Policy & Contract Management Screen Requirements

Screen Inventory

Screen ID	Screen Name	Primary Actor(s)	Workflow(s)	Access Level
SCR-POLICYCONTRACTMGMT-001	Payer Master List	RCM Manager, Contract Manager, Contract Analyst, System Administrator	WF-PCM-001, WF-PCM-006	Users with `view_payer_master` (implicit in manage_payer_master, view_payer_performance, system_config)
SCR-POLICYCONTRACTMGMT-002	Payer Detail / Onboarding	RCM Manager, Contract Manager, System Administrator	WF-PCM-001	Users with `manage_payer_master` or `manage_payer_connectivity`
SCR-POLICYCONTRACTMGMT-003	Contract Management	Contract Manager, Contract Analyst, RCM Manager, Finance Director	WF-PCM-002, WF-PCM-005	Users with `view_contracts` or `view_all_contracts`
SCR-POLICYCONTRACTMGMT-004	Contract Detail / Editor	Contract Manager, RCM Manager, Finance Director	WF-PCM-002, WF-PCM-005	Users with `create_contracts`, `edit_contracts`, `approve_contracts`, or `final_approve_contracts`
SCR-POLICYCONTRACTMGMT-005	Fee Schedule Editor	Fee Schedule Analyst, RCM Manager, Contract Analyst	WF-PCM-003, WF-PCM-005	Users with `create_fee_schedules`, `edit_fee_schedules`, `import_tariffs`, `publish_fee_schedules`
SCR-POLICYCONTRACTMGMT-006	Coverage Rule Builder	Contract Analyst, Utilization Management Lead, RCM Manager	WF-PCM-004	Users with `configure_coverage_rules`, `override_rules`
SCR-POLICYCONTRACTMGMT-007	Payer Performance Dashboard	RCM Manager, Finance Director, Contract Manager	WF-PCM-006	Users with `view_payer_performance`, `payer_performance_dashboards`, `view_financial_reports`
SCR-POLICYCONTRACTMGMT-008	Contract Renewal Alerts	Contract Manager, RCM Manager, Finance Director	WF-PCM-005	Users with `manage_amendments`, `view_contracts`, `view_all_contracts`

Screen Specifications

SCR-POLICYCONTRACTMGMT-001: Payer Master List

Purpose

Central searchable list of all payers/TPAs with quick access to contracts, plans, connectivity status, and performance indicators. Supports payer onboarding (WF-PCM-001) and payer performance monitoring (WF-PCM-006).

Field Specifications

Field	Type	Required	Validation	Default	Notes
Global Search	Text input	No	Min 2 chars to trigger search	Empty	Searches payer name (EN/AR), payer code, TPA name, license numbers
Payer Type Filter	Dropdown	No	Value in (`Government`, `Private`, `Self-pay`, `International`)	All	Maps to `payers.payer_type`
Payer Class Filter	Dropdown	No	Value in configured payer classes	All	Uses master data “Payer Classification Codes”
Network Status Filter	Multi-select	No	Values in (`In-Network`, `Out-of-Network`, `Terminated`)	All	Derived from `payer_networks`
eClaim Status Filter	Multi-select	No	Values in (`Configured`, `Not Configured`, `Error`)	All	Derived from connectivity config
Active Only Toggle	Checkbox	No	—	Checked	Filters `payers.is_active = true`
Payer Name	Column text	—	Max 200 chars	—	Shows EN with AR in smaller text below
Payer Type	Column text	—	—	—	Government / Private / etc.
Payer Class	Column text	—	—	—	e.g., THIQA, SAADA, Daman, etc.
Active Contracts	Column badge	—	Non-negative integer	—	Count of active contracts for this payer
Network Status	Column badge	—	—	—	Highest-tier network status for current facility
eClaim Status	Column badge	—	—	—	Configured / Not Configured / Error
Actions	Column buttons	—	—	—	View Payer, View Contracts, Performance

Validation Messages

Condition	Message	Severity
Search < 2 chars and user presses Enter	"Enter at least 2 characters to search payers."	Info
No results	"No payers match the selected filters."	Info
User without manage permission clicks "New Payer"	"You do not have permission to create or edit payer records."	Error
Connectivity error flag present	"Some payers have connectivity errors. Filter by eClaim Status = 'Error' to review."	Warning (banner)

Actions / Buttons

New Payer (top-right, primary)
Visible to: RCM Manager, System Administrator with manage_payer_master
Action: Opens SCR-POLICYCONTRACTMGMT-002 in create mode.
View Payer (row action)
Opens SCR-POLICYCONTRACTMGMT-002 for selected payer.
View Contracts (row action)
Opens SCR-POLICYCONTRACTMGMT-003 filtered by payer.
Performance (row action)
Opens SCR-POLICYCONTRACTMGMT-007 filtered by payer.
Export List (toolbar)
Exports current filtered list to CSV (payer name, type, class, active contracts, status).

