DRG_Registration_Form 20140826 shortened

Data Release
Governance
Program, Process, SharePoint
Registration Site and Form
7/28/2014

Data Release Governance Guide for Requesters
© Copy right 2014, UnitedHealth Group. All Rights Reserv ed. 3
Table of Contents
Introduction...............................................................................................................................5
Why Do We Need DRG?.......................................................................................................5
Data Release Governance Program.......................................................................................6
Data Release Governance Process .......................................................................................3
Data Release Governance Process Diagram..........................................................................3
Getting Started .........................................................................................................................3
Data Release Business Process Documentation.....................................................................3
Vendors ...............................................................................................................................3
Prerequisites.............................................................................................................................4
Coursework ..........................................................................................................................4
Applying in Secure................................................................................................................4
Navigating to the DRG Registration Form...............................................................................5
Working with the Registration Form .......................................................................................9
Form Completion—Part 1: General.............................................................................................12
Load....................................................................................................................................13
.........................................................................................................................................13
Contact Information...............................................................................................................14
Requesting Source ...............................................................................................................14
Registration Details ..............................................................................................................15
Business Process-specific Fields...........................................................................................16
General Registration Details..................................................................................................19
Data Source.........................................................................................................................Error!
Bookmark not defined.
Process Controls ..................................................................................................................Error!
Form Completion—Part 2: External Entities................................................................................Error!
Vendor.................................................................................................................................Error!
Target Audience ...................................................................................................................Error!
Business Segment................................................................................................................Error!
Form Completion—Part 3: Submit..............................................................................................Error!
Risk Identification..................................................................................................................Error!
Other Registration Functions .....................................................................................................Error!
Approving a Registered Release............................................................................................Error!

DRG Registration Guide
Finding a Request ................................................................................................................Error!
Finding (via Report) and Reviewing a Registration ..................................................................Error!
Putting a Registration on Hold ...............................................................................................Error!
Recertifying a Data Release..................................................................................................Error!
Retiring a Registration...........................................................................................................Error!
Sending a Message..............................................................................................................Error!
Verifying an Ad Hoc Release.................................................................................................Error!
Withdrawing a Registration....................................................................................................Error!
Appendices...............................................................................................................................Error!
Appendix X: Policy 13...........................................................................................................Error!
Appendix X: Role Checklists .................................................................................................Error!
Appendix X: Business Process Documentation Template, Directions, and Sample...................Error!
Appendix X: Adding or Removing a Vendor ............................................................................Error!
Appendix X: DRG Registration of Non-integrated UnitedHealth Group Entities (M&As) Releasing
Protected Information ............................................................................................................Error!
Appendix X: Reporting ..........................................................................................................Error!
Appendix X: Glossary ...........................................................................................................Error!

Introduction
The purpose of this guide is to provide users of the Data Release Governance (DRG) with knowledge of:
 The DRG program
 The DRG process including required roles
 Detailed tasks by role
 The SharePoint DRG Registration site
 The DRG Registration Form
 A field-by-field description of the data that needs to be entered into the three-part form
 Common online tasks around the registration after it is submitted
Several appendices contain additional information.
Why Do We Need DRG?
UnitedHealth Group’s constituents rely on us to protect members’ private information, and laws
require this of us as well. Our company has put in place Information Security Policy 13 (see Appendix
X for a link to the policy) to provide guidance for employees around this crucial responsibility. The
Data Release Governance program comes from Policy 13.
We need data release governance because:
 It’s About Trust. In serving our customers, we send out millions of mailings and files with
protected or confidential customer data each year. Our customers and stockholders expect and
deserve 100% accuracy and quality in support of our trusted relationship. The current transmission
or mailing of customer or member data is a complex process with lots of variability. When not the
process is improperly followed, this could result in protected or confidential information being
improperly dispersed.
 It’s About Vigilance. While the most pressing reason for this urgency is our desire to retain the
hard-earned confidence of those we serve, there are other reasons:
o Recent legislation increases the risk of monetary penalties of up to $1.5 million for any
disclosure that improperly includes protected or confidential customer information.
o Such a mishap may also require us to identify the breach on a national website and notify the
media, tarnishing our market reputation.
o Continued vigilance and building trust are key components to our future, the retention of
customers, and growth of new business.
 It’s About Protection. The Data Release Governance Program supports our goal for a vigilant
culture. The program’s purpose to eliminate or reduce and mitigate the risk and exposure of data
breaches. Eliminating or reducing risk will enhance the protection of information we own or
maintain through the implementation of an enterprise-wide process.
The next several pages explain the DRG program and process.

