scope-of-disputes.md

description
Envisioned list of disputes whose resolution can be facilitated by HCX

Scope of disputes

Initially envisioned List of Disputes HCX can assist with:

Dispute Category	Type of Dispute	Examples
Delays	TATs related disputes	Delay in submission of supporting documents e.g., hospital bills, discharge summary to the insurer Delay in processing claims Delay in communicating pre-authorization approval/rejections to the customers Delays from HCX Switch Operator
Data Transmission Related	Disputes related to transmission failures (packet drop)Disputes related to transmission data mismatch between origination and receipt	Delay in data transmission Data mismatch Data transmission failure
Data Privacy	Disputes related to data privacy violation by an entity in the HCX ecosystem	Data sharing without consent Data storage which is not in compliance with agreed standards
Policy Related (E.g., Onboarding )	Disputes related to the non compliance of HCX with respect to HCX policies	Examples Onboarding entities not in accordance to HCX policies HCX not agreeing to share data for dispute resolution HCX not in compliance with contractual agreements like fast track arbitration
Enforcement of Data Standards	Disputes related to members of the HCX ecosystem not adhering data transmission standards	Non compliance with agreed data formats

{% hint style="info" %} The list of disputes is not exhaustive and the categories may grow with subsequent iterations {% endhint %}