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Appeals policy catalog

Appeals packet policies

Appeals policies reward contracted packet-readiness operating milestones only. Payment policies remain plan-level Hedera Agent Kit settlement controls before any approved payment leaves the treasury.

Business policies

Business contract policies define appeals packet readiness criteria after a denied prior authorization. Final appeal outcome is excluded from payout.

Business policy
Policy ID
appeals-packet-quality-v1
Plan
Acme Health PPO
Submitter
Lakeside Provider Admin
Eligible request types
Pharmacy Benefit, Outpatient Service
Payout
3 HBAR
Outcome guardrail
No appeal outcome incentive
Active
Business policy
Policy ID
appeals-acme-riverside-packet-quality-v1
Plan
Acme Health PPO
Submitter
Riverside Provider Admin
Eligible request types
Pharmacy Benefit, Outpatient Service
Payout
4 HBAR
Outcome guardrail
No appeal outcome incentive
Active
Business policy
Policy ID
appeals-summit-packet-quality-v1
Plan
Summit Health HMO
Submitter
Lakeside Provider Admin
Eligible request types
Pharmacy Benefit, Outpatient Service
Payout
5 HBAR
Outcome guardrail
No appeal outcome incentive
Active
Business policy
Policy ID
appeals-summit-riverside-packet-quality-v1
Plan
Summit Health HMO
Submitter
Riverside Provider Admin
Eligible request types
Pharmacy Benefit, Outpatient Service
Payout
6 HBAR
Outcome guardrail
No appeal outcome incentive
Active

Payment policies

Payment policies remain plan-level Hedera Agent Kit settlement controls selected from centrally maintained payment policy blocks.

Payment policyAcme Health PPO Agent Kit Settlement PolicyPlan-level settlement controls selected from centrally maintained Hedera Agent Kit policy blocks.
Plan
Acme Health PPO
Token
HBAR
Max payment
7 HBAR
Business attestation
Enabled
Duplicate prevention
Enabled
Envelope integrity
Enabled
Active
Payment policySummit Health HMO Agent Kit Settlement PolicyPlan-level settlement controls selected from centrally maintained Hedera Agent Kit policy blocks.
Plan
Summit Health HMO
Token
HBAR
Max payment
7 HBAR
Business attestation
Enabled
Duplicate prevention
Enabled
Envelope integrity
Enabled
Active