Data Release Governance Program
The DRG program is designed to reduce the risk of data exposure or data breaches as information is
sent outside UnitedHealth Group. The program also aims to limit the amount of information released
(specifically Protected Health Information) to the minimum required to meet business needs.
As part of the program, a process and tool have been created to register Protected Information sent
outside of the organization. Registration for a recurring release of data requires that quality and
security measures be documented and utilized within a business group and segment. Such measures
are intended to ensure that Protected Information stays protected before, during, and after it is
released.
Data protection includes close examination of business processes that send individual member data
outside of UnitedHealth Group. Examples include EOBs or credit card statements. Refer to the Data
Elements Chart to determine if the data you are sending outside of UnitedHealth Group meets the
criteria requiring registration.
Registrations for data releases come in two major types: Ad Hoc (one time) or Business Process
(recurring).
 Ad Hoc is a one-time method of creating and delivering information. Such data goes to an external
entity for a specific business reason using an approved delivery method. An Ad Hoc registration
does not require a documented business process.
 Each Business Process registration requires a documented functional and repeatable business
segment or group process. The documented process shows how Protected Information is
processed and securely delivered to a specific vendor(s) or target audience(s) to fulfill a business
need. Such a release is either regularly scheduled or released on-demand.
Reasons for Registration
Registering Protected Information for a data release must occur when:
 Releasing data to an external entity, such as a:
o Customer
o Employer
o Member
o Provider
o Regulatory Body
o Vendor
 Releasing data internally to:
o UnitedHealth Group business segments
o Mergers & Acquisitions (acquired entities)
 Registering an Ad Hoc (one time) or Business Process release that matches data types in the
Data Elements Chart

Data Release Governance Process
The DRG process is designed to prevent Protected Information from being exposed or misused in
any way. If there is potential for this, a release may be deemed high risk.
A high risk release has the potential for data exposure or a data breach if sent outside the
organization. This could compromise the Protected Information of UnitedHealth Group’s members.
A diagram showing the DRG process appears later in this document. Become familiar with the
process and the roles within the DRG process.
DRG Roles
The DRG process calls for several different roles (see the Prerequisites section for certification
requirements for the first four roles):
 Submitter: An individual authorized by the business group to submit DRG registrations on
behalf of someone within the group. The Submitter is responsible for working with the person
requesting the release to collect appropriate information and complete registration tasks.
 Approver: An individual authorized by the business group to ensure the DRG registration is
business-appropriate and meets applicable legal, regulatory, and business requirements
before approving the release of data to an external party. In the event of uncertainty, the
Approver should contact their segment or UnitedHealth Group Privacy Office for guidance.
 Information Owner: An individual authorized by the business group to review the data
produced for the release for quality and integrity and to verify that it meets necessary
requirements.
 Reviewer: An individual authorized by the business group to ensure the DRG registration
meets minimum necessary requirements, applicable legal, regulatory, and business
requirements as well as applicable Privacy and Information Security policies. In the event of
uncertainty, the Reviewer should contact their segment or UnitedHealth Group Privacy Office
for assistance.
 Extract Team: The team responsible for developing the extract of data in whatever form it is
being requested.
 Distributor: An internal UHG group or individual through which information is sent to an
external entity.
 Requesting Source: The individual from a Business Group who has identified a business
need for releasing information (mailing, welcome kit, etc.) to a recipient.
To familiarize yourself with duties required by the DRG process, review the checklist associated with
the role you will fill. Each role’s checklist first defines the role and then lays out required tasks. See
Appendix for role checklists.