HTML Wireframe Mockup

Show HTML code

HTML

<div style="font-family: Arial, sans-serif; max-width: 1100px; margin: 0 auto; border: 1px solid #ccc; border-radius: 8px; overflow: hidden;">
  <div style="background: #1a73e8; color: white; padding: 12px 20px; display: flex; justify-content: space-between; align-items: center;">
    <h3 style="margin: 0;">Payer Master List</h3>
    <button type="button" style="background:#fff;color:#1a73e8;border:none;padding:6px 12px;border-radius:4px;font-weight:bold;">+ New Payer</button>
  </div>
  <div style="padding: 16px;">
    <!-- Filters -->
    <div style="display:flex; flex-wrap:wrap; gap:12px; margin-bottom:12px;">
      <div style="flex:2 1 220px;">
        <label for="search" style="display:block;font-size:12px;color:#555;">Search</label>
        <input id="search" type="text" placeholder="Search by payer name, code, license..." style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;">
      </div>
      <div style="flex:1 1 150px;">
        <label style="display:block;font-size:12px;color:#555;">Payer Type</label>
        <select style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;">
          <option>All</option><option>Government</option><option>Private</option><option>Self-pay</option><option>International</option>
        </select>
      </div>
      <div style="flex:1 1 150px;">
        <label style="display:block;font-size:12px;color:#555;">Payer Class</label>
        <select style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;">
          <option>All</option><option>THIQA</option><option>Daman</option><option>Oman Insurance</option>
        </select>
      </div>
      <div style="flex:1 1 150px;">
        <label style="display:block;font-size:12px;color:#555;">Network Status</label>
        <select style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;">
          <option>All</option><option>In-Network</option><option>Out-of-Network</option><option>Terminated</option>
        </select>
      </div>
      <div style="flex:0 0 140px; display:flex; align-items:flex-end;">
        <label style="font-size:12px;color:#555; margin-right:6px;">Active only</label>
        <input type="checkbox" checked>
      </div>
    </div>

    <!-- Table -->
    <div style="border:1px solid #ddd;border-radius:4px;overflow:auto; max-height:420px;">
      <table style="width:100%;border-collapse:collapse;font-size:13px;">
        <thead style="background:#f5f5f5;">
          <tr>
            <th style="text-align:left;padding:8px;border-bottom:1px solid #ddd;">Payer Name</th>
            <th style="text-align:left;padding:8px;border-bottom:1px solid #ddd;">Type</th>
            <th style="text-align:left;padding:8px;border-bottom:1px solid #ddd;">Class</th>
            <th style="text-align:center;padding:8px;border-bottom:1px solid #ddd;">Active Contracts</th>
            <th style="text-align:center;padding:8px;border-bottom:1px solid #ddd;">Network Status</th>
            <th style="text-align:center;padding:8px;border-bottom:1px solid #ddd;">eClaim Status</th>
            <th style="text-align:center;padding:8px;border-bottom:1px solid #ddd;">Actions</th>
          </tr>
        </thead>
        <tbody>
          <tr>
            <td style="padding:8px;border-bottom:1px solid #eee;">
              Daman Health Insurance<br>
              <span style="font-size:11px;color:#777;">ضمان للتأمين الصحي</span>
            </td>
            <td style="padding:8px;border-bottom:1px solid #eee;">Government</td>
            <td style="padding:8px;border-bottom:1px solid #eee;">THIQA</td>
            <td style="padding:8px;border-bottom:1px solid #eee;text-align:center;">5</td>
            <td style="padding:8px;border-bottom:1px solid #eee;text-align:center;">
              <span style="background:#e6f4ea;color:#137333;padding:2px 6px;border-radius:10px;font-size:11px;">In-Network</span>
            </td>
            <td style="padding:8px;border-bottom:1px solid #eee;text-align:center;">
              <span style="background:#e8f0fe;color:#1a73e8;padding:2px 6px;border-radius:10px;font-size:11px;">Configured</span>
            </td>
            <td style="padding:8px;border-bottom:1px solid #eee;text-align:center;">
              <button style="margin:0 2px;padding:2px 6px;font-size:11px;">View</button>
              <button style="margin:0 2px;padding:2px 6px;font-size:11px;">Contracts</button>
              <button style="margin:0 2px;padding:2px 6px;font-size:11px;">Performance</button>
            </td>
          </tr>
          <!-- more rows -->
        </tbody>
      </table>
    </div>
  </div>
</div>

Accessibility (WCAG 2.1 AA)

Table uses <th scope="col"> for headers.
Filters and search have associated <label> elements.
Row actions accessible via keyboard (Tab/Shift+Tab) and have descriptive aria-label (e.g., aria-label="View contracts for Daman").
Colour-coded badges include text labels; colour is not the only indicator.
Live region for global messages (aria-live="polite").

Responsive / Mobile

On screens < 768px:
Filters collapse into an accordion “Filters” panel.
Table switches to card layout: each payer displayed as a card with key fields and action buttons stacked.
Touch targets (buttons, checkboxes) minimum 44x44 px.
Horizontal scrolling allowed for table on small screens.

SCR-POLICYCONTRACTMGMT-002: Payer Detail / Onboarding

Purpose

Create and maintain payer master data, including demographics, licensing, contacts, connectivity configuration (eClaimLink, DOH eClaims), and associated plans. Supports payer onboarding workflow (WF-PCM-001).

Layout Overview

Header: Payer name, status (Active/Inactive), quick actions.
Tabs: 1. General Info (demographics, licenses, classification) 2. Contacts 3. Plans 4. Connectivity & Submission 5. Notes & Attachments

Key Field Specifications (General Info Tab)

Field	Type	Required	Validation	Default	Notes
Payer Name (English)	Text	Yes	3–200 chars; letters, numbers, spaces, `&`	—	Stored as `payers.payer_name_en`
Payer Name (Arabic)	Text	Recommended	3–200 chars; Arabic Unicode range	—	`dir="rtl"` in UI
Payer Code	Text	Yes	Max 20 chars; unique	Auto-suggest from name	Used internally and for mapping to DHA/DOH codes
Payer Type	Dropdown	Yes	In (`Government`, `Private`, `Self-pay`, `International`)	—	Master data
Payer Class	Dropdown	Yes	Value from “Payer Classification Codes”	—	e.g., THIQA, SAADA
TPA Name	Text	No	Max 200 chars	—	If payer uses a TPA
DHA License Number	Text	Conditional	Alphanumeric, max 30	—	Required if payer operates in Dubai
DOH License Number	Text	Conditional	Alphanumeric, max 30	—	Required if payer operates in Abu Dhabi
Is Active	Toggle	Yes	Boolean	On	Deactivation requires confirmation dialog
Primary Email	Email	Yes	Valid email format	—	Used for notifications
Primary Phone	Text	Yes	UAE format `+971 5X XXX XXXX` or landline	—	Input mask
Address (EN)	Textarea	No	Max 300 chars	—	Include PO Box, Emirate
Address (AR)	Textarea	No	Max 300 chars	—	`dir="rtl"`
Notes	Textarea	No	Max 1000 chars	—	Internal notes, not sent to payers

