at 11am EST.  

Thanks, 

Candace Gray

Candace Gray wrote:

Good afternoon,

The workgroup for IRR CLM915 met last Tuesday and continued to try to work out the concerns related to adding new values.  Additional comments and recommendations were made and are included in the attached document, which reflects the life of this IRR, as well as the original PDF which includes notes to the proposed value/examples provided. As always, additional comments/questions/feedback is always welcome!

We will be meeting again Tuesday, 3/16/2021.  

Thanks,

Candace Gray

Candace Gray wrote:

Gregg Lutz wrote:

Business Requirement / Issue: Additional Benefit Change Reason Codes for SROI CA and CB.

Requester's Proposed Resolution: NYSIF has proposed six additional Benefit Change Reason Codes (see attached).















on 3/15/2021 at 8:41 PM

From: Candace Gray

User Posts: 28 - New User

Download Attachment IRR 915 workgroup_20210309Meeting.docx 42.91 kB 3 downloads
Download Attachment IRR CLM915 Additional BCRC for SROI CA and CB_updated 20200309.pdf 86.35 kB 1 downloads

Good afternoon,

The workgroup for IRR CLM915 met last Tuesday and continued to try to work out the concerns related to adding new values.  Additional comments and recommendations were made and are included in the attached document, which reflects the life of this IRR, as well as the original PDF which includes notes to the proposed value/examples provided. As always, additional comments/questions/feedback is always welcome!

We will be meeting again Tuesday, 3/16/2021.  

Thanks,

Candace Gray

Candace Gray wrote:

Gregg Lutz wrote:

Business Requirement / Issue: Additional Benefit Change Reason Codes for SROI CA and CB.

Requester's Proposed Resolution: NYSIF has proposed six additional Benefit Change Reason Codes (see attached).













on 3/9/2021 at 3:34 AM

From: Candace Gray

User Posts: 28 - New User

Download Attachment IRR 915 workgroup_20210302Meeting.docx 39.19 kB 1 downloads
Download Attachment IRR CLM915 Additional BCRC for SROI CA and CB_updated 20200302.pdf 77.41 kB 2 downloads

Good evening,

The workgroup for IRR CLM915 met last Tuesday and continued to try to work out the concerns related to adding new values.  Additional comments and recommendations were made and are included in the attached document, which reflects the life of this IRR, as well as the original PDF which includes notes to the 2nd proposed value/examples provided. As always, additional comments/questions/feedback is always welcome!

We will be meeting again Tuesday, 3/9/2021.  

Candace

Candace Gray wrote:

Good evening,

The workgroup for IRR CLM915 met last Tuesday and continued to try to work out the concerns related to adding new values.  We have set up additional meeting dates to continue our work on this and will be meeting again Tuesday, 3/2/2021.  

As always, additional comments/questions/feedback is always welcome!

Candace Gray

Gregg Lutz wrote:

Business Requirement / Issue: Additional Benefit Change Reason Codes for SROI CA and CB.

Requester's Proposed Resolution: NYSIF has proposed six additional Benefit Change Reason Codes (see attached).











on 3/1/2021 at 6:10 AM

From: Candace Gray

User Posts: 28 - New User

Download Attachment IRR 915 workgroup_20210223Meeting.docx 34.73 kB 4 downloads

Good evening,

The workgroup for IRR CLM915 met last Tuesday and continued to try to work out the concerns related to adding new values.  We have set up additional meeting dates to continue our work on this and will be meeting again Tuesday, 3/2/2021.  

As always, additional comments/questions/feedback is always welcome!

Candace Gray

Candace Gray wrote:

Good evening,

The workgroup for IRR CLM915 met earlier today and discussed feedback that was received related to the current proposed values to be added to DN0439 (Benefit Change Reason Code).  It was a great deal of conversation and I captured what I believe to be everything, which is provided in the attached meeting notes.  Since the conclusion of today's meeting, I received an email with additional feedback from the Claim Admin community, which is towards the very end of my notes for your review as well.  (Additional attachment is original PDF from NYSIF with comments included.)

