Payer workflows

The repository contains payer interaction, payer intelligence, policy/evidence, outcome, and revenue-recovery domains.

These workflows can track payer facts and interactions and can support evidence-backed operational work.

Connectivity boundary

A payer profile or interaction record does not prove a live payer API or clearinghouse connection. Any external payer connectivity remains specific to its connector and activation evidence.

Evidence boundary

Payer policy, adjudication, and authorization decisions remain source-backed. When authoritative payer information is unavailable, the relevant fact remains unknown rather than being inferred as an official payer decision.