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[z.facultad/75.10/miklolife.git] / especificaciones / recibir_y_cotejar_consumos_ y_prestaciones.rtf

diff --git a/especificaciones/recibir_y_cotejar_consumos_ y_prestaciones.rtf b/especificaciones/recibir_y_cotejar_consumos_ y_prestaciones.rtf
index 744b47ba7b0dc075e0d3fd29de229d528e26c289..aef668d88e4282320bf6e2162592d0ae05bdfcf0 100644 (file)
--- a/especificaciones/recibir_y_cotejar_consumos_ y_prestaciones.rtf
+++ b/especificaciones/recibir_y_cotejar_consumos_ y_prestaciones.rtf
@@ -1,164 +1,247 @@
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-Caso de uso: }{\f1\fs20\insrsid9206653 Analizar Consumos y Prestaciones}{\f37\noproof0\insrsid4072389 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f37\noproof0\insrsid4072389 \trowd \irow0\irowband0\r
-\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw5\brdrcf1 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\r
-\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\trowd \irow1\irowband1\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \r
-\trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\pard \r
-\ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid227399 {\f37\noproof0\insrsid4072389 \r
-\par }{\b\f37\fs20\noproof0\insrsid4072389 Actores: }{\f1\fs20\insrsid331756 Prestador}{\f1\fs20\insrsid9206653 , Pagos.}{\f37\noproof0\insrsid4072389 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\r
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+{\pntxtb (}{\pntxta )}}\pard\plain \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 \fs24\lang1024\langfe1024\cgrid\noproof\langnp1033\langfenp1033 {\f1\fs20\insrsid7562310\charrsid13056714 \r
+\par }\trowd \irow0\irowband0\ts11\trleft-113\trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw5\brdrcf1 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \r
+\cltxlrtb\clftsWidth3\clwWidth8951\clshdrawnil \cellx8838\pard \ql \li0\ri0\nowidctlpar\intbl\aspalpha\faauto\rin0\lin0 {\b\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 Caso de uso: }{\r
+\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 Recibir y Cotejar Consumos y Prestaciones\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\r
+\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 \trowd \irow0\irowband0\ts11\trleft-113\trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw5\brdrcf1 \clbrdrl\brdrs\brdrw5\brdrcf1 \r
+\clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8951\clshdrawnil \cellx8838\row }\trowd \irow1\irowband1\ts11\trleft-113\trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\clbrdrt\r
+\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8951\clshdrawnil \cellx8838\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0 {\r
+\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 \r
+\par }\pard \ql \li0\ri0\nowidctlpar\intbl\aspalpha\faauto\rin0\lin0 {\b\f1\fs20\insrsid7562310\charrsid13056714 Actores: }{\f1\fs20\insrsid7562310\charrsid13056714 Prestador, Pagos.\cell }\pard \r
+\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f1\fs20\insrsid7562310\charrsid13056714 \trowd \irow1\irowband1\ts11\trleft-113\trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\clbrdrt\brdrnone \r
+\clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8951\clshdrawnil \cellx8838\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0 {\r
+\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 \r
+\par }\pard \ql \li0\ri0\nowidctlpar\intbl\aspalpha\faauto\rin0\lin0 {\b\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 Precondiciones: }{\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 Existe alg\'fa\r
+n tipo de comunicaci\'f3n entre el Prestador y el Sistema, que permita al Prestador enviar informaci\'f3n hacia \'e9ste \'faltimo; as\'ed como entre el Sistema y Pagos.\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \r
+{\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 \trowd \irow2\irowband2\ts11\trleft-113\trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\r
+\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8951\clshdrawnil \cellx8838\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0 {\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 \r
+\par }{\b\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 Poscondiciones: }{\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 \r
+\par Historia cl\'ednica de los afiliados afectados actualizada.\r
+\par \'c1rea de Pagos notificada acerca de las aprobaciones/rechazos de la info enviada por el prestador acerca de prestaciones realizadas.\r
+\par \'c1rea de Pagos dispone de los reportes de consumo de los afiliados.\r
+\par }\pard \ql \li0\ri0\nowidctlpar\intbl\aspalpha\faauto\rin0\lin0 {\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\r