Our next workgroup meeting will be held Tuesday, 2/23/2021 at 10am Central Time.  An update to this IRR will also be presented at the Claims Committee Meeting on Wednesday, 2/17/2021.  As always, additional feedback is always welcome!

Thanks again to everyone involved!

Candace Gray

Candace Gray wrote:

Good afternoon everyone,

The workgroup met today and has drafted some comments/concerns/questions we'd like to have other jurisdictions/submitters weigh in on as it relates to these newly submitted values.  Attached are the updated notes related to the life of this IRR to include edits to the proposed resolution and date for today's workgroup meeting (denoted in red).  We have one more workgroup meeting before the Claims Committee meeting on Wednesday, February 17, 2021 where we will present the committee with any updates we have for this IRR. 

Thank you,

Candace

Candace Gray wrote:

Good evening all,

The workgroup for this IRR met last Tuesday (2/2/2021) for which I failed to upload the meeting minutes as promised.  It appears in my delay, my computer decided to eliminate those notes and now I have had to restart with what I have from memory.  I did compile what I could remember, as well as including what was in the original proposed IRR.  The workgroup will meet again on Tuesday, 2/10/2021 at 10am Central Time.  While I know this does not give everyone a lot of time to review everything within the document, one thing we have requested is for jurisdictions that may be considering one day utilizing DN0439 (Benefit Change Reason Code) to review the proposed values and provide your feedback on them.  

Thank you,

Candace Gray

Gregg Lutz wrote:

Business Requirement / Issue: Additional Benefit Change Reason Codes for SROI CA and CB.

Requester's Proposed Resolution: NYSIF has proposed six additional Benefit Change Reason Codes (see attached).









on 2/17/2021 at 4:58 AM

From: Candace Gray

User Posts: 28 - New User

Download Attachment IRR 915 workgroup_20210216Meeting.docx 32.19 kB 6 downloads
Download Attachment IRR CLM915 Additional BCRC for SROI CA and CB_updated 20200216.pdf 76.63 kB 4 downloads

Good evening,

The workgroup for IRR CLM915 met earlier today and discussed feedback that was received related to the current proposed values to be added to DN0439 (Benefit Change Reason Code).  It was a great deal of conversation and I captured what I believe to be everything, which is provided in the attached meeting notes.  Since the conclusion of today's meeting, I received an email with additional feedback from the Claim Admin community, which is towards the very end of my notes for your review as well.  (Additional attachment is original PDF from NYSIF with comments included.)

Our next workgroup meeting will be held Tuesday, 2/23/2021 at 10am Central Time.  An update to this IRR will also be presented at the Claims Committee Meeting on Wednesday, 2/17/2021.  As always, additional feedback is always welcome!

Thanks again to everyone involved!

Candace Gray


Candace Gray wrote:

Good afternoon everyone,

The workgroup met today and has drafted some comments/concerns/questions we'd like to have other jurisdictions/submitters weigh in on as it relates to these newly submitted values.  Attached are the updated notes related to the life of this IRR to include edits to the proposed resolution and date for today's workgroup meeting (denoted in red).  We have one more workgroup meeting before the Claims Committee meeting on Wednesday, February 17, 2021 where we will present the committee with any updates we have for this IRR. 

Thank you,

Candace

Candace Gray wrote:

Good evening all,

The workgroup for this IRR met last Tuesday (2/2/2021) for which I failed to upload the meeting minutes as promised.  It appears in my delay, my computer decided to eliminate those notes and now I have had to restart with what I have from memory.  I did compile what I could remember, as well as including what was in the original proposed IRR.  The workgroup will meet again on Tuesday, 2/10/2021 at 10am Central Time.  While I know this does not give everyone a lot of time to review everything within the document, one thing we have requested is for jurisdictions that may be considering one day utilizing DN0439 (Benefit Change Reason Code) to review the proposed values and provide your feedback on them.  

Thank you,

Candace Gray

Gregg Lutz wrote:

Business Requirement / Issue: Additional Benefit Change Reason Codes for SROI CA and CB.

Requester's Proposed Resolution: NYSIF has proposed six additional Benefit Change Reason Codes (see attached).