Voting for IRR CLM925 completed on Thursday, September 1, 2022. The proposed resolution was APPROVED along with the implementation timeline.

A total of 29 responses were received consisting of 26 Yes Votes, 0 No Votes and 3 Abstentions. Per the requirements of the IRR process, a two-thirds majority is required for an IRR to be considered approved. The outcome of this vote exceeded the two-thirds requirement with 100% in favor of the proposed resolution. A detailed report of the voting results for CLM925 is attached.

The voting period for this IRR has begun and will extend through 9/1/22. A ballot for this IRR was sent to the voting body via email on 8/12/22. The voting body is comprised of current IAIABC jurisdictional and EDI members in good standing. Each eligible organization is allowed one vote per IRR. It is the responsibility of the designated voter (or the alternate, if the designated voter is not available) to discuss the issue up for vote with all stakeholders within their organization and vote accordingly.

Reporting  beneficiary information for spouse,  the options are as follows:

 Dependent/Payee Relationship Code (DN0097)

2- Widow

3- Widower

 Our  ITS Dept. raised the question asking how to report spouse when gender is U or X.

 Is this something IAIABC will need to address?

Hello,

   We updated the resolution on Wednesday after the claims meeting, and the latest resolution has cut these options out, partly for the reasons you have specified.  Also there was concern about being a little too close to HIPPA information with the "non-sexed" and "unsex able" options.  Regarding the "not provided" and "not applicable", we thought "Unknown" speaks to both of these options, so we removed the redundancy. 

Jason Kreps wrote:

Sorry I was not able to participate in this working group so I don't have any of the background behind why or how these options where selected. Could someone please explain to me the difference between "non-sexed", "unknown", and "not provided"?  It sounds to me like "non-sexed" and "not provided" are reasons why it is "unknown" - not actually a different value.  Additionally, I'd think a claim handler would have a difficult time distinguishing between these and just pick "unknown" every time. I understand the importance of accurate data but when the difference between options becomes so nuanced it's difficult to tell the difference, you tend to end up getting less accurate data. Also, can you please provide an example or scenario when "not applicable" would the correct option? Thank you.

Sorry I was not able to participate in this working group so I don't have any of the background behind why or how these options where selected. Could someone please explain to me the difference between "non-sexed", "unknown", and "not provided"?  It sounds to me like "non-sexed" and "not provided" are reasons why it is "unknown" - not actually a different value.  Additionally, I'd think a claim handler would have a difficult time distinguishing between these and just pick "unknown" every time. I understand the importance of accurate data but when the difference between options becomes so nuanced it's difficult to tell the difference, you tend to end up getting less accurate data. Also, can you please provide an example or scenario when "not applicable" would the correct option? Thank you.

The final 14-day review period has begun for this IRR and will extend through August 11, 2022. Please respond with any final feedback or objections.

Final Proposed Resolution (see attached).

Just an FYI. X12, which provides the basis for our Medical State Reporting Standard, is considering expanding allowable values to include “Nonbinary,” “Self-reported as Transgender,” “Not provided,” and “Unknown.” Further clarification is being considered to indicate that “Not Provided” should be used when gender cannot be sent due to reporting restrictions and “Unknown” should be used when gender is unknown.

A new work group is being formed to work on this IRR. Please respond to the following poll if you want to participate: https://doodle.com/meeting/participate/id/e9rpjo4a

We agree with Anthony from the NYS Workers' Comp Board. We see a need for this in New York as residents are currently able to use "X" and it has come in internal discussions on how to identify this on claims. 

Vincent Bell
Director of Information Technology & Telecommunications / IT Services
The Black Car Fund | New York Black Car Operators’ Injury Compensation Fund
30 Wall Street, 10th Floor  | New York, NY 10005
212.269.4800 ext. 257
www.nybcf.org

Vincent Bell
Director of Information Technology & Telecommunications / IT Services
The Black Car Fund | New York Black Car Operators’ Injury Compensation Fund
30 Wall Street, 10th Floor  | New York, NY 10005
212.269.4800 ext. 257
www.nybcf.org