HCX Protocol
v0.9
v0.9
  • Summary*
  • Glossary*
  • Context
  • Introduction to HCX*
  • Technical Specifications
    • Open Protocol
      • Registries*
        • QR Code Specifications*
      • Claims Data Exchange (HCX) Protocol
        • Message Flows*
          • Primary Message Flow
          • Additional Message Flows
            • Redirect
            • Forward
            • Intra Cycle Communication*
              • Seeking Supporting Information
              • Seeking Beneficiary Consent
              • Seeking Account Information
            • Relay
            • Third party Information sharing
          • Notifications
            • Categories
            • List of key topics
        • Message Structure
        • API Specifications*
          • Registry APIs
          • Primary Flow APIs
          • Supporting APIs
          • Notification APIs
        • Error Handling
      • Data Security and Privacy
        • Transport Security
        • Message Security and Integrity
        • API Security*
      • Audit and Reporting
    • Digital Network Policies
  • Domain Specifications
    • Domain Data Models
      • Handling Attachments
      • Handling Processing Errors
    • Terminologies
    • Domain Specific Languages (DSLs)
    • FHIR Implementation Guide*
  • Business Policy Specifications
    • Access Control (Roles)*
    • Guidelines for Participant Onboarding*
      • Sandbox process
      • Production onboarding (Go live)*
      • Potential De-boarding scenarios
    • Guidelines for Grievance Redressal
      • Scope of disputes
      • Involved participants
      • Guideline process for dispute resolution
      • Guidelines for leveraging FTA
      • Next steps
    • Guidelines for SLAs and ecosystem satisfaction
    • Guidelines for Operating charges
    • Guidelines for Beneficiary Authentication by Providers/Payors
    • Guidelines for Event audits
    • Reference Templates
      • HCX - Terms of use
      • Payer-Provider addendum
      • Payer-Policyholder addendum
    • Next steps
  • Use cases*
    • OPD
      • Typical Workflows
        • Cashless
        • Reimbursement
      • Mapping to the HCX protocol
        • Cashless
        • Reimbursement
    • IPD
      • Typical Workflows
        • Cashless
        • Reimbursement
      • Mapping to the HCX protocol
        • Cashless
        • Reimbursement
    • Implementation Considerations
  • Contributing to the protocol
  • Future Focus Areas*
Powered by GitBook
On this page

Was this helpful?

Edit on GitHub
  1. Business Policy Specifications
  2. Guidelines for Participant Onboarding*

Potential De-boarding scenarios

Guidelines on potential deboarding scenarios

This section lists some of the deboarding scenarios that may be considered as part of the final deboarding policies by the HCX operators:

  1. Involuntary deboarding of a participant initiated by Regulator/Legal Authority. Few examples:

    1. Suspension/Deactivation of a provider by the regulator for fraudulent activities.

    2. Suspension/Deactivation of a TPA or a Payer by IRDA

  2. Involuntary de-boarding of a participant (mostly TSPs) initiated by HCX. Few cases:

    1. Serious violation of HCX policies (e.g. grave SLA violation repeatedly)

    2. Hacking attempts made by participants for unauthorized access, after an investigation by HCX

    3. Bad or irresponsible behaviour from participants if it significantly impacts the stability and performance of the HCX (like frequent bursts of requests beyond authorised rate limits).

  3. Voluntary de-boarding of participants. Few examples:

    1. A provider or payer shifting to another HCX

    2. A provider or payer shuts down their business

    3. A provider or payer merges with another entity listed on the exchange

Please note that while the above list suggests a few of the scenarios for potential de-boarding of a participant, this process should be treated with utmost care and an elaborate warning mechanism should be kept in place whenever the de-boarding is not voluntary.

In addition, to provide a fair chance of appeal, the grievance redressal process on HCX is expected to provide grievance mechanisms to handle appeal against de-boarding of a participant.

Potential Next Steps on Guidelines for Participant onboarding

In future there may be further work on:

  1. Inclusion of new type of members on HCX network and their respective verification processes.

  2. Evolution of verification process for currently defined participants

  3. Recommendations on ways to automate and simplify the onboarding process

PreviousProduction onboarding (Go live)*NextGuidelines for Grievance Redressal

Last updated 1 year ago

Was this helpful?