+\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 \trowd \irow3\irowband3\ts11\trleft-113\trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\r
+\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8951\clshdrawnil \cellx8838\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0 {\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 \r
+\par }{\b\f1\fs20\insrsid7562310\charrsid13056714 Flujo Principal:\r
+\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid7562310\charrsid13056714 \hich\af1\dbch\af0\loch\f1 1\tab}}\pard\plain \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls2\pnrnot0\r
+\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls2\rin0\lin720 \fs24\lang2058\langfe2058\cgrid\langnp2058\langfenp2058 {\f1\fs20\insrsid7562310\charrsid13056714 El Prestador env\'eda }{\b\f1\fs20\insrsid7562310\charrsid13056714 informaci\'f3\r
+n de prestaciones e intervenciones}{\f1\fs20\insrsid7562310\charrsid13056714  de los afiliados.}{\f1\fs20\insrsid7562310 \r
+\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid7562310\charrsid13056714 \hich\af1\dbch\af0\loch\f1 2\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls2\pnrnot0\r
+\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls2\rin0\lin720\pararsid7757395 {\f1\fs20\insrsid7562310\charrsid13056714 El Sistema valida cada l}{\f1\fs20\insrsid7757395\charrsid13056714 \'ednea de la informaci\'f3\r
+n recibida. Validaciones sobre la info recibida:\r
+\par {\listtext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid8614436 \hich\af1\dbch\af0\loch\f1 -\tab}}\pard \s15\ql \fi-360\li829\ri0\nowidctlpar\intbl\jclisttab\tx829\faauto\ls3\rin0\lin829\pararsid7757395 {\r
+\f1\fs20\insrsid8614436 El Prestador existe en el Sistema.\r
+\par {\listtext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid13056714 \hich\af1\dbch\af0\loch\f1 -\tab}}{\f1\fs20\insrsid13056714 La}{\f1\fs20\insrsid7757395\charrsid13056714  autorizaci\'f3n existe en el Sistema.}{\r
+\f1\fs20\insrsid7757395 \r
+\par {\listtext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid8614436 \hich\af1\dbch\af0\loch\f1 -\tab}}{\f1\fs20\insrsid8614436 Prestador debe ser el mismo que}{\f1\fs20\insrsid8614436\charrsid13056714  }{\r
+\f1\fs20\insrsid8614436 e}{\f1\fs20\insrsid8614436\charrsid13056714 l relacionado con la autorizaci\'f3n en el Sistema\r
+\par {\listtext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid13056714 \hich\af1\dbch\af0\loch\f1 -\tab}}{\f1\fs20\insrsid13056714 La}{\f1\fs20\insrsid7757395\charrsid13056714  autorizaci\'f3n }{\f1\fs20\insrsid13056714 est\r
+\'e1}{\f1\fs20\insrsid7757395\charrsid13056714  relacionada con la prestaci\'f3n descripta por el Prestador.\r
+\par {\listtext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid7757395\charrsid13056714 \hich\af1\dbch\af0\loch\f1 -\tab}La autorizaci\'f3n }{\f1\fs20\insrsid8614436 deber ser una que est\'e9 aprobada en la fecha de recepci\r
+\'f3n de la }{\b\f1\fs20\insrsid8614436\charrsid13056714 informaci\'f3n de prestaciones e intervenciones}{\b\f1\fs20\insrsid8614436  }{\f1\fs20\insrsid8614436 enviada por el Prestador.}{\f1\fs20\insrsid7757395 \r
+\par {\listtext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid6114349 \hich\af1\dbch\af0\loch\f1 -\tab}}{\f1\fs20\insrsid6114349 La autorizaci\'f3n no debe estar realizada (en los datos del Sistema)\r
+\par {\listtext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid6114349 \hich\af1\dbch\af0\loch\f1 -\tab}}\pard \s15\ql \fi-360\li829\ri0\nowidctlpar\intbl\jclisttab\tx829\faauto\ls3\rin0\lin829\pararsid6114349 {\r
+\f1\fs20\insrsid6114349 La prestaci\'f3n deber existir en el Sistema y NO tiene que estar dada de baja.\r
+\par {\listtext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid7757395\charrsid13056714 \hich\af1\dbch\af0\loch\f1 -\tab}}\pard \s15\ql \fi-360\li829\ri0\nowidctlpar\intbl\r
+\jclisttab\tx829\faauto\ls3\rin0\lin829\pararsid7757395 {\f1\fs20\insrsid7757395\charrsid13056714 Porcentaje de cobertura }{\f1\fs20\insrsid13056714 debe ser igual al}{\f1\fs20\insrsid7757395\charrsid13056714  que se aplicaba al momento de la aprobaci\'f3\r
+n de la autorizaci\'f3n\r
+\par {\listtext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid13056714 \hich\af1\dbch\af0\loch\f1 -\tab}}\pard \s15\ql \fi-360\li829\ri0\nowidctlpar\intbl\jclisttab\tx829\faauto\ls3\rin0\lin829\pararsid11668463 {\r
+\f1\fs20\insrsid13056714 El afiliado }{\f1\fs20\insrsid6114349 deb}{\f1\fs20\insrsid12397594 e}{\f1\fs20\insrsid6114349  existir en el Sistema y }{\f1\fs20\insrsid13056714 estar relacionado con la autorizaci\'f3n recibida.\r
+\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid11668463\charrsid13056714 \hich\af1\dbch\af0\loch\f1 3\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls2\pnrnot0\r