Connectivity & Submission Tab Fields (subset)

Field	Type	Required	Validation	Default	Notes
eClaimLink Enabled	Checkbox	No	—	Off	For DHA Dubai
eClaimLink Payer ID	Text	Conditional	Required if eClaimLink Enabled; max 20 chars	—	Must match DHA registry
DOH eClaims Enabled	Checkbox	No	—	Off	For Abu Dhabi
DOH Payer ID	Text	Conditional	Required if DOH eClaims Enabled; max 20 chars	—	Must match DOH registry
Submission Channel	Multi-select	Yes	At least one selected	—	Portal, SFTP, API, Clearinghouse
Claim Submission Deadline	Numeric	No	0–365	90	Days from DOS per contract default
Resubmission Limit	Numeric	No	0–10	2	Number of allowed resubmissions

Validation Messages

Condition	Message	Severity
Missing English name	"Payer Name (English) is required."	Error
Duplicate payer code	"Payer Code already exists. Please choose a different code."	Error
eClaimLink enabled but ID empty	"eClaimLink Payer ID is required when eClaimLink is enabled."	Error
Invalid UAE phone format	"Enter a valid UAE phone number, e.g., +971 50 123 4567."	Error
Deactivating payer with active contracts	"This payer has active contracts. Deactivation will prevent new claims. Proceed?"	Warning (confirmation)

Actions / Buttons

Save: Validates current tab and saves payer record.
Save & Close: Saves and returns to Payer Master List.
Cancel: Discards unsaved changes (confirmation if dirty).
Add Contact (Contacts tab): Opens inline row for new contact.
Add Plan (Plans tab): Opens plan creation dialog (links to insurance_plans).

HTML Wireframe Mockup (General Info + Tabs)

Show HTML code

HTML

<div style="font-family: Arial, sans-serif; max-width: 960px; margin: 0 auto; border: 1px solid #ccc; border-radius: 8px; overflow: hidden;">
  <div style="background:#1a73e8;color:#fff;padding:12px 20px;display:flex;justify-content:space-between;align-items:center;">
    <div>
      <h3 style="margin:0;">Payer Detail / Onboarding</h3>
      <span style="font-size:12px;opacity:0.9;">Status: <strong>Active</strong></span>
    </div>
    <div>
      <button style="margin-right:8px;padding:6px 12px;border-radius:4px;border:1px solid #fff;background:#1a73e8;color:#fff;">Cancel</button>
      <button style="margin-right:8px;padding:6px 12px;border-radius:4px;border:none;background:#fff;color:#1a73e8;font-weight:bold;">Save</button>
      <button style="padding:6px 12px;border-radius:4px;border:none;background:#0b5ed7;color:#fff;font-weight:bold;">Save &amp; Close</button>
    </div>
  </div>
  <div style="padding:16px;">
    <!-- Tabs -->
    <div style="border-bottom:1px solid #ddd;margin-bottom:12px;">
      <button style="border:none;background:#fff;border-bottom:3px solid #1a73e8;padding:8px 12px;font-weight:bold;">General Info</button>
      <button style="border:none;background:#fff;border-bottom:3px solid transparent;padding:8px 12px;">Contacts</button>
      <button style="border:none;background:#fff;border-bottom:3px solid transparent;padding:8px 12px;">Plans</button>
      <button style="border:none;background:#fff;border-bottom:3px solid transparent;padding:8px 12px;">Connectivity &amp; Submission</button>
      <button style="border:none;background:#fff;border-bottom:3px solid transparent;padding:8px 12px;">Notes &amp; Attachments</button>
    </div>

    <!-- General Info Form -->
    <div style="display:flex;flex-wrap:wrap;gap:16px;">
      <div style="flex:1 1 260px;">
        <label style="display:block;font-size:12px;color:#555;">Payer Name (English) *</label>
        <input type="text" style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;" placeholder="e.g., Daman Health Insurance">
      </div>
      <div style="flex:1 1 260px;">
        <label style="display:block;font-size:12px;color:#555;">Payer Name (Arabic)</label>
        <input type="text" style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;direction:rtl;" placeholder="مثال: ضمان للتأمين الصحي">
      </div>
      <div style="flex:0.7 1 180px;">
        <label style="display:block;font-size:12px;color:#555;">Payer Code *</label>
        <input type="text" style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;" placeholder="DAMAN">
      </div>
      <div style="flex:0.7 1 180px;">
        <label style="display:block;font-size:12px;color:#555;">Payer Type *</label>
        <select style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;">
          <option>Government</option><option>Private</option><option>Self-pay</option><option>International</option>
        </select>
      </div>
      <div style="flex:0.7 1 180px;">
        <label style="display:block;font-size:12px;color:#555;">Payer Class *</label>
        <select style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;">
          <option>THIQA</option><option>Daman</option><option>Oman Insurance</option>
        </select>
      </div>
      <div style="flex:1 1 260px;">
        <label style="display:block;font-size:12px;color:#555;">DHA License Number</label>
        <input type="text" style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;">
      </div>
      <div style="flex:1 1 260px;">
        <label style="display:block;font-size:12px;color:#555;">DOH License Number</label>
        <input type="text" style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;">
      </div>
      <div style="flex:1 1 260px;">
        <label style="display:block;font-size:12px;color:#555;">Primary Email *</label>
        <input type="email" style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;" placeholder="[email protected]">
      </div>
      <div style="flex:1 1 260px;">
        <label style="display:block;font-size:12px;color:#555;">Primary Phone *</label>
        <input type="text" style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;" placeholder="+971 50 123 4567">
      </div>
      <div style="flex:1 1 260px;display:flex;align-items:flex-end;">
        <label style="font-size:12px;color:#555;margin-right:8px;">Active</label>
        <input type="checkbox" checked>
      </div>
    </div>
  </div>
</div>

Accessibility

Tabs implemented with proper ARIA roles (role="tablist", role="tab", aria-selected).
Arabic fields use lang="ar" and dir="rtl" to aid screen readers.
Error messages associated with fields via aria-describedby.
Connectivity status changes announced via aria-live="polite".