The DRG Process
The DRG process works like this:
1. The Requesting Source communicates to a Certified Submitter the need to release Protected
Information outside their group.
2. The Submitter creates and submits a registration for the data release.
a. If the data release is supposed to go to a vendor, the vendor must be on the
UnitedHealth Group’s approved DRG Vendor List.
i. If it is not on the list, the vendor must complete the SAR process/security review.
ii. If the vendor passes the review, the Submitter may proceed with the registration.
iii. If the vendor does not pass the security review, data cannot be released.
b. If it is a one-time request (Ad Hoc), a data extract is created, based on business
requirements. At this point, the Submitter sends a request for verification to the
Information Owner and Certified Reviewer who determine whether the release is high
risk.
c. If it is a Business Process registration, it goes directly to the Approver.
3. A Certified Approver performs a comprehensive analysis of the registration.
a. If the registration is for a vendor and the vendor is already approved and on the list, the
Approver then validates the business need. They also inspect and follow up on the
attached business process. They do this to ensure the data is the minimum required,
accurate, will be delivered safely, and follows regulations.
b. If the registration is for a Business Process release, the Approver receives a verification
form and scrutinizes the registration’s potential as a high-risk release.
4. If it is a high-risk release, the Approver contacts the business segment’s Certified Information
Owner and Certified Reviewer for a compliance review.
5. The Information Owner and Reviewer discuss the registration request.
a. The Reviewer assesses the request to ensure that the high-risk release serves a valid
business need and that the release meets policy and compliance requirements.
b. The Information Owner then checks to see that the registration meets business
requirements.
c. If the registration complies with both requirements, it can be approved.
d. If it does not meet one or both requirements, the registration must be rejected.
6. The Information Owner and Reviewer communicate their decision to the Approver.
7. For an Ad Hoc request, the Approver ensures that data verification is performed and submits
a Verification Form.
8. The Approver either approves or rejects the registration.
a. If the request does not meet valid a business need or requirements, the Approver rejects
the registration.

b. If they find that a registration is not high risk, or the Information Owner and Reviewer
have reviewed and support the registration, and it meets a valid business need, the
Approver approves the registration.
9. The Submitter facilitates the execution of approved data releases:
a. First, the Submitter confirms with the Requesting Source that the release should be
released as registered.
b. For Business Process registrations, a Distributor releases the data to the third party: a
vendor, a target audience or another business segment within UnitedHealth Group.
c. For Ad Hoc registrations, an Extract Team uses an existing fulfillment request process to
produce and release the data.
The next page shows a diagram of this process.

Data Release Governance Process Diagram
Placeholder for Updated Swimlane Diagram

Data Release Governance Guide
Getting Started
Like any business effort around a release of critical, sensitive information, your business segment/group
must perform due diligence before any data can be released.
Before considering a data release, ensure that these two essential tasks are completed:
 A repeatable business process for recurring data releases is fully documented
 All vendors to receive data are on the approved DRG Vendor List
Data Release Business Process Documentation
Before your organization may release data, it must provide proof that its process ensures the data’s
safety, quality, and accuracy. Such proof means that documents must be available showing the steps
taken to protect and verify quality and protection of the data released.
A detailed explanation of requirements and expectations around a fully documented and repeatable
business process is in Appendix. Materials in that appendix include a business process
documentation template, directions, and a sample.
Prior to registering for a data release, the following must be documented:
1. Business process
2. Training records or description
3. Business risk evaluations
4. Quality reviews
Vendors
Any vendor intended to receive a UnitedHealth Group data release must have completed a risk
assessment and been added to the approved DRG Vendor list.
If a vendor has not completed a risk assessment, its name will not be available within the DRG
Registration Form for selection.
To see if a vendor is approved, check the Vendor List on your intranet’s DRG Home page.
See Appendix for complete instructions for adding a vendor.

Prerequisites
While the Getting Started tasks are being completed (if not already), you can complete two required role-
oriented tasks:
 Become certified for a role: Before you can assume DRG registration duties, you must complete two
tasks.
 Obtain role-holder security; you must have proper security access to get into the DRG tool
(dashboard and registration form).
Coursework
To qualify for a role, you must first:
1. Complete the two CBTs, Data Release Governance Overview and Data Release Governance
Roles and Responsibilities, found on LearnSource.
2. Pass the test that accompanies the CBTs.
Applying in Secure
You must have role-holder security assigned to access the DRG tool.
To request DRG role-holder security:
1. Access the Secure website at https://secure.uhc.com/.
2. From the left navigation pane under My Access, select Request New Access and complete the
form.
You may also change or remove DRG role-holder access in Secure.

