U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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Revenue Operations Manual (ROM)


The Indian Health Service Revenue Operations Manual provides a system-wide reference resource for all Indian, Tribal, and Urban (I/T/U) facilities across the United States, to assist any and all staff with any function related to business operation procedures and processes.

The Revenue Operations Manual is available for viewing, saving, and printing at the local level. Each part and chapter of the manual addresses a specific area, department, or function. A part may also contain one or more appendices of topic-related reference materials. Access to the manual has been designed to allow facilities to view, save, and print only those chapters that relate to their type of facility.

The manual is divided into five (5) parts. Click on any part title to go to its table of contents.

Click here to review the entire contents of the ROM Manual.

The Acronym dictionary and Glossary can be accessed within each Part as noted above.

To view the announcement from the Director of Resource Access and Partnership, click on the following link: