Instructions:Β 

Describe the information that will be stored in the system (e.g. beneficiary information, claim data, etc.) Identify if any of the information is personally identifiable information (PII), individually identifiable information (IIF), or personal health information (PHI).

Data

Identify all data (as well as the format of the data β€” paper, manual input, electronic data) supplied to the system as well as who/what is supplying the data.

Manual/Electronic Inputs

Provide instructions on what happens to the manual/electronic inputs after they are entered into the master file/database and are verified.

Master Files

Provide a detailed description of the data maintained in the system/database.