+\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls2\rin0\lin720 {\f1\fs20\insrsid11668463\charrsid13056714 Si la l\'ednea pasa la validaci\'f3n, se registra en el sistema la prestaci\'f3n realizada por el afiliado. Sino, se\r
+ la marca como linea rechazada.\r
+\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid7562310\charrsid13056714 \hich\af1\dbch\af0\loch\f1 4\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls2\pnrnot0\r
+\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls2\rin0\lin720\pararsid2299470 {\f1\fs20\insrsid7562310\charrsid13056714 El Sistema, en base a estos datos y el resultado de la validaci\'f3n, construye un }{\b\f1\fs20\insrsid7562310\charrsid13056714 \r
+informe de aprobaciones/rechazos de prestaciones}{\f1\fs20\insrsid7562310\charrsid13056714  }{\b\f1\fs20\insrsid7562310\charrsid13056714 realizadas}{\f1\fs20\insrsid7562310\charrsid13056714  y lo env\'eda a Pagos}{\f1\fs20\insrsid13043882  (se incluyen s\r
+\'f3lo las prestaciones realizadas que hayan sido aprobadas)}{\f1\fs20\insrsid2299470 \r
+\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid2299470 \hich\af1\dbch\af0\loch\f1 5\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls2\pnrnot0\r
+\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls2\rin0\lin720\pararsid2299470 {\f1\fs20\insrsid2299470 El Sistema }{\f1\fs20\insrsid2299470\charrsid14763021 genera un }{\b\f1\fs20\insrsid2299470\charrsid14763021 reporte de consumo de los afiliados}{\r
+\f1\fs20\insrsid2299470 , bas\'e1ndose en la informaci\'f3n recibida del prestador e informaci\'f3n disponible en el propio Sistema y lo env\'eda a Pagos}{\f1\fs20\insrsid2299470\charrsid13056714 \r
+\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid7562310\charrsid13056714 \hich\af1\dbch\af0\loch\f1 6\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls2\pnrnot0\r
+\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls2\rin0\lin720 {\f1\fs20\insrsid7562310\charrsid13056714 Finaliza }{\f1\fs20\insrsid7490485 el }{\f1\fs20\insrsid7562310\charrsid13056714 caso de uso.\r
+\par }\pard \s15\ql \li289\ri0\nowidctlpar\intbl\aspalpha\faauto\rin0\lin289 {\f1\fs20\insrsid7562310\charrsid13056714 \cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \r
+\fs24\lang1024\langfe1024\cgrid\noproof\langnp1033\langfenp1033 {\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7490485 \trowd \irow4\irowband4\ts11\trleft-113\trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \r
+\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8951\clshdrawnil \cellx8838\row }\pard \ql \li0\ri0\nowidctlpar\intbl\aspalpha\faauto\rin0\lin0 {\r
+\b\f1\fs20\insrsid7562310\charrsid13056714 Flujos Alternativos: }{\f1\fs20\insrsid7562310\charrsid13056714 No hay.}{\f1\fs20\insrsid7562310 \r
+\par }{\f1\fs20\insrsid2299470\charrsid13056714 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f1\fs20\insrsid7562310\charrsid13056714 \trowd \irow5\irowband5\r
+\ts11\trleft-113\trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8951\clshdrawnil \r
+\cellx8838\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid12397594 {\b\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 Flujos de Excepci\'f3n: }{\f1\fs20\lang1024\langfe1024\langnp11274\insrsid12397594  No hay.}\r
+{\f1\fs20\lang1024\langfe1024\langnp11274\insrsid2299470 \r
+\par }{\f1\fs20\lang1024\langfe1024\langnp11274\insrsid12397594\charrsid13056714 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 \r
+\trowd \irow6\irowband6\ts11\trleft-113\trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \r
+\cltxlrtb\clftsWidth3\clwWidth8951\clshdrawnil \cellx8838\row }\pard \ql \li0\ri0\nowidctlpar\intbl\aspalpha\faauto\rin0\lin0 {\b\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 Notas: }{\r
+\cs68\f1\fs20\lang11274\noproof0\langnp11274\insrsid7562310\charrsid13056714 \~\~\~ - La comunicaci\'f3n Prestador-Sistema }{\cs68\f1\fs20\lang11274\noproof0\langnp11274\insrsid12397594 se da mediante un operador, el cual recibe la informaci\'f3\r
+n de prestaciones e intervenciones (en cualquier medio y formato) enviada por el Prestador y carga la info en el sistema.}{\f1\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 \cell }\pard \r
+\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f1\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 \trowd \irow7\irowband7\lastrow \r
+\ts11\trleft-113\trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8951\clshdrawnil \r
+\cellx8838\row }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \r
+\par }{\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 Especificaci\'f3n de Datos:\r
+\par }{\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \r
+\par }{\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 1) }{\b\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 Informaci\'f3n de prestaciones e intervenciones}{\r
+\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \r
