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v� <br />processing; <br />vii. <br />Billing and collection activities related to health care data <br />Obtaining payment under a contract for reinsurance <br />including stop-loss and excess of loss insurance; <br />viii. Claims management and related health care data processing <br />including auditing payments, investigating and resolving payment <br />disputes, and responding to participant inquires regarding payment; <br />ix. Medical necessity reviews or reviews of appropriateness of <br />care or justification of charges; <br />x. Utilization review, including precertification, <br />preauthorization, concurrent review, and retrospective review; <br />xi. Disclosure to consumer reporting agencies related to the <br />collection of premiums or reimbursement. The following protected health <br />information (PHI) may be disclosed for payment purposes: date of birth, <br />Social Security Number (except where prohibited by state law), payment <br />history, account number and name, and address of the health care provider <br />or health plan; <br />xii. Reimbursement to the plan. <br />Health care operations include, but are not limited to the following: <br />i. Quality assessment; <br />ii. Population-based activities relating to improving health <br />care or reducing health care costs, protocol development, case <br />management and care coordination, disease management, contacting <br />6 City of Roseville MPD <br />