To perform one or more actions on information used for conducting administrative and contractual activities by or on behalf of organizational entities responsible for delivery of an individual\'s benefits in a healthcare program, health plan or insurance. Explicitly excludes the use of information to organize the delivery of health care for care coordination and case management, or to provide healthcare treatment.
Usage Note:Examples of activities conducted under this purpose of use: provider profiling, risk adjustment, underwriting, fraud and abuse, quality improvement population health and care management. Aligns with HIPAA Operation POU minus coordination of care or other treatment related activities. Similar to the description in SAMHSA Confidentiality of Substance Use Disorder Patient Records Supplemental notice of proposed rulemaking.Map:Maps to ISO 14265 Classification Term \'Administration of care for an individual subject of care\' described as \'To inform persons or processes responsible for enabling the availability of resources or funding or permissions for providing health care services to the subject of care.\'However, this classification term is described as activities, i.e., \'to inform persons\' or \'to inform processes\' rather than the rationale for performing actions/operations on information related to the activity.
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