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Minnesota AUC Administrative Simplification
 

Technical Advisory Groups (TAGs)

AUC Newsletter: November 3, 2016 AUC Newsletter (PDF)

TAGs

Focus-Improving particular administrative transactions/processes

Eligibility

Health care eligibility benefit inquiry and response (270/271)

Claims Data Definition

Health care claims: Professional (837P), Institutional (837I) and Dental (837D)

Pharmacy claim/reversal submission and response (NCPDP D.0)

Medical Code

Common medical coding across payers for the 837P, 837I, and 837D

Explanation of Benefits/ Remittance Advice

Health care claim payment/advice (835)

Acknowledgments

Health care claim acknowledgment (277CA)

Implementation acknowledgment for health care insurance (999)

Interchange acknowledgment segment (TA1)

Prescription Drug Electronic Prior Authorizations

Create a companion guide for electronic prior authorizations (ePA) for prescription drugs.

ACO Data Analytics

Recommend standard formats for exchanging member contact, demographic, and associated responsible provider data as part of data analytics furnished by health plans to providers participating in accountable health models.

Home Health Prior Authorization Form

Review a proposed single, common form for home health care prior authorizations.

Additional TAGs

Focus

Legislative

Monitors state and federal legislative activity, develops AUC-identified legislative proposals, reviews the Administrative Simplification Act for necessary changes/updates

Committees

Focus

Operations

Serves as AUC committee of the whole for oversight, strategy, priorities; reviews and approves AUC work products and recommendations

Executive

Guides and informs Operations Committee, serves as liaison to Minnesota Department of Health and other organizations

 

 
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