VI. SUBCOMMITTEES/PANELS/TASK GROUPS
Subcommittees/Panels/Task groups will be formed at the
discretion of the NUBC chair with NUBC member approval to deal
with policy issues. Each subcommittee/panel/task group will
have an equal number of payer and provider representatives.
Subcommittee/panel/task group members may include nonNUBC
members. The NUBC chair will appoint the group chair. The
subcommittees will report all recommendations to the NUBC. All
final decisions will be made by the NUBC.
A. Subcommittees
1. Revenue Code Subcommittee
A revenue code subcommittee may be formed if
necessary to review any revenue code change requests
prior to the NUBC meeting or NUBC vote. The
subcommittee through discussion and vote provides
recommendations to the NUBC on each revenue code
request. As necessary, the subcommittee may make
specific revenue code change and/or interpretation
requests. All subcommittee decisions will, however, be
documented in the NUBC meeting minutes.
2. Protocol Subcommittee
This group may be formed and charged with
maintaining the currency, accuracy and reasonableness
of the NUBC protocol manual. This group would be
utilized only as required.
B. Appeals Process Subcommittee
1. Composition will be unbiased and objective
representatives of the NUBC spectrum of members. It
should exclude members who are the direct sponsors of
a change request
- Purpose is to review the request for
reconsideration and to show what affect the
proposed change request will have on institutional
health care billing, remittance, and other related
business requirements.
The subcommittee will be used for consulting
purposes. Additional input will be sought on the
issues brought before the subcommittee for further
consideration and/or an alternative NUBC solution.
C. Task Groups
1. Health Care Institutional Electronic Data
Interchange (EDI) Advisory Task Group
An EDI advisory task group of both institutional
health care providers and payers will be formed in
order to address the need to maintain uniform and
standardized EDI formats and data sets for billing,
remittance, and other related claims processing
applications. Membership will include payer and
provider members of the NUBC, selected SUBCs, and EDI
representatives.
The task group will specifically address only the
EDI issues and instructional EDI implementation
guides. Issues and recommendations will be forwarded
to the NUBC for consideration, deliberation, and
resolution.
The task group will be used for consulting purposes
and should meet prior to any scheduled NUBC meeting.
Members of this panel should be actively involved in
health care EDI claim billing, remittance, and other
related American National Standards Institute (ANSI)
claims processing transaction set mapping and
procedures.
The American Hospital Association will provide
administrative support for this task group.
The Task Group chairperson will maintain direct
communications with all members of this task group.
Task Group Roles and Responsibilities
Review changes to EDI implementation guides
with particular emphasis on the institutional
provider:
Manage the frequency of ANSI X12 Transaction
set data maintenance changes
Ensure the:
-
Consistent use of the NUBC data set, data
elements and related codes between providers
and payers
-
Integrity of the NUBC data element
definition and specifications
-
Consistency between Institutional and
Professional ANSI implementation guides and
tutorials
-
Compatible alignment of NUBC coding table
values to/from matching ANSI X12 coding table
values
-
Preparation and submission of data
maintenance issues and recommendations to the
appropriate ANSI X12N work group
-
Distribute electronic file copies of the
NUBC UB92 Data Element Manual, EMC Version 4
Specifications, the Version 4 EMC/837 matrix,
the 837/EMC Version 4 matrix and ANSI X12N
837/835 national implementation guides
-
Manage the electronic file copy maintenance
and distribution frequency
-
Maintain the EDI Advisory Task Group portion
of the NUBC Operational Protocol Manual
-
Maintain the national unique identifier
tables for patient, provider, payer and employer
codes
-
Interface with Health Care Industry EDI
workgroups, committees, organizations,
associations and government advisory committees