+\par {\listtext\pard\plain\i\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid3550631\charrsid3550631 \hich\af0\dbch\af0\loch\f0 1.\tab}}\pard \ql \fi-360\li1428\ri0\nowidctlpar\jclisttab\tx1428\faauto\ls6\rin0\lin1428\itap0\pararsid14755567 {\r
+\i\fs20\lang1024\langfe1024\langnp11274\insrsid3550631\charrsid3550631 Cabecera:\r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid4599262 \hich\af0\dbch\af0\loch\f0 a.\tab}}\pard \ql \fi-360\li2148\ri0\nowidctlpar\jclisttab\tx2148\faauto\ls6\ilvl1\rin0\lin2148\itap0\pararsid14755567 {\r
+\fs20\lang1024\langfe1024\langnp11274\insrsid4599262 N\'famero de CUIT del Prestador.}{\fs20\lang1024\langfe1024\langnp11274\insrsid7562310 \r
+\par {\listtext\pard\plain\i\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid3550631\charrsid3550631 \hich\af0\dbch\af0\loch\f0 2.\tab}}\pard \ql \fi-360\li1428\ri0\nowidctlpar\jclisttab\tx1428\faauto\ls6\rin0\lin1428\itap0\pararsid14755567 {\r
+\i\fs20\lang1024\langfe1024\langnp11274\insrsid3550631\charrsid3550631 Detalle:\r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f0 a.\tab}}\pard \ql \fi-360\li2148\ri0\nowidctlpar\jclisttab\tx2148\faauto\ls6\ilvl1\rin0\lin2148\itap0\pararsid14755567 {\r
+\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 C\'f3digo de autorizaci\'f3n relacionada a la prestaci\'f3n}{\fs20\lang1024\langfe1024\langnp11274\insrsid4599262 .\r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f0 b.\tab}}{\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 C\'f3digo de prestaci\'f3n}{\r
+\fs20\lang1024\langfe1024\langnp11274\insrsid4599262 .}{\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f0 c.\tab}Fecha de Realizaci\'f3n de la prestaci\'f3n \r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f0 d.\tab}Porcentaje de cobertura a cubrir por la Obra Social.\r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid3550631 \hich\af0\dbch\af0\loch\f0 e.\tab}}{\fs20\lang1024\langfe1024\langnp11274\insrsid3550631 C\'f3digo}{\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \r
+ de afiliado. \r
+\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \r
+\par 2) }{\b\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 Informe de aprobaciones/rechazos de prestaciones}{\b\f1\fs20\lang1024\langfe1024\langnp11274\insrsid13056714  realizadas}{\r
+\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \r
+\par {\listtext\pard\plain\i\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid14755567\charrsid14755567 \hich\af0\dbch\af0\loch\f0 1.\tab}}\pard \ql \fi-360\li1428\ri0\nowidctlpar\jclisttab\tx1428\faauto\ls7\rin0\lin1428\itap0\pararsid11564094 {\r
+\i\fs20\lang1024\langfe1024\langnp11274\insrsid14755567\charrsid14755567 Cabecera:}{\i\fs20\lang1024\langfe1024\langnp11274\insrsid14755567 \r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid14755567\charrsid11821112 \hich\af0\dbch\af0\loch\f0 a.\tab}}\pard \ql \fi-360\li2148\ri0\nowidctlpar\jclisttab\tx2148\faauto\ls7\ilvl1\rin0\lin2148\itap0\pararsid11564094 {\r
+\fs20\lang1024\langfe1024\langnp11274\insrsid14755567\charrsid11821112 Fecha de generaci\'f3n de }{\fs20\lang1024\langfe1024\langnp11274\insrsid14755567 \'e9ste informe}{\fs20\lang1024\langfe1024\langnp11274\insrsid14755567\charrsid14755567 \r
+\par {\listtext\pard\plain\i\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid14755567\charrsid14755567 \hich\af0\dbch\af0\loch\f0 2.\tab}}\pard \ql \fi-360\li1428\ri0\nowidctlpar\jclisttab\tx1428\faauto\ls7\rin0\lin1428\itap0\pararsid11564094 {\r
+\i\fs20\lang1024\langfe1024\langnp11274\insrsid14755567\charrsid14755567 Detalle:\r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid9260979 \hich\af0\dbch\af0\loch\f0 a.\tab}}\pard \ql \fi-360\li2148\ri0\nowidctlpar\jclisttab\tx2148\faauto\ls7\ilvl1\rin0\lin2148\itap0\pararsid11564094 {\r
+\fs20\lang1024\langfe1024\langnp11274\insrsid9260979 N\'famero de CUIT}{\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310  del Prestador\r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f0 b.\tab}Nombre del Prestador\r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f0 c.\tab}C\'f3digo de autorizaci\'f3n relacionada a la prestaci\'f3n}{\fs20\lang1024\langfe1024\langnp11274\insrsid11494555 \r
+, enviado}{\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310  por el  Prestador.\r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f0 d.\tab}C\'f3digo de prestaci\'f3n}{\fs20\lang1024\langfe1024\langnp11274\insrsid11494555  enviado por el Prestador.}{\r
+\fs20\lang1024\langfe1024\langnp11274\insrsid9260979 \r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f0 e.\tab}}{\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 C\'f3digo de afiliado}{\r