Responsive / Mobile

Tabs collapse into a dropdown “Section” selector on very small screens.
Form fields stack in a single column; labels remain above inputs.
Contacts and Plans tables switch to card layout with key fields.

SCR-POLICYCONTRACTMGMT-003: Contract Management

Purpose

Manage the list of contracts across all payers and facilities: search, filter, monitor status and expiry, and access contract details. Supports WF-PCM-002 and WF-PCM-005.

Field Specifications

Field	Type	Required	Validation	Default	Notes
Payer Filter	Autocomplete dropdown	No	Must match existing payer	All	Filters by `contracts.payer_id`
Facility Filter	Dropdown	No	Must match existing facility	Current facility (if scoped)	FK to `facilities`
Status Filter	Multi-select	No	Values in (`Draft`, `In Review`, `Approved`, `Active`, `Expired`, `Terminated`)	Active, In Review
Expiry Range	Date range picker	No	Start <= End	Next 12 months	Used for expiry alerts
Show Expiring Only	Checkbox	No	—	Off	Shows contracts expiring within 90/60/30 days
Contract List Columns	—	—	—	—	See below

Contract List Columns

Column	Description
Contract ID	Internal ID / code
Payer Name	EN/AR
Facility	Facility name
Contract Type	From master data (fee-for-service, per diem, etc.)
Effective Date	Start date
Expiry Date	End date
Days to Expiry	Calculated; negative if already expired
Status	Workflow status
Version	Current version number
Expiry Alert	Badge: 90 / 60 / 30 days, Expired
Actions	View / Edit / Renew / Download PDF

Validation Messages

Condition	Message	Severity
Invalid date range	"Expiry 'From' date must be before 'To' date."	Error
No contracts found	"No contracts match the selected filters."	Info
User without edit permission clicks Edit	"You have read-only access to contracts in this module."	Error

Actions / Buttons

New Contract: Opens SCR-POLICYCONTRACTMGMT-004 in create mode.
View / Edit: Opens SCR-POLICYCONTRACTMGMT-004 for selected contract.
Renew: Opens SCR-POLICYCONTRACTMGMT-004 pre-populated as new version.
Download PDF: Downloads latest signed contract document.
Go to Renewal Alerts: Opens SCR-POLICYCONTRACTMGMT-008 with current filters.

Accessibility

Expiry alerts use text badges (e.g., "30 days", "Expired") plus colour.
Table is keyboard navigable; row focus visible.
Filters have labels and can be operated via keyboard only.

Responsive / Mobile

On small screens, contract rows become cards with key fields and action buttons.
Expiry badges remain visible at top of each card.

SCR-POLICYCONTRACTMGMT-004: Contract Detail / Editor

Purpose

Create, edit, review, approve, and digitally sign contracts, including terms, covered facilities, payment terms, and linkage to fee schedules. Supports WF-PCM-002 and WF-PCM-005.

Layout Overview

Header: Contract ID, payer, facility, status, version, quick actions.
Left column: Contract metadata and terms.
Right column: Approval workflow, version history, attachments.
Tabs or sections: Overview, Terms & Rates, Covered Services & Exclusions, Approval & Signatures.

Key Field Specifications (Overview / Metadata)

Field	Type	Required	Validation	Default	Notes
Payer	Autocomplete	Yes	Must match existing payer	From navigation context	FK to `payers`
Facility	Dropdown	Yes	Must match existing facility	Current facility	FK to `facilities`
Contract Type	Dropdown	Yes	From “Contract Types” master	—
Rate Methodology	Dropdown	Yes	From “Rate Methodologies” master	—	e.g., % of DHA tariff
Effective Date	Date picker	Yes	<= Expiry Date	—
Expiry Date	Date picker	Yes	>= Effective Date	—
Auto-Renew	Checkbox	No	—	Off
Payment Terms (days)	Numeric	Yes	0–365	60	`contracts.payment_terms_days`
Status	Read-only dropdown	System	Workflow states	Draft	Controlled by workflow
Document Path	File upload	Conditional	PDF only, max size per policy	—	Required before final approval

Terms & Rates Section (subset)

Field	Type	Required	Validation	Default	Notes
Base Tariff Source	Dropdown	Yes	(`DHA`, `DOH`, `Custom`)	—	Drives fee schedule defaults
Discount / Markup (%)	Numeric	No	-100 to 500	0	Applied to base tariff
Covered Facilities	Multi-select	Yes	At least one facility	Current facility	For multi-facility groups
Notes on Penalties	Textarea	No	Max 1000 chars	—	Late payment penalties, etc.

Approval & Signatures Section

Field	Type	Required	Validation	Default	Notes
Approval Chain	Ordered list	Yes	At least one approver	From template	Users with approve permissions
Current Approver	Read-only	System	—	—	Based on workflow state
Digital Signature (Internal)	Signature control	Conditional	Required for final approval	—	Uses enterprise signing service
Payer Signature Status	Read-only	—	—	Pending / Signed	Manual update or integration

Validation Messages

Condition	Message	Severity
Missing payer	"Payer is required."	Error
Effective date after expiry	"Expiry Date must be on or after Effective Date."	Error
Attempt to activate without document	"Signed contract document must be uploaded before activation."	Error
Missing approval chain	"At least one approver is required in the approval chain."	Error
User not in approval chain attempts approve	"You are not an approver for this contract."	Error

Actions / Buttons

Save Draft: Saves without changing status.
Submit for Approval: Moves status from Draft to In Review; notifies first approver.
Approve: For current approver; moves to next approver or Approved.
Reject: Sends back to Draft with comment.
Activate Contract: Available after Approved and signed; sets status to Active.
Generate PDF: Renders contract summary to PDF.
Compare Versions: Opens side-by-side comparison with previous version.