Navigating to the DRG Registration Form
After completing business process documentation, adding needed vendors, getting certified and
security access, you are ready to complete your first registration.
To do so, you must know how to:
1. Navigate to the DRG Home page.
2. Access the SharePoint DRG Registration site.
Navigating to the DRG Home Page
The SharePoint DRG Registration site is where to view and work with DRG registrations and
perform duties assigned to your role.
To navigate to the SharePoint DRG Registration site:
1. Go to Frontier or any UnitedHealth Group Intranet Home page.
2. On the right side of the page under Important Links > Resources & Support, find and select
the link, Data Release Governance (DRG). The DRG Home page is displayed.
3. Click the Data Release Registration Form link. The SharePoint DRG Registration site is
displayed.

Working in the SharePoint DRG Registration Site
The SharePoint DRG Registration site contains three important sections:
 Home tab
 Left navigation pane
 DRG dashboard, which shows registrations that you have either created or require your
attention, depending on your role.
Home tab: Click this tab to return to the dashboard from anywhere within the site. It is available
on every view and form within the site.
Left navigation pane: The left navigation pane also stays in place regardless of the form or view
displaying within the SharePoint site. It contains several links to views and forms.
Dashboard
Left
navigation
pane
Home tab

Pages
The Pages area offers a variety of links to forms and views.
The New Registration link opens a new, unpopulated DRG Registration Form.
The Request Search link is displayed in a new page with a search field and buttons.
The Dashboard link is re-displayed the SharePoint Home page from anywhere within the
site.
Clicking the Recycle Bin link allows you to view any discarded registrations.

Dashboard
This section of the DRG SharePoint site allows you to work with registrations as defined by your
role.
It contains the following sections:
 My Draft Registrations: View registrations that are not yet submitted
 Draft Registrations for which I am the Backup Submitter: View registrations for which you
have been named Backup Submitter
 My Submitted Registrations: View or withdraw registrations that you have submitted
 Review Registrations: Shows the queue of Business Process registrations awaiting your
review for approval or rejection
 Ad Hoc Registrations: Shows the list of Ad Hoc registrations for your review and approval or
rejection

Working with the Registration Form
Form completion is covered in the next three sections, each corresponding to the three parts of the
form. Functionality around other DRG tasks is fully explained after Form Completion—Part 3.
Several actions may be completed with a DRG Registration Form, depending on the role you are
certified for.
Note: A registration ID is not assigned until after a completed registration is submitted.
Required Action Purpose Starting Point
Access a new
registration
Complete a brand new DRG
Registration Form
Select the Create a new DRG
Registration or Recertify a
previous Registration link
under Pages in left navigation
pane on the DRG SharePoint
site
Edit an existing
registration
Make changes to a registration that
has not yet been submitted
Select the Request Search
link (left navigation pane) on
the DRG SharePoint site and
search for the desired request
(for example: by ID number or
the name you created for the
registration) OR click the Edit
link under My Draft
Registrations
Load an existing
registration
Clone an existing registration to
create one similar
The top field (Load) of any
open form
Review a release
(Approver)
Assess the risk, business need an
business process behind a data
release registration
DRG dashboard under the
Review Registrations section
Re-certify a
registration
(Submitter)
Renew an existing request for the
coming year or an alternate option to
link and retire.
Load section (top of form) in
any new or existing form OR
Submit (Part 3 of the form
Search for a
registration
Find a registration to edit, review,
verify, recertify or withdraw it
DRG Registration Search link
from SharePoint DRG
Registration page
Verify a registration
(Approver)
Review to verify the success of an
Ad Hoc release
Access this form on the DRG
Home page, immediately
under the DRG Registration
form link
Withdraw a
registration
(Submitter)
Cancel the request and dispose of
existing form. A registration can be
withdrawn as long as it has not been
approved. If approved, must retire
instead
Click the Withdraw link under
My Submitted Registrations on
the dashboard.

