1. Process
1.1. Referral Process ( Ellgibility )
1.1.1. Enternal Refarrel
1.1.2. External Refarrel
1.2. Claims Process
1.3. Treatment Plan
1.4. Transportation Plan
1.5. Return To MOH Hospitals
1.6. Reconsilation Process
1.7. Process Governence
1.7.1. Authority Matrix
1.7.2. SLAs
1.7.3. OLAs
1.8. Payment Process
1.8.1. Calims Payment
1.8.1.1. Enternal claims
1.8.1.2. External Claims
1.8.1.3. Reconsilation
1.8.2. Tickets
1.8.3. Miscellanies
2. Data
2.1. Overspill Data
2.1.1. Referrals
2.1.2. Approvals
2.1.3. Claims
2.2. Beneficiaries Data
2.2.1. Medical Data
2.2.2. Non-Medical Data
2.3. Provider Data
2.3.1. Enternal Providers
2.3.2. Externals providers
2.4. Historical Data
2.4.1. Archived Documents
2.4.2. Transaction History
2.5. Data Processign
2.5.1. Data modilling & Analysis
2.5.2. Data Management & Governance
2.5.3. Data Storage
2.5.4. Data Integration
2.5.5. BI & Reporting
2.5.5.1. daily
2.5.5.2. Weekly
2.5.5.3. Monthly
2.5.5.4. Quraterly
3. Budget
3.1. Plan Budget
3.2. Approved Budget
3.3. Budget Flow
3.4. Budget Management
4. Providers
4.1. Enternal Providers
4.1.1. Private Sector
4.1.2. OGS
4.2. External Providers
4.3. Communication With Providers
5. Beneficiaries
5.1. Commuincation With Beneficiaries
5.1.1. Complains
5.1.2. Appeals
5.1.3. Inquaries
5.2. Notification for refarrel status
6. Technologies & System
6.1. Enternal - CNHI systems
6.1.1. CNHI - ERP
6.2. Externals systems
6.2.1. ETEMAD
6.2.2. MOH - MAWARD
6.2.3. Claims Systems
6.3. Future Systems
6.3.1. XRM
6.3.2. Communication Channels
6.3.2.1. social media
6.3.2.2. Whatsapp
6.3.2.3. SMS