HTML Wireframe Mockup

Show HTML code

HTML

<div style="font-family: Arial, sans-serif; max-width: 1100px; margin: 0 auto; border:1px solid #ccc;border-radius:8px;overflow:hidden;">
  <div style="background:#1a73e8;color:#fff;padding:12px 20px;display:flex;justify-content:space-between;align-items:center;">
    <div>
      <h3 style="margin:0;">Contract Detail / Editor</h3>
      <span style="font-size:12px;">Contract ID: CT-2026-001 &nbsp;|&nbsp; Status: <strong>Draft</strong> &nbsp;|&nbsp; Version: 3</span>
    </div>
    <div>
      <button style="margin-right:6px;padding:6px 10px;border-radius:4px;border:1px solid #fff;background:#1a73e8;color:#fff;">Save Draft</button>
      <button style="margin-right:6px;padding:6px 10px;border-radius:4px;border:none;background:#fff;color:#1a73e8;font-weight:bold;">Submit for Approval</button>
      <button style="padding:6px 10px;border-radius:4px;border:none;background:#0b5ed7;color:#fff;font-weight:bold;">Generate PDF</button>
    </div>
  </div>
  <div style="display:flex; padding:16px; gap:16px;">
    <!-- Left column -->
    <div style="flex:2 1 0;">
      <h4 style="margin-top:0;">Overview</h4>
      <div style="display:flex;flex-wrap:wrap;gap:12px;margin-bottom:12px;">
        <div style="flex:1 1 220px;">
          <label style="display:block;font-size:12px;color:#555;">Payer *</label>
          <input type="text" style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;" placeholder="Start typing payer name...">
        </div>
        <div style="flex:1 1 220px;">
          <label style="display:block;font-size:12px;color:#555;">Facility *</label>
          <select style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;">
            <option>Dubai General Hospital</option>
            <option>Abu Dhabi Medical Center</option>
          </select>
        </div>
        <div style="flex:1 1 180px;">
          <label style="display:block;font-size:12px;color:#555;">Contract Type *</label>
          <select style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;">
            <option>Fee-for-service</option><option>Per diem</option><option>Case rate</option><option>Capitation</option>
          </select>
        </div>
        <div style="flex:1 1 180px;">
          <label style="display:block;font-size:12px;color:#555;">Rate Methodology *</label>
          <select style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;">
            <option>100% of DHA tariff</option><option>90% of DOH tariff</option><option>Custom</option>
          </select>
        </div>
        <div style="flex:1 1 160px;">
          <label style="display:block;font-size:12px;color:#555;">Effective Date *</label>
          <input type="date" style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;">
        </div>
        <div style="flex:1 1 160px;">
          <label style="display:block;font-size:12px;color:#555;">Expiry Date *</label>
          <input type="date" style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;">
        </div>
        <div style="flex:0.5 1 120px;display:flex;align-items:flex-end;">
          <label style="font-size:12px;color:#555;margin-right:6px;">Auto-renew</label>
          <input type="checkbox">
        </div>
        <div style="flex:0.5 1 120px;">
          <label style="display:block;font-size:12px;color:#555;">Payment Terms (days) *</label>
          <input type="number" style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;" value="60">
        </div>
      </div>

      <h4>Terms &amp; Rates</h4>
      <div style="display:flex;flex-wrap:wrap;gap:12px;margin-bottom:8px;">
        <div style="flex:1 1 200px;">
          <label style="display:block;font-size:12px;color:#555;">Base Tariff Source *</label>
          <select style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;">
            <option>DHA</option><option>DOH</option><option>Custom</option>
          </select>
        </div>
        <div style="flex:1 1 160px;">
          <label style="display:block;font-size:12px;color:#555;">Discount / Markup (%)</label>
          <input type="number" style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;" value="0">
        </div>
      </div>
      <textarea style="width:100%;min-height:80px;padding:6px;border:1px solid #ccc;border-radius:4px;font-size:12px;" placeholder="Additional terms, penalties, dispute resolution..."></textarea>
    </div>

    <!-- Right column -->
    <div style="flex:1 1 0;">
      <h4 style="margin-top:0;">Approval Workflow</h4>
      <ol style="font-size:13px;padding-left:18px;">
        <li>Contract Manager (Pending)</li>
        <li>RCM Manager</li>
        <li>Finance Director</li>
      </ol>
      <button style="margin-top:6px;padding:6px 10px;border-radius:4px;border:none;background:#34a853;color:#fff;">Approve</button>
      <button style="margin-top:6px;margin-left:4px;padding:6px 10px;border-radius:4px;border:1px solid #d93025;background:#fff;color:#d93025;">Reject</button>

      <h4 style="margin-top:16px;">Version History</h4>
      <ul style="font-size:12px;padding-left:18px;">
        <li>v3 &mdash; Draft &mdash; 07 Feb 2026 &mdash; Edited by Ahmed</li>
        <li>v2 &mdash; Active &mdash; 01 Jan 2025 &mdash; Approved by Fatima</li>
      </ul>
      <button style="margin-top:6px;padding:6px 10px;border-radius:4px;border:1px solid #ccc;background:#fff;">Compare Versions</button>

      <h4 style="margin-top:16px;">Signed Document</h4>
      <input type="file" style="font-size:12px;">
    </div>
  </div>
</div>

Accessibility

Approval buttons have clear labels and confirmation dialogs for Reject.
Version history list is structured with <ul> and <li> for screen readers.
File upload control labelled "Signed Contract PDF".

Responsive / Mobile

Right column stacks below left column.
Approval workflow and version history become collapsible sections.

