What are health care operation activities?
Health care operation activities include-but are not limited to-credentialing, business planning and development, quality assessment and improvement, premium rating, enrollment, underwriting, claims processing, customer service, medical management, fraud and abuse detection, obtaining legal and auditing services, and business management. Making members aware of these health care options as well as other treatment alternatives or other health-related benefits and services that may interest the member, are examples of Guardian’s permitted use of protected health information (PHI).
Related Questions
- Staff cost. In the calculation of the hourly rate of each in-house personnel performing operation activities directly employed by the beneficiary the Italian tax IRAP must be excluded?
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