|||
| Players |
| Category |
Applicable |
Narrative |
| Sponsor |
Yes |
|
| Provider |
Yes |
|
| Vendor |
No |
|
| Supplier |
No |
|
| Pharmacy |
Yes |
|
| Payer |
No |
|
| Patient |
Yes |
|
| Claims Processing |
Yes |
|
| Marketing |
No |
|
| Agent |
No |
|
| Organized Crime |
No |
|
| Players |
Yes |
|
|||
| Standards |
| Category |
Applicable |
Narrative |
| Public Policy |
No |
|
| Relevant Certifications |
Yes |
|
| Market Standards |
Yes |
|
| Professional Services |
Yes |
|
| Public Health Data |
Yes |
|
| Autonomy Standards |
No |
|
| Data Repositories |
Yes |
|
| Data Intelligence Metrics |
Yes |
|
| Data Analytics |
Yes |
|
| Information Network Standards |
No |
|
| Standards Conclusion |
Yes |
|
|||
| Information Flow |
| Category |
Applicable |
Narrative |
| Data Input |
Yes |
|
| Data Processing |
Yes |
|
| Service Industry Support |
Yes |
|
| Data Output |
Yes |
|
| Information Flow Conclusion |
Yes |
|
|||
| Damages / Impact |
| Category |
Applicable |
Narrative |
| Damages due to Service, Medical and Financial errors |
Yes |
|
| Damages due to Economic business benefit and/or loss |
Yes |
|
| Damages due to Serviceability and service integrity |
Yes |
|
| Damages due to Human integrity - disability to loss of life |
Yes |
|
| Damages / Impact Conclusion |
No |
|
|||
| Disclosures |
| Category |
Applicable |
Narrative |
| Disclosures - Patient |
Yes |
|
| Disclosures - Provider |
Yes |
|
| Disclosures - Plan Sponsor |
Yes |
|
| Disclosures - Payer |
No |
|
| Disclosures - Criminal |
No |
|
| Disclosures - Vendor |
No |
|
| Disclosures - Other |
|
|
| Disclosures Conclusion |
Yes |
|
|||
| Rules & Regulations |
| Category |
Applicable |
Narrative |
| Rules - General Principles and Market Standards |
Yes |
|
| Rules - Government Agency |
Yes |
|
| Rules - Agency Code of Regulation |
Yes |
|
| Rules - Fraud Management Program |
Yes |
|
| Rules - Legal Statutes, Case Law, Legislation |
Yes |
|
| Rules & Regulations Conclusion |
Yes |
|
| |