SCR-POLICYCONTRACTMGMT-005: Fee Schedule Editor

Purpose

Spreadsheet-style interface to manage fee schedule items (CPT to rate mapping), bulk import tariffs, and run rate change impact analysis. Supports WF-PCM-003 and WF-PCM-005.

Field Specifications

Header fields:

Field	Type	Required	Validation	Default	Notes
Fee Schedule Name	Text	Yes	3–200 chars	—	`contract_fee_schedules.schedule_name`
Linked Contract	Read-only text	Yes	Must reference existing contract	From context
Base Tariff	Dropdown	Yes	(`DHA`, `DOH`, `Custom`)	From contract
Effective Date	Date	Yes	<= Expiry Date	—
Expiry Date	Date	No	>= Effective Date	—
Status	Dropdown	Yes	(`Draft`, `In Review`, `Active`, `Archived`)	Draft

Grid columns (fee_schedule_items):

Column	Type	Required	Validation	Notes
CPT Code	Autocomplete	Yes	Must exist in CPT master	`cpt_code`
Description	Text (read-only or editable)	Yes	Max 255 chars	Defaults from CPT master
Facility Rate	Numeric	Conditional	>= 0	Required if facility billing used
Professional Rate	Numeric	Conditional	>= 0	Required if professional billing used
Modifier	Text	No	Valid CPT modifier format
Rate Type	Dropdown	Yes	(`Flat`, `% of Tariff`)	Flat
Active	Checkbox	Yes	Boolean	On

Validation Messages

Condition	Message	Severity
Missing fee schedule name	"Fee Schedule Name is required."	Error
CPT code not found	"CPT code not found in master list."	Error
Negative rate	"Rates must be zero or positive."	Error
Attempt to activate with no items	"At least one active fee schedule item is required before activation."	Error

Actions / Buttons

Import Tariff (CSV): Uploads CSV; maps columns to CPT, rates.
Add Row: Adds new fee schedule item row.
Delete Row: Marks row as inactive (soft delete).
Run Impact Analysis: Compares against previous schedule; opens summary panel.
Publish: Sets status to Active (with confirmation).

HTML Wireframe Mockup

Show HTML code

HTML

<div style="font-family: Arial, sans-serif; max-width: 1100px; margin: 0 auto; border:1px solid #ccc;border-radius:8px;overflow:hidden;">
  <div style="background:#1a73e8;color:#fff;padding:12px 20px;display:flex;justify-content:space-between;align-items:center;">
    <h3 style="margin:0;">Fee Schedule Editor</h3>
    <div>
      <button style="margin-right:6px;padding:6px 10px;border-radius:4px;border:1px solid #fff;background:#1a73e8;color:#fff;">Import CSV</button>
      <button style="margin-right:6px;padding:6px 10px;border-radius:4px;border:none;background:#fff;color:#1a73e8;font-weight:bold;">Run Impact Analysis</button>
      <button style="padding:6px 10px;border-radius:4px;border:none;background:#34a853;color:#fff;font-weight:bold;">Publish</button>
    </div>
  </div>
  <div style="padding:12px;">
    <!-- Header fields -->
    <div style="display:flex;flex-wrap:wrap;gap:12px;margin-bottom:12px;">
      <div style="flex:1 1 260px;">
        <label style="display:block;font-size:12px;color:#555;">Fee Schedule Name *</label>
        <input type="text" style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;" placeholder="DHA 2026 Outpatient">
      </div>
      <div style="flex:1 1 260px;">
        <label style="display:block;font-size:12px;color:#555;">Linked Contract</label>
        <input type="text" disabled style="width:100%;padding:6px;border:1px solid #eee;border-radius:4px;background:#f9f9f9;" value="CT-2026-001 - Daman / Dubai General Hospital">
      </div>
      <div style="flex:0.7 1 180px;">
        <label style="display:block;font-size:12px;color:#555;">Base Tariff *</label>
        <select style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;">
          <option>DHA</option><option>DOH</option><option>Custom</option>
        </select>
      </div>
      <div style="flex:0.7 1 160px;">
        <label style="display:block;font-size:12px;color:#555;">Effective Date *</label>
        <input type="date" style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;">
      </div>
      <div style="flex:0.7 1 160px;">
        <label style="display:block;font-size:12px;color:#555;">Expiry Date</label>
        <input type="date" style="width:100%;padding:6px;border:1px solid #ccc;border-radius:4px;">
      </div>
    </div>

    <!-- Grid -->
    <div style="margin-top:8px;margin-bottom:8px;display:flex;justify-content:space-between;align-items:center;">
      <span style="font-size:12px;color:#555;">Items</span>
      <button style="padding:4px 8px;border-radius:4px;border:1px solid #ccc;background:#fff;font-size:12px;">+ Add Row</button>
    </div>
    <div style="border:1px solid #ddd;border-radius:4px;overflow:auto;max-height:420px;">
      <table style="width:100%;border-collapse:collapse;font-size:12px;">
        <thead style="background:#f5f5f5;">
          <tr>
            <th style="padding:6px;border-bottom:1px solid #ddd;">CPT Code</th>
            <th style="padding:6px;border-bottom:1px solid #ddd;">Description</th>
            <th style="padding:6px;border-bottom:1px solid #ddd;">Facility Rate (AED)</th>
            <th style="padding:6px;border-bottom:1px solid #ddd;">Professional Rate (AED)</th>
            <th style="padding:6px;border-bottom:1px solid #ddd;">Modifier</th>
            <th style="padding:6px;border-bottom:1px solid #ddd;">Rate Type</th>
            <th style="padding:6px;border-bottom:1px solid #ddd;">Active</th>
          </tr>
        </thead>
        <tbody>
          <tr>
            <td style="padding:4px;border-bottom:1px solid #eee;"><input type="text" value="99213" style="width:100%;border:1px solid #ccc;border-radius:3px;padding:3px;"></td>
            <td style="padding:4px;border-bottom:1px solid #eee;">Office/outpatient visit est</td>
            <td style="padding:4px;border-bottom:1px solid #eee;"><input type="number" value="250" style="width:100%;border:1px solid #ccc;border-radius:3px;padding:3px;"></td>
            <td style="padding:4px;border-bottom:1px solid #eee;"><input type="number" value="150" style="width:100%;border:1px solid #ccc;border-radius:3px;padding:3px;"></td>
            <td style="padding:4px;border-bottom:1px solid #eee;"><input type="text" style="width:100%;border:1px solid #ccc;border-radius:3px;padding:3px;"></td>
            <td style="padding:4px;border-bottom:1px solid #eee;">
              <select style="width:100%;border:1px solid #ccc;border-radius:3px;padding:3px;">
                <option>Flat</option><option>% of Tariff</option>
              </select>
            </td>
            <td style="padding:4px;border-bottom:1px solid #eee;text-align:center;">
              <input type="checkbox" checked>
            </td>
          </tr>
          <!-- more rows -->
        </tbody>
      </table>
    </div>
  </div>
</div>

