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The regs involving broken arrow are the following: United States Department of Defense (DoD) directive 5230.16, Nuclear Accident and Incident Public Affairs (PA) Guidance,Chairman Joint Chiefs of Staff Manual (JCSM) 3150.03B Joint Reporting Structure Event and Incident Reporting, and theUnited States Air Force Operation Reporting System, as set out in Air Force Instruction (AFI) 10-206

Very complicated, inefficient, and ripe for innovation. But hard to improve because there are over 1,000 insurance billing standards in the USA and doctors are largely a cottage industry - most doctors' offices are small independent businesses.A snapshop from https://healthcare.nacha.org/sites/healthcare.nacha.org/files/files/Healthcare-Payments-FINAL1.pdf...The general processing flow as I understand it:1. Patient receives care2a. If patient doesn't have insurance, doctor bills the patient. A very high percentage of post-paid medical care is written off.2b. If patient has insurance, and the doctor accepts it, the doctor collects a co-payment at the time of service.3. Doctor's office staff manually prepare insurance claims in insurance company's proprietary format/coding4. Doctor sends claims directly to each insurance company5. Insurance company processes claims, which rarely results in full payment. Insurers will reject any claims that have technical errors, they will reject any services they deem excessive or out of policy, and they will reduce the allowed payment to what they deem "usual and customary" rates.6. Insurer pays approved claims to doctor via ACH or paper check.7. Insurer sends claim information to the patient and doctor, showing what was paid and what was not.8. Doctor's office staff manually reconcile payments.9. Doctor's office staff re-code and re-submit claims rejected for technical reasons. They may also re-submit claims rejected for policy reasons, with additional detail.10. Steps 5-8 repeat11. Doctor's office bills patient for rejected claims.12. Patient pays (sometimes, when they get around to it) via paper check or credit card.13. Doctors take it on the chin for bad debt.I heard that the average doctor's office employs one person full time just to do payments processing. This means conventional payment processing is costing doctors about $45,000 per year in direct staff costs plus the cost of bad debt.This sounds ripe for re-invention but there are a ton of stakeholders in healthcare payments processing, including:o Providerso Insurance/Claimso Employerso Banks/Financial Institutionso Federal Entities (HHS, Federal Reserve System, Centers for Disease Control,etc.,)o State Level Administration & Regulationo Consumerso Value added Vendors (HIEs, /RHIOs, Health Vaults, Software Vendors, etc.)There are some companies trying to make this all simpler: InstaMed, Sage Payments, First Data, RMS (Revenue Management Solutions), TransEngen, etc.For more information, take a look at these white papers:http://www.ama-assn.org/resources/doc/psa/follow-that-claim.pdfhttp://www.firstdata.com/downloads/thought-leadership/fd_health_care_pymts_wp.pdfhttps://healthcare.nacha.org/sites/healthcare.nacha.org/files/files/Healthcare-Payments-FINAL1.pdfhttp://www.slideshare.net/jonesmith587606/automating-healthcare-payment-and-claims-remittance-processing-systemwares-medical-banking-automation-summit-report

A bank is fundamentally a database - a record of debts to and from the bank. The fundamental function of the bank is to inspect and update that database in a very secure manner. Lots of people want to do this in lots of ways - automatically, manually by bank staff, manually by bank customers. People want checks and reports, all of which must appear seamless to customers. Credit balances must be invested as fast as possible; debtors checked and delinquents flagged up. Fraud detection systems must scan for suspicious transfers without adding a significant delay to transactions. Credit ratings must be maintained, exchanged with other organisations, checked automatically. Traders want screens with information accurate to the last second. And everything must be very, very secure.All of these are software operations. The fact is that most of the things that banks do are software. At the top you have a small amount of management. At the bottom, you have low skilled cashiers and phone - who you endeavour to replace with ATMs. Round the edge are traders who are essentially peripherals, converting information screens into orders.So a bank is mostly composed of software. Which needs to be developed and maintained.