+\fs20\lang1024\langfe1024\langnp11274\insrsid11494555  enviado por el Prestador}{\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f0 f.\tab}% cobertura reclamado por el prestador\r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f0 g.\tab}% cobertura correspondiente al momento de aprobar la autorizaci\'f3n (si la autorizaci\'f3n existe en el sistema)\r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f0 h.\tab}Fecha de aprobaci\'f3n de la autorizaci\'f3n (si la autorizaci\'f3n existe en el Sistema)\r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f0 i.\tab}Fecha de vencimiento de la autorizaci\'f3n (si la autorizaci\'f3n existe en el Sistema)}{\r
+\fs20\lang1024\langfe1024\langnp11274\insrsid7562310 \r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid11564094 \hich\af0\dbch\af0\loch\f0 j.\tab}}{\fs20\lang1024\langfe1024\langnp11274\insrsid11564094 Fecha de recepci\'f3n de la }{\r
+\b\fs20\lang1024\langfe1024\langnp11274\insrsid11564094\charrsid11564094 Informaci\'f3n de prestaciones e intervenciones}{\b\fs20\lang1024\langfe1024\langnp11274\insrsid11564094  }{\fs20\lang1024\langfe1024\langnp11274\insrsid11564094 \r
+enviada por el prestador, }{\fs20\lang1024\langfe1024\langnp11274\insrsid11494555 en la cual ven\'eda la autorizaci\'f3n especificada en c).}{\fs20\lang1024\langfe1024\langnp11274\insrsid11564094\charrsid11494555 \r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid11494555\charrsid7562310 \hich\af0\dbch\af0\loch\f0 k.\tab}}{\fs20\lang1024\langfe1024\langnp11274\insrsid11494555\charrsid7562310 Identificador de l\'ednea Aprobada/Rechazada}{\r
+\fs20\lang1024\langfe1024\langnp11274\insrsid11494555 .}{\fs20\lang1024\langfe1024\langnp11274\insrsid11494555\charrsid7562310 \r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f0 l.\tab}}{\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 Motivo del rechazo de la l\'ednea (ej: \'93\r
+Autorizaci\'f3n recibida inexistente\'94, \'93Autorizaci\'f3n Vencida\'94, \'93% cobertura recibido inv\'e1lido\'94, }{\fs20\lang1024\langfe1024\langnp11274\insrsid8614436 \'93Autorizaci\'f3n recibida no relacionada con el afiliado\'94, \'93Autorizaci\'f3\r
+n recibida no relacionada con la prestaci\'f3n\'94}{\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 )\r
+\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \tab }{\fs20\lang1024\langfe1024\langnp11274\insrsid2299470 \r
+\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid2299470 {\b\f1\fs20\lang1024\langfe1024\langnp11274\insrsid2299470\charrsid7562310 Reporte de consumo de los afiliados}{\b\fs20\lang1024\langfe1024\langnp11274\insrsid2299470\charrsid7562310 \r
 \r
-\par }{\b\f37\fs20\noproof0\insrsid4072389 Precondiciones: }{\f37\fs20\noproof0\insrsid1194460 Existe alg\'fan tipo de comunicaci\'f3n entre }{\f37\fs20\noproof0\insrsid331756 el}{\f37\fs20\noproof0\insrsid1194460  }{\f37\fs20\noproof0\insrsid331756 \r
-Prestador y el Sistema, que permita a}{\f37\fs20\noproof0\insrsid1194460 l }{\f37\fs20\noproof0\insrsid331756 Prestador}{\f37\fs20\noproof0\insrsid1194460  enviar informaci\'f3n hacia \'e9ste \'faltimo}{\f37\fs20\noproof0\insrsid10759101 ; as\'ed como\r
- entre el Sistema y Pagos.}{\f1\fs20\insrsid4072389\charrsid1194460 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f37\noproof0\insrsid4072389 \trowd \irow2\irowband2\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \r
-\trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \r
-\cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid227399 {\f37\noproof0\insrsid4072389 \r
-\par }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid9206653 {\b\f37\fs20\noproof0\insrsid1275109 Poscondiciones}{\b\f37\fs20\noproof0\insrsid4072389 : }{\b\f37\fs20\noproof0\insrsid9206653 \r
-\par }{\f1\fs20\insrsid9206653 Historia cl\'ednica de los a}{\f1\fs20\insrsid5514698 filiados afectados actualizada.}{\f1\fs20\insrsid9206653 \r
-\par \'c1rea de Pagos notificada acerca de las aprobaciones/rechazos de }{\f1\fs20\insrsid10759101 la info enviada por el prestadort acerca de }{\f1\fs20\insrsid9206653 prestaciones}{\f1\fs20\insrsid10759101  realizadas.}{\f1\fs20\insrsid9206653 \r
-\par \'c1rea de Pagos dis}{\f1\fs20\insrsid662813 pone de los reportes de consumo de los afiliados.}{\f1\fs20\insrsid9206653 \r
-\par }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid227399 {\f37\noproof0\insrsid4072389 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f37\noproof0\insrsid4072389 \trowd \irow3\irowband3\r
-\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\r
-\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid227399 {\f37\noproof0\insrsid4072389 \r
-\par }{\b\f37\fs20\noproof0\insrsid4072389 Flujo Principal:\r
-\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid331756 \hich\af1\dbch\af0\loch\f1 1\tab}}\pard\plain \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0\r
-\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls1\rin0\lin720\pararsid9206653 \fs24\lang2058\langfe2058\cgrid\langnp2058\langfenp2058 {\f1\fs20\insrsid331756 El Prestador}{\f1\fs20\insrsid9206653  env\'eda }{\r