Accessibility

Grid cells are keyboard navigable; use arrow keys and Tab.
Import CSV button has aria-describedby pointing to help text describing required format.
Error cells highlighted with both colour and icon plus tooltip text.

Responsive / Mobile

Grid becomes horizontally scrollable; header row remains sticky.
On very small screens, an alternative “form per item” view may be offered.

SCR-POLICYCONTRACTMGMT-006: Coverage Rule Builder

Purpose

Visual rule builder to configure coverage and medical necessity rules per payer/plan, including CPT/ICD mappings, age/gender limits, frequency limits, and prior auth flags. Supports WF-PCM-004.

Field Specifications

Field	Type	Required	Validation	Default	Notes
Rule Name	Text	Yes	3–200 chars	—	Human-readable label
Rule Type	Dropdown	Yes	(`Coverage`, `Benefit Limit`, `Clinical Pathway`)	Coverage	`coverage_rules.rule_type`
Payer	Autocomplete	Yes	Must match existing payer	—
Plan	Autocomplete	No	Must match plan for payer	All plans	Optional for payer-wide rules
CPT Codes	Multi-select autocomplete	Yes	Must exist in CPT master	—	Stored as list/JSON
ICD-10-AM Codes	Multi-select autocomplete	No	Must exist in ICD-10-AM master	—
Age Min	Numeric	No	0–120	—
Age Max	Numeric	No	0–120; >= Age Min	—
Gender	Dropdown	No	(`Any`, `Male`, `Female`)	Any
Frequency Limit	Numeric	No	>= 0	—
Frequency Period	Dropdown	Conditional	(`Per Day`, `Per Month`, `Per Year`, `Lifetime`)	Per Year	Required if Frequency Limit > 0
Requires Prior Auth	Checkbox	No	—	Off
Effective Date	Date	Yes	—	Today
Active	Toggle	Yes	Boolean	On

Test Claim Panel

Field	Type	Required	Validation
Test CPT	Autocomplete	Yes	CPT exists
Test ICD-10-AM	Autocomplete	No	ICD exists
Patient Age	Numeric	Yes	0–120
Patient Gender	Dropdown	Yes	(`Male`, `Female`)

Validation Messages

Condition	Message	Severity
Missing rule name	"Rule Name is required."	Error
No CPT codes selected	"At least one CPT code must be selected."	Error
Frequency limit without period	"Select a frequency period when a frequency limit is set."	Error
Age Max < Age Min	"Maximum age must be greater than or equal to minimum age."	Error
Test claim fails rule	"Test claim does NOT meet coverage criteria. Reason: [detail]."	Info

Actions / Buttons

Save Rule: Saves rule in Draft or Active state depending on toggle.
Test Claim: Runs test against current rule; shows pass/fail.
Activate / Deactivate: Toggles is_active with confirmation.
Clone Rule: Copies current rule to new draft.

Accessibility

Rule builder uses clear labels and grouping; drag-and-drop (if used) must have keyboard alternative (e.g., “Add condition” buttons).
Test result displayed in aria-live="polite" region.

Responsive / Mobile

Conditions stack vertically; multi-column layout collapses.
Test panel collapses into an accordion section.

SCR-POLICYCONTRACTMGMT-007: Payer Performance Dashboard

Purpose

Executive dashboard showing payer scorecards: denial rate, average days to pay, reimbursement variance, volume trends, and top denial reasons. Supports WF-PCM-006.

Field Specifications

Field	Type	Required	Validation	Default	Notes
Date Range	Date range picker	Yes	Start <= End	Last 3 months
Payer Filter	Multi-select	No	Must match existing payers	All
Metric Cards	Display	—	—	—	Denial Rate, Avg Days to Pay, Reimbursement Variance, Volume
Payer Scorecard Table	Display	—	—	—	One row per payer
Top Denial Reasons Chart	Display	—	—	—	Bar/pie chart

Validation Messages

Condition	Message	Severity
No data for period	"No claims data available for the selected period."	Info

Actions / Buttons

Export PDF: Exports dashboard snapshot.
Export Data (CSV): Exports underlying metrics.
Drill-down: Clicking a payer row opens detailed view or Contract Management filtered by payer.

Accessibility

Charts must have text equivalents (tables or lists).
Colour-coded metrics accompanied by text labels and numeric values.

Responsive / Mobile

Metric cards stack vertically.
Charts resize; some may collapse into summary tables.

SCR-POLICYCONTRACTMGMT-008: Contract Renewal Alerts

Purpose

Dedicated view for expiring contracts with 90/60/30-day alerts, renewal status, and quick actions to start renewal or amendment. Supports WF-PCM-005.

