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}{\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 +\par Historia cl\'ednica de los afiliados afectados actualizada. +\par \'c1rea de Pagos notificada acerca de las aprobaciones/rechazos de la info enviada por el prestador acerca de prestaciones realizadas. +\par \'c1rea de Pagos dispone de los reportes de consumo de los afiliados. +\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 { +\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 +\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 +\par }{\b\f1\fs20\insrsid7562310\charrsid13056714 Flujo Principal: +\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 +\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 +n de prestaciones e intervenciones}{\f1\fs20\insrsid7562310\charrsid13056714 de los afiliados. +\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 +\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\'f3n recibida. Validaciones + sobre la info recibida: +\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\pararsid7757395 { +\f1\fs20\insrsid13056714 La}{\f1\fs20\insrsid7757395\charrsid13056714 autorizaci\'f3n existe en el Sistema. +\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 +\'e1}{\f1\fs20\insrsid7757395\charrsid13056714 relacionada con la prestaci\'f3n descripta por el Prestador. +\par {\listtext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid7757395\charrsid13056714 \hich\af1\dbch\af0\loch\f1 -\tab}La autorizaci\'f3n deber ser una que est\'e9 aprobada. +\par {\listtext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid7757395\charrsid13056714 \hich\af1\dbch\af0\loch\f1 -\tab}Porcentaje de cobertura }{\f1\fs20\insrsid13056714 debe ser igual al}{ +\f1\fs20\insrsid7757395\charrsid13056714 que se aplicaba al momento de la aprobaci\'f3n de la autorizaci\'f3n +\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 { +\f1\fs20\insrsid13056714 Prestador debe ser el mismo que}{\f1\fs20\insrsid7757395\charrsid13056714 }{\f1\fs20\insrsid13056714 e}{\f1\fs20\insrsid7757395\charrsid13056714 l relacionado con la autorizaci\'f3n en el Sistema}{\f1\fs20\insrsid7562310 +\par {\listtext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid13056714 \hich\af1\dbch\af0\loch\f1 -\tab}}{\f1\fs20\insrsid13056714 El afiliado debe estar relacionado con la autorizaci\'f3n recibida.}{ +\f1\fs20\insrsid13056714\charrsid13056714 +\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 +\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 +n realizada por el afiliado. Sino, se la marca como linea rechazada. +\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 +\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 +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\insrsid2299470 +\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 +\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}{ +\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 +\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 +\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls2\rin0\lin720 {\f1\fs20\insrsid7562310\charrsid13056714 Finaliza caso de uso. +\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 +\fs24\lang1024\langfe1024\cgrid\noproof\langnp1033\langfenp1033 {\f1\fs20\insrsid7562310\charrsid13056714 \trowd \irow4\irowband4\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 \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.}{\f1\fs20\insrsid7562310 +\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 \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 -\cellx8838\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0 {\fs20\lang1024\langfe1024\loch\af38\langnp11274\insrsid7562310\charrsid7562310 -\par }\pard \ql \li0\ri0\nowidctlpar\intbl\aspalpha\faauto\rin0\lin0 {\b\f38\fs20\insrsid7562310 Actores: }{\f1\fs20\insrsid7562310 Prestador, Pagos.}{\fs20\insrsid7562310 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 { -\fs20\insrsid7562310 \trowd \irow1\irowband1\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 \cellx8838\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0 {\fs20\lang1024\langfe1024\loch\af38\langnp11274\insrsid7562310\charrsid7562310 -\par }\pard \ql \li0\ri0\nowidctlpar\intbl\aspalpha\faauto\rin0\lin0 {\b\f38\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 Precondiciones: }{\f38\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 Existe alg\'fa -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.