Common Field Types and Functions
 Button: Clicking one initiates the action displayed on the button.
 Text or numeric field: Accepts keyed or copy/pasted entry. It requires that
you click inside the field to place the cursor before typing. Character length may range from 100
(one row text fields) to 250 (large description fields).
Text fields on narrow rows are easy to overlook. If you neglect to add entry to a required text
field, you will not be allowed to submit the registration. Review all entry on Part 1 of the form,
especially before continuing to the next page.
 Check Names icon: Assesses the entry to see if it matches any name record. For data to
be recovered, the person’s entire name--last, first, and middle initial--must be typed exactly as it
is in the record. Spelling errors, typing issues, or no record existing returns the message: No
exact match was found.
 Browse icon: Displays a dialog box for you to:
1. In the Find field, click and key a portion of a person’s name.
2. Pressing Enter or clicking the magnifying glass icon engages the search.
3. Records closely matching the supplied text display below the Find field.
4. Double-click on the desired name OR single-click it and click the OK button to populate the
text field

 People Picker: Contains a text field, Check Names, and Browse
icons.
 Radio button: Accepts only one selection.
 Checkbox: Accepts more than one selection. Click as many as fit your needs.
 Scrollable field: May accept text explanations or contain checkbox fields. For this checkbox field
type, scroll to the end to review all choices.
 Drop-down list: Upon clicking the down arrow, it displays a list of options
to select from. Clicking the option populates the field.
 Table and Button:
Click the button to initiate a series of actions to be completed in new fields that are displayed below.
When clicking a Finish or Save… button after completing the added fields, the form reconfigures to
the original display, showing a row populated with your entry.
 Actions links: Usually are displayed inside an Action column. They allow the
registration to be used or altered in some way. Common links include Edit, Copy, Delete, View, and
Withdraw.
The fields described below begin at the top of the form and end with the buttons at the end of Part 1 of
the form.

Form Completion—Part 1: General
The DRG Registration Form contains a set of standard questions and fields for responses. The form has
three parts: General, External Entities, and Submit.
Part 1 of the form contains the following sections:
 Load Registration
 Contact Information
 Requesting Source
 Registration Details
 General Registration Details
 Data Source
 Processing Controls
The fields in the DRG Registration Form are documented as follows:
 A screen capture of the fields documented is displayed on the page.
 Each field is explained separately in this format:
o Field or question text in boldfaced type
o Purpose with whether the field is Required, Optional, Autofill, or Conditionally Required. A
Conditionally Required field means that if the form reconfigures to display the field, you must
complete it.
o Procedure steps or options listing, depending on what is relevant. This includes a full explanation
of how the interface works or what the option means as well as the implications of selecting the
option.
o Note: any additional relevant information
o Troubleshoot: what to do if your selection negatively does not allow you to submit the form or
other common problems.
If the field does not require some of the information above, it will be omitted.

Load
Purpose: Optional. Use this part of the form when to work with a previously submitted or approved
registration. You may use this section to:
 Clone an existing registration to create a new one similar to it
 Look up a current registration to recertify or link it to another one for tracking or reference
purposes
 Find a registration to retire it
Procedure:
1. Click in the Registration ID field and key the desired registration’s assigned number. If you
don’t know the registration number, return to the DRG Dashboard to find it.
2. If needed, click in the Year and Version number fields to record these details for reference or
continuity purposes. Scenario: This is the fourth version of this specific registration we
created in 2014. So, you would key “14” and “4” in the fields.
3. Click the Load Registration button. This engages the search engine.
Note: A registration is not assigned a registration ID until it has been successfully submitted.
Troubleshoot:
 Check the DRG Dashboard to see if the desired registration is in My Draft Registrations or My
Submitted Registrations. If you recorded the registration ID of a withdrawn registration, you may
search using that.
 Check the number you entered to see if you keyed it accurately.

Contact Information
Submitter
Purpose: Autofill. Shows who created the registration. The fields include: the Submitter’s name,
system user ID, MS ID: identifies an active user within UnitedHealth Group’s environment, cube
location, external email address, business segment, division, and manager’s name.
Select Backup to the Submitter
Purpose: Optional. Select the person whom to contact if you are unavailable.
Procedure:
1. Use the People Picker to find the individual and select them.
2. The selection autofills all the fields. See Submitter above for a description of the fields’
contents.
Requesting Source
Purpose: Required. Indicate the person who alerted you to the business need for releasing data.
Procedure:
1. Use the People Picker to find the individual and select them.
2. The selection autofills all the fields. See Submitter above for a description of the fields’
contents.