Field Specifications

Field	Type	Required	Validation	Default	Notes
Alert Window Filter	Dropdown	No	(`30 days`, `60 days`, `90 days`, `Expired`)	90 days
Payer Filter	Autocomplete	No	Must match payer	All
Renewal Status Filter	Dropdown	No	(`Not Started`, `In Negotiation`, `Pending Approval`, `Renewed`)	All
Expiring Contracts List	Table	—	—	—	See columns below

Columns:

Column	Description
Payer	Payer name
Facility	Facility name
Contract ID	ID/code
Expiry Date	Date
Days to Expiry	Numeric
Renewal Status	Status badge
Performance Summary	Key metrics (denial rate, avg days to pay)
Actions	Open Contract, Start Renewal

Validation Messages

Condition	Message	Severity
No expiring contracts	"No contracts are due for renewal in the selected window."	Info

Actions / Buttons

Start Renewal: Creates new contract version and opens SCR-POLICYCONTRACTMGMT-004.
Mark as In Negotiation: Updates renewal status.
View Performance: Opens dashboard filtered to payer.

Accessibility

Alerts use text badges ("90 days", "Expired") plus colour.
Table is keyboard accessible.

Responsive / Mobile

Expiring contracts displayed as cards with prominent Days to Expiry badge.
Actions presented as buttons at bottom of each card.

Common UI Patterns

1. Search Components

Global search inputs with:
Minimum character thresholds (2–3 chars).
Debounced queries (e.g., 300–500 ms).
Clear button (x) to reset.
Autocomplete lists:
Keyboard navigation (Up/Down, Enter, Esc).
aria-expanded, aria-activedescendant, role="listbox" semantics.

2. Alert / Notification Patterns

Inline Field Errors:
Red border, small text below field.
Example: "This field is required."
Form-level Alerts:
Banner at top of form for cross-field issues.
Colours: red (error), amber (warning), blue (info), green (success).
Include icon + text; no colour-only signalling.
Expiry Alerts:
Badges with text: "90 days", "60 days", "30 days", "Expired".
Used consistently in Contract Management and Renewal Alerts.

3. Loading States

Skeleton loaders for tables and dashboards.
Spinners for long-running operations (imports, impact analysis).
aria-busy="true" set on containers during loading.

4. Bilingual (Arabic/English) UI Considerations

All payer and plan names stored in both English and Arabic where available.
Display pattern: English on first line, Arabic on second line with dir="rtl" and lang="ar".
Module supports language toggle at application level:
Labels, buttons, and messages localised.
For full Arabic UI, layout may switch to RTL; ensure mirrored alignment and navigation.
Numeric fields (rates, days) remain LTR even in Arabic UI.

5. Accessibility (WCAG 2.1 AA)

Consistent use of <label> for all inputs; for attribute linked to id.
Keyboard-only operation supported for all actions (no mouse required).
Visible focus indicators on all interactive elements.
Sufficient colour contrast (minimum 4.5:1 for normal text).
Use of ARIA roles and properties for:
Tabs (role="tablist", role="tab", aria-selected).
Dialogs (modals) with role="dialog" and focus trapping.
Live regions (aria-live) for dynamic messages.

6. Responsive / Mobile Behaviour

Breakpoints:
≥ 1024px: full desktop layout with multi-column forms and tables.
768–1023px: two-column forms where possible; tables horizontally scrollable.
< 768px: single-column forms; tables convert to card layouts where appropriate.
Touch-friendly:
Buttons and interactive elements at least 44x44 px.
Adequate spacing between tap targets.

7. Shared Patterns with Other RCM Modules

Consistent “RCM Home / RCM Menu” entry point.
Standard breadcrumb: RCM > Policy & Contract Management > [Screen].
Standard confirmation dialogs for destructive actions (deactivation, rejection, etc.).

This specification is intended to be developer-ready and should be used alongside the data model and workflow specifications for the policy-contract-mgmt module.

Policy & Contract Management Screen Requirements

Screen Inventory

Navigation Flow

Screen Specifications

SCR-POLICYCONTRACTMGMT-001: Payer Master List

Field Specifications

Validation Messages

Actions / Buttons

HTML Wireframe Mockup

Accessibility (WCAG 2.1 AA)

Responsive / Mobile

SCR-POLICYCONTRACTMGMT-002: Payer Detail / Onboarding

Layout Overview

Key Field Specifications (General Info Tab)

Connectivity & Submission Tab Fields (subset)

Validation Messages

Actions / Buttons

HTML Wireframe Mockup (General Info + Tabs)

Accessibility

Responsive / Mobile

SCR-POLICYCONTRACTMGMT-003: Contract Management

Field Specifications

Validation Messages

Actions / Buttons

Accessibility

Responsive / Mobile

SCR-POLICYCONTRACTMGMT-004: Contract Detail / Editor

Layout Overview

Key Field Specifications (Overview / Metadata)

Terms & Rates Section (subset)

Approval & Signatures Section

Validation Messages

Actions / Buttons

HTML Wireframe Mockup

Accessibility

Responsive / Mobile

SCR-POLICYCONTRACTMGMT-005: Fee Schedule Editor

Field Specifications

Validation Messages

Actions / Buttons

HTML Wireframe Mockup

Accessibility

Responsive / Mobile

SCR-POLICYCONTRACTMGMT-006: Coverage Rule Builder

Field Specifications

Test Claim Panel

Validation Messages

Actions / Buttons

Accessibility

Responsive / Mobile

SCR-POLICYCONTRACTMGMT-007: Payer Performance Dashboard

Field Specifications

Validation Messages

Actions / Buttons

Accessibility

Responsive / Mobile

SCR-POLICYCONTRACTMGMT-008: Contract Renewal Alerts

Field Specifications

Validation Messages

Actions / Buttons

Accessibility

Responsive / Mobile

Common UI Patterns

1. Search Components

2. Alert / Notification Patterns

3. Loading States

4. Bilingual (Arabic/English) UI Considerations

5. Accessibility (WCAG 2.1 AA)

6. Responsive / Mobile Behaviour

7. Shared Patterns with Other RCM Modules