}{\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \cell }\pard -\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \trowd \irow2\irowband2\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 \cellx8838\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0 { -\fs20\lang1024\langfe1024\loch\af38\langnp11274\insrsid7562310\charrsid7562310 -\par }{\b\f38\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 Poscondiciones: }{\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 -\par }{\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 Historia cl\'ednica de los afiliados afectados actualizada.}{\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 -\par }{\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \'c1rea de Pagos notificada acerca de las aprobaciones/rechazos de la info enviada por el prestador acerca de prestaciones realizadas.}{ -\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 -\par }{\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \'c1rea de Pagos dispone de los reportes de consumo de los afiliados.}{\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 -\par }\pard \ql \li0\ri0\nowidctlpar\intbl\aspalpha\faauto\rin0\lin0 {\fs20\lang1024\langfe1024\loch\af38\langnp11274\insrsid7562310\charrsid7562310 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 { -\fs20\lang1024\langfe1024\loch\af38\langnp11274\insrsid7562310\charrsid7562310 \trowd \irow3\irowband3\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 \cellx8838\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0 {\fs20\lang1024\langfe1024\loch\af38\langnp11274\insrsid7562310\charrsid7562310 - -\par }{\b\fs20\loch\af38\insrsid7562310 \hich\af0\dbch\af0\loch\f38 Flujo Principal: -\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid7562310 \hich\af1\dbch\af0\loch\f1 1\tab}}\pard\plain \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls2\pnrnot0 -\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls2\rin0\lin720 \fs24\lang2058\langfe2058\cgrid\langnp2058\langfenp2058 {\f1\fs20\insrsid7562310 El Prestador env\'eda }{\b\f1\fs20\insrsid7562310 informaci\'f3n de prestaciones e intervenciones}{ -\f1\fs20\insrsid7562310 de los afiliados.}{\fs20\insrsid7562310 -\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid7562310 \hich\af1\dbch\af0\loch\f1 2\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls2\pnrnot0 -\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls2\rin0\lin720 {\f1\fs20\insrsid7562310 El Sistema valida cada l\'ednea de la informaci\'f3n recibida; si la l\'ednea pasa la validaci\'f3n, se registra en el sistema la prestaci\'f3 -n realizada por el afiliado.}{\fs20\insrsid7562310 -\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid7562310 \hich\af1\dbch\af0\loch\f1 3\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls2\pnrnot0 -\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls2\rin0\lin720 {\f1\fs20\insrsid7562310 El Sistema, en base a estos datos y el resultado de la validaci\'f3n, construye un }{\b\f1\fs20\insrsid7562310 informe de aprobaciones/rechazos de prestaciones}{ -\f1\fs20\insrsid7562310 }{\b\f1\fs20\insrsid7562310 realizadas}{\f1\fs20\insrsid7562310 y lo env\'eda a Pagos}{\fs20\insrsid7562310 -\par {\pntext\pard\plain\s15 \intbl\fs20\lang2058\langfe2058\loch\af1\langnp2058\langfenp2058\insrsid7562310 \hich\af0\dbch\af0\loch\f1 4\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls2\pnrnot0 -\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls2\rin0\lin720 {\fs20\loch\af1\insrsid7562310 \hich\af0\dbch\af0\loch\f1 Se\hich\af0\dbch\af0\loch\f1 llama al Caso de Uso }{\fs20\loch\af1\insrsid7562310 \loch\af1\dbch\af0\hich\f0 \'93}{ -\fs20\loch\af1\insrsid7562310 \hich\af0\dbch\af0\loch\f1 Generar Reporte de Consumo}{\fs20\loch\af1\insrsid7562310 \loch\af1\dbch\af0\hich\f0 \'94}{\fs20\loch\af1\insrsid7562310 -\par {\pntext\pard\plain\s15 \intbl\fs20\lang2058\langfe2058\loch\af1\langnp2058\langfenp2058\insrsid7562310 \hich\af0\dbch\af0\loch\f1 5\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls2\pnrnot0 -\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls2\rin0\lin720 {\fs20\loch\af1\insrsid7562310 \hich\af0\dbch\af0\loch\f1 Finaliza caso de uso. -\par }\pard \s15\ql \li289\ri0\nowidctlpar\intbl\aspalpha\faauto\rin0\lin289 {\fs20\loch\af38\insrsid7562310 \cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 -\fs24\lang1024\langfe1024\cgrid\noproof\langnp1033\langfenp1033 {\fs20\loch\af38\insrsid7562310 \trowd \irow4\irowband4\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 \cellx8838\row }\pard\plain \s15\ql \li289\ri0\nowidctlpar\intbl\faauto\rin0\lin289 -\fs24\lang2058\langfe2058\cgrid\langnp2058\langfenp2058 {\fs20\loch\af38\insrsid7562310 -\par }\pard\plain \ql \li0\ri0\nowidctlpar\intbl\aspalpha\faauto\rin0\lin0 \fs24\lang1024\langfe1024\cgrid\noproof\langnp1033\langfenp1033 {\b\fs20\loch\af38\insrsid7562310 \hich\af0\dbch\af0\loch\f38 Flujos Alternativos: }{\fs20\loch\af38\insrsid7562310 -\hich\af0\dbch\af0\loch\f38 No hay.