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\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
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\par }{\b\f1\fs20\insrsid7562310\charrsid13056714 Flujo Principal:\r
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+\f1\fs20\insrsid12718746 de la misma.\r
+\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid15171231 \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\pararsid15171231 {\f1\fs20\insrsid15171231 El Sistema obtiene dicha informaci\'f3n y verifica su formato. Si el formato NO es v\'e1lido --> }{\b\f1\fs20\insrsid15171231\charrsid5270930 E1\r
+}{\f1\fs20\insrsid15171231 \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\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 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\insrsid7757395\charrsid13056714 \hich\af1\dbch\af0\loch\f1 -\tab}La autorizaci\'f3n }{\f1\fs20\insrsid8614436 deber ser una que est\'e9 aprobada en la }{\r
+\i\f1\fs20\insrsid8614436\charrsid12718746 fecha de recepci\'f3n}{\f1\fs20\insrsid8614436 de la }{\b\f1\fs20\insrsid8614436\charrsid13056714 informaci\'f3n de prestaciones e intervenciones}{\b\f1\fs20\insrsid8614436 }{\f1\fs20\insrsid8614436 \r
+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
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
+\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid11668463\charrsid13056714 \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 {\f1\fs20\insrsid11668463\charrsid13056714 Si la l\'ednea pasa la validaci\'f3n, se registra en el sistema la prestaci\'f3\r
+n realizada por el afiliado. Sino, se 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 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\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
+\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid2299470 \hich\af1\dbch\af0\loch\f1 7\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
+\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\r
+\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid12718746 \hich\af1\dbch\af0\loch\f1 8\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\insrsid12718746 El Sistema le notifica al Operador que finaliz\'f3 el proceso de cotejamiento de datos y generaci\'f3n de reportes.}{\r
+\f1\fs20\insrsid12718746\charrsid13056714 \r
+\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid7562310\charrsid13056714 \hich\af1\dbch\af0\loch\f1 9\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
+\fs24\lang1024\langfe1024\cgrid\noproof\langnp1033\langfenp1033 {\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7490485 \trowd \irow4\irowband4\r
+\ts11\trleft-113\trftsWidth1\trftsWidthB3\trftsWidthA3\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\insrsid7562310\charrsid13056714 Flujos Alternativos: }{\f1\fs20\insrsid7562310\charrsid13056714 No hay.}{\r
+\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
+\ts11\trleft-113\trftsWidth1\trftsWidthB3\trftsWidthA3\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\faauto\rin0\lin0\pararsid5053683 {\b\f1\fs20\lang1024\langfe1024\langnp11274\insrsid15171231\charrsid13056714 Flujos de Excepci\'f3n: }{\r
+\f1\fs20\lang1024\langfe1024\langnp11274\insrsid15171231 \r
+\par }{\b\f1\fs20\lang1024\langfe1024\langnp11274\insrsid15171231\charrsid5270930 E1}{\f1\fs20\lang1024\langfe1024\langnp11274\insrsid15171231 :\r
+\par {\listtext\pard\plain\intbl\f1\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid15171231 \hich\af1\dbch\af0\loch\f1 1.\tab}}\pard \ql \fi-360\li780\ri0\nowidctlpar\intbl\jclisttab\tx780\faauto\ls9\rin0\lin780\pararsid5053683 {\r
+\f1\fs20\lang1024\langfe1024\langnp11274\insrsid15171231 El sistema }{\f1\fs20\lang1024\langfe1024\langnp11274\insrsid15171231 informa al operador que hay un error de formato del archivo y cancela el proceso.}{\r
+\f1\fs20\lang1024\langfe1024\langnp11274\insrsid15171231 \r
+\par {\listtext\pard\plain\intbl\f1\fs20\lang1024\langfe1024\noproof\langnp11274\insrsid15171231 \hich\af1\dbch\af0\loch\f1 2.\tab}Finaliza el caso de uso.\r
+\par }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid5053683 {\f1\fs20\lang1024\langfe1024\langnp11274\insrsid15171231\charrsid13056714 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\r
+\f1\fs20\lang1024\langfe1024\langnp11274\insrsid15171231\charrsid13056714 \trowd \irow6\irowband6\ts11\trleft-113\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl7\trpaddr7\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\clbrdrt\brdrnone \clbrdrl\r
+\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\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 Notas: }{\cs68\f1\fs20\lang11274\noproof0\langnp11274\insrsid7562310\charrsid13056714 \~\~\~ - La comunicaci\'f3n Prestador-Sistema }{\r
+\cs68\f1\fs20\lang11274\noproof0\langnp11274\insrsid12397594 se da mediante un operador, el cual recibe la informaci\'f3n de prestaciones e intervenciones (en cualquier medio) enviada por el Prestador y carga la info en el sistema.}{\r
+\f1\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f1\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 \r
+\trowd \irow7\irowband7\lastrow \ts11\trleft-113\trftsWidth1\trftsWidthB3\trftsWidthA3\trpaddl7\trpaddr7\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\r
+\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8951\clshdrawnil \cellx8838\row }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \r
+\par }{\f1\fs20\lang1024\langfe1024\langnp11274\insrsid15171231 \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
projects / z.facultad / 75.10 / miklolife.git / blobdiff