A pre-determination letter is part of the claims management process for health insurance providers. The letter relates to the coverage of specific medical services under a patient's policy. Insurance companies require health care providers to follow submission instructions, such as the content that must be included in the pre-determination letter.
The Kogi are the last surviving civilization from the world of the Inca and Aztec, and their cities are untouched by our world. The mountain they inhabit is an isolated triangular pyramid rising over 18,000 feet from the sea, the highest coastal mountain on earth.
The snake is the symbol of the creative power of wisdom. The aegis represents its protective power. The helmet and spear relate to the fact that wisdom and strategy is the key to victory in war. It's a Christian image, though there is some use of pagan symbols.