-\b\f1\fs20\insrsid9206653\charrsid1194460 informaci\'f3n de prestaciones e intervenciones}{\f1\fs20\insrsid9206653  de los afiliados.}{\f37\insrsid7029692\charrsid9206653 \r
-\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid9206653 \hich\af1\dbch\af0\loch\f1 2\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0\r
-\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls1\rin0\lin720\pararsid9206653 {\f1\fs20\insrsid9206653 El Sistema }{\f1\fs20\insrsid10759101 valida cada linea de la informaci\'f3n recibida; si la linea pasa la validaci\'f3n, se }{\r
-\f1\fs20\insrsid9206653 registra }{\f1\fs20\insrsid10759101 en el sistema la prestaci\'f3n realizada por el afiliado.}{\f37\insrsid9206653\charrsid9206653 \r
-\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid9206653\charrsid9206653 \hich\af1\dbch\af0\loch\f1 3\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0\r
-\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls1\rin0\lin720\pararsid9206653 {\f1\fs20\insrsid9206653\charrsid9206653 El Sistema, en base a \'e9stos datos}{\f1\fs20\insrsid10759101  y el resultado de la validaci\'f3n}{\r
-\f1\fs20\insrsid9206653\charrsid9206653 , construye un }{\b\f1\fs20\insrsid9206653\charrsid8981056 informe de aprobaciones/rechazos de prestaciones}{\f1\fs20\insrsid9206653\charrsid9206653  }{\b\f1\fs20\insrsid10759101\charrsid10759101 realizadas}{\r
-\f1\fs20\insrsid10759101  }{\f1\fs20\insrsid9206653\charrsid9206653 y lo env\'eda a Pagos\r
-\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid10759101 \hich\af1\dbch\af0\loch\f1 4\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0\r
-\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls1\rin0\lin720\pararsid9206653 {\f1\fs20\insrsid10759101 Se llama al Caso de Uso \'93Generar Reporte de Consumo\'94}{\f1\fs20\insrsid9206653 \r
-\par }\pard \s15\ql \li289\ri0\nowidctlpar\intbl\faauto\rin0\lin289\pararsid9206653 {\f37\insrsid9206653 \cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \r
-\fs24\lang1024\langfe1024\cgrid\noproof\langnp2058\langfenp2058 {\f37\insrsid4072389 \trowd \irow4\irowband4\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \r
-\trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\pard\plain \r
-\s15\ql \li289\ri0\nowidctlpar\intbl\faauto\rin0\lin289\pararsid7029692 \fs24\lang2058\langfe2058\cgrid\langnp2058\langfenp2058 {\f37\insrsid4072389 \r
-\par }\pard\plain \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid9206653 \fs24\lang1024\langfe1024\cgrid\noproof\langnp2058\langfenp2058 {\b\f37\fs20\noproof0\insrsid4072389 Flujos Alternativos:}{\b\f37\fs20\noproof0\insrsid10759101  }{\r
-\f37\fs20\noproof0\insrsid10759101\charrsid10759101 No hay}{\f37\fs20\noproof0\insrsid10759101 .}{\b\f37\fs20\noproof0\insrsid7029692\charrsid9206653 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\r
-\f37\noproof0\insrsid4072389 \trowd \irow5\irowband5\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \r
-\clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid227399 {\f37\noproof0\insrsid4072389 \r
-\r
-\par }{\b\f37\fs20\noproof0\insrsid4072389 Flujos de Excepci\'f3n:}{\b\f37\fs20\noproof0\insrsid10759101  }{\f37\fs20\noproof0\insrsid10759101\charrsid10759101 No hay}{\f37\fs20\noproof0\insrsid10759101 .}{\b\f37\fs20\noproof0\insrsid4072389 \r
-\par }\pard \ql \fi-360\li646\ri0\nowidctlpar\intbl\faauto\rin0\lin646\pararsid8586758 {\f37\noproof0\insrsid8586758\charrsid8586758 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f37\noproof0\insrsid4072389 \r
-\trowd \irow6\irowband6\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw5\brdrcf1 \r
-\clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\trowd \irow7\irowband7\lastrow \ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \r
-\trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\pard \r
-\ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid227399 {\f1\noproof0\insrsid4072389\charrsid9206653 \r
-\par }{\b\f1\fs20\noproof0\insrsid4072389\charrsid9206653 Notas:}{\b\f1\fs20\noproof0\insrsid6974674\charrsid9206653  }{\cs16\f1\fs20\insrsid9206653\charrsid9206653 \~\~\~ }{\cs16\f1\fs20\insrsid10759101 - La comunicaci\'f3n Prestador-Sistema podr\'eda ser \r
-\'93sincr\'f3nica\'94 (el prestador accede al Sistema y carga la informaci\'f3n) \'f3 bien \'93asincr\'f3nica\'94 (el Prestador env\'eda un mail, deja un archivo en un FTP, etc y luego el sistema lo procesa con alg\'fan m\'e9todo scheduleado.)}{\r
-\f1\noproof0\insrsid6974674\charrsid9206653 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f37\noproof0\insrsid4072389 \trowd \irow7\irowband7\lastrow \ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\r
-\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \r