\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs20\loch\af38\insrsid7562310 \trowd \irow5\irowband5 -\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 -\cellx8838\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0 {\fs20\loch\af38\insrsid7562310 -\par }{\b\fs20\lang1024\langfe1024\loch\af38\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f38 Flujos de Excepci}{\b\fs20\lang1024\langfe1024\loch\af38\langnp11274\insrsid7562310\charrsid7562310 \loch\af38\dbch\af0\hich\f0 \'f3}{ -\b\fs20\lang1024\langfe1024\loch\af38\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f38 n: }{\fs20\lang1024\langfe1024\loch\af38\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f38 No hay. -\par }\pard \ql \fi-360\li646\ri0\nowidctlpar\intbl\aspalpha\faauto\rin0\lin646 {\fs20\lang1024\langfe1024\loch\af38\langnp11274\insrsid7562310\charrsid7562310 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 { -\fs20\lang1024\langfe1024\loch\af38\langnp11274\insrsid7562310\charrsid7562310 \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 \cltxlrtb\clftsWidth3\clwWidth8951\clshdrawnil \cellx8838\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0 {\fs20\lang1024\langfe1024\loch\af1\langnp11274\insrsid7562310\charrsid7562310 -\par }\pard \ql \li0\ri0\nowidctlpar\intbl\aspalpha\faauto\rin0\lin0 {\b\fs20\lang1024\langfe1024\loch\af1\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f1 Notas: }{ -\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 \~\~\~}{\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f2 - La comunicaci}{ -\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 \loch\af2\dbch\af0\hich\f0 \'f3}{\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f2 n Prestador-Sistema podr}{ -\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 \loch\af2\dbch\af0\hich\f0 \'ed}{\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f2 a ser }{ -\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 \loch\af2\dbch\af0\hich\f0 \'93}{\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f2 sincr}{ -\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 \loch\af2\dbch\af0\hich\f0 \'f3}{\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f2 nica}{ -\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 \loch\af2\dbch\af0\hich\f0 \'94}{\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f2 - (el prestador accede al Sistema y carga la informaci}{\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 \loch\af2\dbch\af0\hich\f0 \'f3}{\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 -\hich\af0\dbch\af0\loch\f2 n) }{\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 \loch\af2\dbch\af0\hich\f0 \'f3}{\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 -\hich\af0\dbch\af0\loch\f2 bien }{\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 \loch\af2\dbch\af0\hich\f0 \'93}{\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 -\hich\af0\dbch\af0\loch\f2 asincr}{\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 \loch\af2\dbch\af0\hich\f0 \'f3}{\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 -\hich\af0\dbch\af0\loch\f2 nica}{\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 \loch\af2\dbch\af0\hich\f0 \'94}{\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 -\hich\af0\dbch\af0\loch\f2 (el Prestador env}{\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 \loch\af2\dbch\af0\hich\f0 \'ed}{\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 -\hich\af0\dbch\af0\loch\f2 a un mail, deja un archivo en un FTP, etc y luego el sistema lo procesa con alg}{\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 \loch\af2\dbch\af0\hich\f0 \'fa}{ -\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f2 n m}{\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 \loch\af2\dbch\af0\hich\f0 \'e9}{ -\cs68\fs20\lang11274\loch\af2\noproof0\langnp11274\insrsid7562310\charrsid7562310 \hich\af0\dbch\af0\loch\f2 todo scheduleado.)