Healthcare Product from Payor will Have their Own Policy and Terms & Conditions, with Product Type as Group, Family, or Individual. Product also have many Category, such as Managed Care, Cash Plan, ASO, etc.
Payor always Have Product, Standard Terms & Conditions and Policy of Product are Priority Condition that all of participants must Follow as Basic Policy when do Claims Transaction.
Product Policy could Manage and Setting the Terms & Conditions, and Amounts of Claims Transaction. BPJS Kesehatan have their Own Policy and Terms & Conditions as Known as INACBG's (INDONESIA CASE BASE GROUPS). Surely, the System could Manage this Policy and Terms & Conditions runs Very Well, Smooth, and Efficient.
BPJS Kesehatan have INACBG'S Policy, which have Complex Rules and Limit about Treatment and Medication, they just didn't Noticed yet that XIVA are Exist.