-\cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\insrsid4072389 \r
-\par }{\insrsid15751489 Especificaci\'f3n de Datos:}{\insrsid1194460 \r
-\par }{\insrsid15751489 \r
-\par }{\f1\fs20\insrsid8981056\charrsid8981056 1) }{\b\f1\fs20\insrsid1194460 I}{\b\f1\fs20\insrsid1194460\charrsid1194460 nformaci\'f3n de prestaciones e intervenciones}{\b\f1\fs20\insrsid1194460 \r
-\par }\pard \ql \li708\ri0\nowidctlpar\faauto\rin0\lin708\itap0\pararsid3805781 {\insrsid1720812 a) Identificaci\'f3n de Prestador (n\'famero de CUIT) }{\insrsid1720812 {\field{\*\fldinst SYMBOL 224 \\f "Wingdings" \\s 12}{\fldrslt\f10\fs24}}}{\insrsid1720812 \r
- es posible no incluirlo\r
-\par b}{\insrsid12537211 ) C\'f3digo de autorizaci\'f3n relacionada a la }{\insrsid12537211\charrsid1275109 prestaci\'f3n/intervenci\'f3n}{\insrsid12537211 .}{\insrsid5050019  }{\insrsid8981056 \r
-\par }{\insrsid1720812 c) C\'f3digo de prestaci\'f3n/intervenci\'f3n }{\insrsid1720812\charrsid1720812 (\'93Pr\'e1ctica\'94, en el nomenclador)}{\insrsid1720812\charrsid1275109 \r
-\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\insrsid3948734\charrsid1275109 \tab }{\insrsid1720812 c}{\insrsid3948734\charrsid1275109 ) Fecha de R}{\insrsid3805781 ealizaci\'f3n}{\insrsid3948734\charrsid1275109  de la prestaci\'f3n/intervenci\r
-\'f3n }{\insrsid3948734 \r
-\par }{\insrsid1720812 \tab d) Porcentaje de cobertura a cubrir por la Obra Social.}{\insrsid1720812\charrsid1275109 \r
-\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid3948734 {\insrsid3948734\charrsid1275109 \tab }{\insrsid1720812 e}{\insrsid3948734\charrsid1275109 ) N\'famero de afiliado}{\insrsid1720812 .  }{\insrsid1720812 {\field{\*\fldinst SYMBOL\r
- 224 \\f "Wingdings" \\s 12}{\fldrslt\f10\fs24}}}{\insrsid1720812  es posible no incluirlo}{\insrsid3948734\charrsid1275109 \r
-\par }{\insrsid3948734 \r
-\par 2) }{\b\f1\fs20\insrsid3948734\charrsid986895 I}{\b\f1\fs20\insrsid3948734\charrsid8000756 nforme de aprobaciones/rechazos de prestaciones}{\b\f1\fs20\insrsid3948734 \r
-\par }{\insrsid1720812\charrsid6241672 \tab a) Identificaci\'f3n del Prestador\r
-\par \tab b) Nombre del Prestador\r
-\par }\pard \ql \li708\ri0\nowidctlpar\faauto\rin0\lin708\itap0\pararsid6241672 {\insrsid1720812\charrsid6241672 c) C\'f3digo de autorizaci\'f3n }{\insrsid1720812\charrsid6241672 relacionada a la prestaci\'f3n/intervenci\'f3n}{\insrsid6241672 , enviada por el \r
- Prestador.}{\insrsid1720812\charrsid6241672 \r
-\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid15751489 {\insrsid15751489\charrsid6241672 \tab }{\insrsid6241672\charrsid6241672 d}{\insrsid15751489\charrsid6241672 ) C\'f3digo de prestaci\'f3n/intervenci\'f3n (\'93Pr\'e1ctica\'94\r
-, en el nomenclador)\r
-\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid3948734 {\insrsid8000756\charrsid6241672 \tab }{\insrsid1720812\charrsid6241672 e) }{\insrsid6241672\charrsid6241672 Identificador de linea Aprobada/Rechazada}{\insrsid3886421\charrsid6241672 \r
-\r
-\par }{\insrsid6241672\charrsid6241672 \tab f) }{\insrsid6241672 C\'f3digo de afiliado\r
-\par \tab g) % cobertura reclamado por el prestador\r
-\par }\pard \ql \li708\ri0\nowidctlpar\faauto\rin0\lin708\itap0\pararsid6241672 {\insrsid6241672 h) % cobertura correspondiente al momento de aprobar la autorizaci\'f3n (si la autorizaci\'f3n existe en el sistema)\r
-\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid3948734 {\insrsid6241672 \tab }{\insrsid662813 i) F}{\insrsid6241672 echa de aprobaci\'f3n de la autorizaci\'f3n (si la autorizaci\'f3n existe en el Sistema)\r
-\par }\pard \ql \fi708\li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid6241672 {\insrsid6241672 j}{\insrsid662813 ) F}{\insrsid6241672 echa de vencimiento de la autorizaci\'f3n (si la autorizaci\'f3n existe en el Sistema)\r
-\par }\pard \ql \li708\ri0\nowidctlpar\faauto\rin0\lin708\itap0\pararsid662813 {\insrsid662813 k) Motivo del rechazo de la linea (ej: \'93Autorizaci\'f3n recibida inexistente\'94, \'93Autorizaci\'f3n Vencida\'94, \'93% cobertura recibido inv\'e1lido\'94, etc)}\r
-{\insrsid6241672 \r
-\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid3948734 {\insrsid6241672 \tab }{\insrsid1720812\charrsid662813 \r
-\par }{\insrsid3886421\charrsid6241672 3) }{\b\insrsid3886421\charrsid6241672 Reporte de consumo de los afiliados}{\b\insrsid3948734 \r
-\par }{\b\insrsid662813 \tab Cada linea:}{\insrsid662813\charrsid6241672 \r
-\par {\listtext\pard\plain\lang1024\langfe1024\noproof\langnp2058\langfenp2058\insrsid3886421\charrsid6241672 \hich\af0\dbch\af0\loch\f0 a)\tab}}\pard \ql \fi-360\li1065\ri0\nowidctlpar\jclisttab\tx1065\faauto\ls5\rin0\lin1065\itap0\pararsid662813 {\r
-\insrsid3886421\charrsid6241672 N\'famero de afiliado}{\insrsid3948734 \r