Registration Details
This section is where you supply the high level details for the data release. This is also where you
specify whether the registration is for an Ad Hoc (one time) or Business Process (recurring) data
release.
Enter the name of this Registration:
Purpose: Required. Give the registration a name that it can be referred to by. Example: Cancer
Research for CDC.
Procedure: Click in the field and key the name or title for the registration and subsequent data
release.
Registration Summary:
Purpose: Required. Enter a complete description of the registered data release, its purpose and
intent. Example: Delivering records as mandated by the government to the CDC for yearly
statistical analysis and compilation.
Procedure: Click in the field and key the summary.
Is this a one time/Ad Hoc release?
Purpose: Required. Identifies whether the release is a one-time occurrence or if it will recur
periodically.
Options:
 Yes: This is an Ad Hoc release; continue to the General Registration section below it.
 No: The form reconfigures. Several Business Process-specific fields display below this field.
Those fields will be described next.
 Before attempting to register for a Business Process release, certain requirements must be
met. Example: Having a fully documented and repeatable segment/group business process
for the release, having quality reviews and training in place for stakeholders, ensuring that the
process is followed completely and consistently, etc. See the Getting Started section at the
beginning of this guide for a complete list of requirements.
Note: In the subsequent fields, if a selection made is counter to the requirements for a Business
Process data release, the form will reconfigure and present an Ad Hoc Information agreement.

Business Process-specific Fields
Is your Business Process fully documented (process and/or procedures, workflow, etc.)?
Purpose: Required. Ascertain whether the steps leading up to and surrounding the data release
has been thought through and captured for posterity. A recurring release requires this.
Options:
 Yes: Your business has completed an essential requirement for releasing data. You may
continue to the next field.
 No: The form displays an Ad Hoc Information field with a disclaimer. The reasoning behind this
is that unless the release is required for a repeatable fully documented business need, it is a
one-time only request. You will be presented fields for an Ad Hoc data release in the rest of
the form.
Ad Hoc Information Agreement
Purpose: Conditionally Required. Only is displayed if your selection(s) within the Business
Process field(s) indicate(s) that your registration does not fit the requirements for a recurring
release. It requires a changed approach to the current registration, given your current selections
or that you change your selections.
Options:
 I Agree: This allows you to continue registering the data release to the General Registration
Details section. It means the data will be released only one time.
 Cancel: This causes the Ad Hoc Information field to go away, allowing you to alter your
selection(s) in the previous field(s). This means that due diligence will be performed on the
data (it has a fully documented repeatable process) within the business segment and that it is
being released for the same reason each time.
Troubleshoot: If your data release must be registered as a recurring event, you have two
options:
 Your business group/segment must document its process before registering for the data
release. See Getting Started for a list of business process documentation requirements.
 Request a one-time release for this single event, then ensure the process is documented and
re-register for a Business Process/recurring release before the next time the data needs to go
out.

Additional Business Process-specific Fields
A link to your Business Process documentation is required.
Purpose: Required. Allows your designated Approver to peruse the business process. They
must see if has included all requirements to ensure data accuracy, safety and quality. See
Getting Started for a list of business process documentation requirements.
Procedure: Click in the field and either key the path, URL, etc. or copy/paste it into the field.
Note: Please be sure that the Approver you designate later in the form has access to this drive,
SharePoint site path, or other website.
Is the documented process followed?
Purpose: Required. Allows your designated Approver to assess the documented process.
Options:
 All of the Time: Means that the process is always following, showing a dedication to quality,
etc.
 Some of the Time: Shows that the process is followed intermittently, putting the data at risk.
You will not be allowed to submit the registration because it is a control risk. Selecting this
option displays an alert: You may not continue.
 Rarely or Never: Means that currently data safety and quality is lacking. You will not be
allowed to submit the registration because it is a control risk. Selecting this option displays an
alert: You may not continue.
What best describes the action taken within the process from start to finish?
Purpose: Required. Allows the Approver insight into how the data for the release is processed
within the requesting business segment.
Options:
 Manual: All processing is done by an employee(s)
 Fully Automated: All data collation, testing, and quality checking is done behind the scenes
through computer processes.
 Mixed: Some of the work is done via computers and some is done by hand. Example: an
employee downloads data from an existing report into Excel and removes unnecessary data.
Will this process be used to release data for the same business purpose every time?
Purpose: Required. Used by the Approver to understand if the reason for the release changes
from time to time.
Options:

 Yes: The consistency and purpose of the data released is assured. No negative implications
apply.
 No: The form displayed an Ad Hoc Information field with a disclaimer. The reasoning behind
this is that when the business reason behind release changes, it is a one-time only request.
You will be presented an Ad Hoc Information agreement. See B on the previous page.

