Voting for IRR CLM948 completed on Monday, April 14, 2025. The proposed resolution was APPROVED along with the implementation timeline.

A total of 27 responses were received consisting of 20 Yes Votes, 0 No Votes and 7 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 CLM948 is attached.

The voting period for this IRR has begun and will extend through 4/14/25. A ballot for this IRR was sent to the voting body via email on 3/24/25. 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.

The 14-Day Review period for this IRR has begun and will extend through Friday, March 21, 2025.

Upon completion of this review period, this IRR will move to the Voting phase. 

Attached is the proposed resolution final version.  This IRR will move into 14 day review on March 3, 2025.  

Please review the attached proposed resolution for IRR CLM948.  We will review this proposed resolution in the February Claims Committee call (2/19/2025), but feel free to leave any comments/questions in the community as well.  

Follow-up from our Claims Committee meeting on November 20th, 2024:

There was conversation during the call about a concern with adding MTC AB to DN192 (Benefit Payment Issue Date) because of a comment in the DP Rule of DN195 (Payment Issue Date).  There was a request for us to research what happened with a past IRR where we had to ask for Council approval for changes to DN195.    

In the past:

We worked on IRR CLM901 several years ago where CA and CB were added to DN192.  At that time, we thought we might be adding these MTCs to DN195 (Payment Issue Date) as well and were concerned about this comment in the DP Rule of DN195:

“The Steering Committee/EDI Council directed that Payment Issue Date (DN0195) (and the corresponding Benefit Payment Issue Date DN0192) was established for specified transactions only (IP, AP, PY, RB, SX or any corresponding 02 or CO for those specified Maintenance Type Codes) and that individual weekly check information would not be reported.” 

We went to the Council for approval to consider adding MTCs to DN195.  We were approved to move forward, but as the proposed resolution was constructed, no changes were made to DN195 after all.

Today:

IRR CLM948 is only requesting a change to DN192.  There are no requested changes to DN195 (already double checked with VA just to be sure).  We will moving forward with a proposed resolution as soon as possible, but wanted to make sure the Claims Committee had the background on our research before we proceeded any further. 

Thank you!

Monica