-\par {\listtext\pard\plain\lang1024\langfe1024\noproof\langnp2058\langfenp2058\insrsid662813 \hich\af0\dbch\af0\loch\f0 b)\tab}}{\insrsid662813 Nombre, apellido del afiliado\r
-\par }\pard \ql \li1065\ri0\nowidctlpar\faauto\rin0\lin1065\itap0\pararsid662813 {\insrsid662813 Por cada afiliado:\r
-\par }\pard \ql \fi708\li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid662813 {\insrsid662813 c}{\insrsid3886421\charrsid6241672 ) C\'f3digo de prestaci\'f3n/intervenci\'f3n REALIZADA}{\insrsid3886421 \r
-\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\insrsid662813 \tab d) Nombre de la prestaci\'f3n realizada\r
-\par \tab e) C\'f3digo del plan del afiliado\r
-\par \tab f) % Cobertura}{\insrsid662813\charrsid6241672 \r
+\par {\listtext\pard\plain\i\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid11821112\charrsid11821112 \hich\af0\dbch\af0\loch\f0 1.\tab}}\pard \ql \fi-360\li1425\ri0\nowidctlpar\jclisttab\tx1425\faauto\ls5\rin0\lin1425\itap0\pararsid2299470 {\r
+\i\fs20\lang1024\langfe1024\langnp11274\insrsid11821112\charrsid11821112 Cabecera}{\fs20\lang1024\langfe1024\langnp11274\insrsid11821112\charrsid11821112 :}{\fs20\lang1024\langfe1024\langnp11274\insrsid11821112 \r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid11821112\charrsid11821112 \hich\af0\dbch\af0\loch\f0 a.\tab}}\pard \ql \fi-360\li2145\ri0\nowidctlpar\jclisttab\tx2145\faauto\ls5\ilvl1\rin0\lin2145\itap0\pararsid2299470 {\r
+\fs20\lang1024\langfe1024\langnp11274\insrsid11821112\charrsid11821112 Fecha de generaci\'f3n de \'e9ste reporte}{\b\fs20\lang1024\langfe1024\langnp11274\insrsid2299470\charrsid7562310 \tab }{\r
+\i\fs20\lang1024\langfe1024\langnp11274\insrsid11821112\charrsid11821112 \r
+\par {\listtext\pard\plain\i\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid14755567 \hich\af0\dbch\af0\loch\f0 2.\tab}}\pard \ql \fi-360\li1425\ri0\nowidctlpar\jclisttab\tx1425\faauto\ls5\rin0\lin1425\itap0\pararsid11821112 {\r
+\i\fs20\lang1024\langfe1024\langnp11274\insrsid14755567 Detalle (c}{\i\fs20\lang1024\langfe1024\langnp11274\insrsid2299470\charrsid9260979 ada l\'ednea}{\i\fs20\lang1024\langfe1024\langnp11274\insrsid14755567 )}{\r
+\i\fs20\lang1024\langfe1024\langnp11274\insrsid2299470\charrsid9260979 :\r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid9260979\charrsid9260979 \hich\af0\dbch\af0\loch\f0 a.\tab}}\pard \ql \fi-360\li2145\ri0\nowidctlpar\jclisttab\tx2145\faauto\ls5\ilvl1\rin0\lin2145\itap0\pararsid14755567 {\r
+\fs20\lang1024\langfe1024\langnp11274\insrsid9260979\charrsid9260979 C\'f3digo}{\fs20\lang1024\langfe1024\langnp11274\insrsid2299470\charrsid9260979  de afiliado\r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid11821112 \hich\af0\dbch\af0\loch\f0 b.\tab}}{\fs20\lang1024\langfe1024\langnp11274\insrsid11821112 Nombre y a}{\fs20\lang1024\langfe1024\langnp11274\insrsid2299470\charrsid9260979 \r
+pellido del afiliado\r
+\par {\listtext\pard\plain\i\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid2299470\charrsid9260979 \hich\af0\dbch\af0\loch\f0 c.\tab}}{\i\fs20\lang1024\langfe1024\langnp11274\insrsid2299470\charrsid9260979 Por cada afiliado}{\r
+\fs20\lang1024\langfe1024\langnp11274\insrsid2299470\charrsid9260979 :\r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid11821112 \hich\af0\dbch\af0\loch\f0 i.\tab}}\pard \ql \fi-180\li2865\ri0\nowidctlpar\jclisttab\tx2865\faauto\ls5\ilvl2\rin0\lin2865\itap0\pararsid14755567 {\r
+\fs20\lang1024\langfe1024\langnp11274\insrsid11821112 N\'famero de CUIT del Prestador donde se realiz\'f3 la prestaci\'f3n\r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid11821112 \hich\af0\dbch\af0\loch\f0 ii.\tab}Nombre Prestador donde se realiz\'f3 la prestaci\'f3n\r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid2299470\charrsid7562310 \hich\af0\dbch\af0\loch\f0 iii.\tab}}{\fs20\lang1024\langfe1024\langnp11274\insrsid2299470\charrsid7562310 C\'f3digo de prestaci\'f3n REALIZADA\r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid2299470\charrsid7562310 \hich\af0\dbch\af0\loch\f0 iv.\tab}Nombre de la prestaci\'f3n realizada}{\fs20\lang1024\langfe1024\langnp11274\insrsid2299470 \r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid11821112\charrsid7562310 \hich\af0\dbch\af0\loch\f0 v.\tab}}{\fs20\lang1024\langfe1024\langnp11274\insrsid11821112\charrsid7562310 Fecha de Realizaci\'f3n de la prestaci\'f3n\r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid2299470\charrsid7562310 \hich\af0\dbch\af0\loch\f0 vi.\tab}}{\fs20\lang1024\langfe1024\langnp11274\insrsid2299470\charrsid7562310 C\'f3digo del plan del afiliado\r
+\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid2299470\charrsid11821112 \hich\af0\dbch\af0\loch\f0 vii.\tab}}{\fs20\lang1024\langfe1024\langnp11274\insrsid2299470\charrsid11821112 % Cobertura\r
+\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid2299470\charrsid7562310 \r
 \par }}
\ No newline at end of file