General Registration Details
This section records the business reason behind the release as well as Approver and Reviewer role
holders and the UnitedHealth Group business areas releasing the data.
Provide the business justification for the data release:
Purpose: Required. Describe why the data is being released and how this supports your
organization’s business goals.
Procedure: Use the text field to key in the valid business reason behind registering this release
of protected data. Example: Due to contractual obligations the members will receive EOBs on a
quarterly basis.
Select the type of Registration:
Purpose: Required. Identifies the general kind of business activity that is driving the data release
for this registration.
Options:
Option Definition
Audit The records of activity that involves checking existing work against
requirements like laws, regulations, policy, standards, best practices,
etc.
Case Management The records around members’ treatment plan and outcomes
Claims The records of the costs of care submitted by a provider or patient to a
health insurance organization.
Clinical The techniques and approaches utilized in treating health conditions
Customer Mailing Member logistical information like name, address, city, state, and zip
code, or email address
Disease Management The process of coordinating communications and healthcare
interventions for populations with illnesses for which self-care is
important.
Eligibility Ability of individuals to meet requirements for coverage.
Enrollment The process of covered individuals making decisions about the
healthcare plans they desire.
Exchange The marketplace set up to facilitate the purchase of health insurance
Financial The accounting and costs around healthcare and how they’re handled
Health Information Data about members and their physical and mental condition(s)
Human Resources The efforts practiced by a company to support its workforce and their
needs
Legal The issues, practices, and situations involving lawful and unlawful
application of healthcare and its payment/funding.
Marketing/Sales Information used to promote the services and products of the company

Option Definition
Member Services The activity around responding and caring for the individuals covered
by our policies
Other An activity not defined in any of the listed options
Provider Network A group of professionals or institutions joined together to offer
healthcare services
Regulatory Compliance with federal, state, and local healthcare rules and
requirements
Utilization Appropriateness, necessity, and quality of healthcare services
Vendor Service The activity around managing vendor relationships
Wellness Prevention of disease for prolonging of life.
If you select Other, the form reconfigures to display a text field below the Describe your
Registration type field
Describe your Registration type:
Purpose: Conditionally Required. Provide a description or explanation for the business activity
that calls for the release of protected data.
Procedure: Click in the field and key the text that describes the activity

These General Details fields reconfigure after the Business Segment and Business Group
fields are populated. This causes the drop-down fields to display only those options
relevant to the business segment and group selected.
Which Business Segment is responsible to the recipient for this data release?
Purpose: Required. Identifies the organization within UnitedHealth Group that initiated the data
release. This overall group is responsible for the due diligence required for releasing the
registered data.
Procedure: Select the overall organization from which the request for a data release is coming.
Troubleshoot: If you don’t see the specific organization’s name, it could be that you are
representing and acting on behalf of an entity considered an M&A organization. Select your
organization as the Business Segment acting on their behalf. See Appendix for more information
on M & As and the DRG registration process.
Which Business Group is responsible for this data release?
Purpose: Required. The subgroup within the business segment initiating and providing oversight
of the data release registered for.
Options: Only those functional areas within the previously selected business segment will
display.
Select the Preferred Approver for Your Registration
Purpose: Required. Indicate the name of the individual certified to approve/reject this request for
a data release.
Options: Only the Certified Approvers within the previously selected business segment and
group are displayed.
Troubleshoot: If the individual has not taken the courses and passed the test to become
certified, their name will not display in the drop-down list. However, any individual listed for your
group is qualified to perform the duties.
Select the Preferred Reviewer for Your Registration
Purpose: Required. Select the name of the person certified and positioned to act on and review
this registration from their DRG dashboard.
Options: Only the Certified Reviewers within the previously selected business segment and
group display. They are only required to serve if the release is deemed high risk.
Troubleshoot: If the individual has not taken the courses and passed the test to become
certified, their name will not display in the drop-down list. However, any individual listed for your
group is qualified to perform the duties.

DRG_Registration_Form 20140826 shortened

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