}{\lang1024\langfe1024\loch\af1\langnp11274\insrsid7562310\charrsid7562310 \cell }\pard -\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\lang1024\langfe1024\loch\af1\langnp11274\insrsid7562310\charrsid7562310 \trowd \irow7\irowband7\lastrow +\cellx8838\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid2299470 {\b\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 Flujos de Excepci\'f3n: }{ +\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 No hay.}{\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310 +\par }{\f1\fs20\lang1024\langfe1024\langnp11274\insrsid2299470\charrsid13056714 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 +\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 +\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: }{ +\cs68\f1\fs20\lang11274\noproof0\langnp11274\insrsid7562310\charrsid13056714 \~\~\~ - La comunicaci\'f3n Prestador-Sistema podr\'eda ser \'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.)}{\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 \trowd \irow7\irowband7\lastrow \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 \cellx8838\row }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 -\par Especificaci\'f3n de Datos: -\par +\par }{\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid13056714 Especificaci\'f3n de Datos: +\par }{\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \par }{\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 1) }{\b\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 Informaci\'f3n de prestaciones e intervenciones}{ \fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 -\par }\pard \ql \li708\ri0\nowidctlpar\faauto\rin0\lin708\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 a) Identificaci\'f3n de Prestador (n\'famero de CUIT) }{\f10\fs20\cgrid0\noproof0\insrsid7562310 \'e0}{ -\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 es posible no incluirlo +\par }\pard \ql \li708\ri0\nowidctlpar\faauto\rin0\lin708\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 a) Identificaci\'f3}{\fs20\lang1024\langfe1024\langnp11274\insrsid13056714 n de Prestador (n\'famero de CUIT)}{ +\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \par b) C\'f3digo de autorizaci\'f3n relacionada a la prestaci\'f3n/intervenci\'f3n. \par c) C\'f3digo de prestaci\'f3n/intervenci\'f3n (\'93Pr\'e1ctica\'94, en el nomenclador) \par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \tab c) Fecha de Realizaci\'f3n de la prestaci\'f3n/intervenci\'f3n \par \tab d) Porcentaje de cobertura a cubrir por la Obra Social. -\par \tab e) N\'famero de afiliado. }{\f10\fs20\cgrid0\noproof0\insrsid7562310 \'e0}{\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 es posible no incluirlo +\par \tab e) N\'famero de afiliado. \par -\par 2) }{\b\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 Informe de aprobaciones/rechazos de prestaciones}{\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 +\par 2) }{\b\f1\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 Informe de aprobaciones/rechazos de prestaciones}{\b\f1\fs20\lang1024\langfe1024\langnp11274\insrsid13056714 realizadas}{ +\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \par \tab a) Identificaci\'f3n del Prestador \par \tab b) Nombre del Prestador \par }\pard \ql \li708\ri0\nowidctlpar\faauto\rin0\lin708\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 c) C\'f3digo de autorizaci\'f3n relacionada a la prestaci\'f3n/intervenci\'f3n, enviada por el Prestador. @@ -134,5 +137,16 @@ n realizada por el afiliado.}{\fs20\insrsid7562310 \par }\pard \ql \fi708\li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 j) Fecha de vencimiento de la autorizaci\'f3n (si la autorizaci\'f3n existe en el Sistema) \par }\pard \ql \li708\ri0\nowidctlpar\faauto\rin0\lin708\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 k) Motivo del rechazo de la l\'ednea (ej: \'93Autorizaci\'f3n recibida inexistente\'94, \'93Autorizaci\'f3n Vencida\'94, \'93 % cobertura recibido inv\'e1lido\'94, etc) -\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \tab +\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid7562310\charrsid7562310 \tab }{\fs20\lang1024\langfe1024\langnp11274\insrsid2299470 +\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 + +\par \tab }{\b\fs20\insrsid2299470 Cada l\'ednea: +\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\insrsid2299470 \hich\af0\dbch\af0\loch\f0 a)\tab}}\pard \ql \fi-360\li1065\ri0\nowidctlpar\faauto\ls1\rin0\lin1065\itap0\pararsid2299470 {\fs20\insrsid2299470 N\'famero de afiliado +\par {\listtext\pard\plain\fs20\lang1024\langfe1024\noproof\insrsid2299470 \hich\af0\dbch\af0\loch\f0 b)\tab}Nombre, apellido del afiliado +\par }\pard \ql \li1065\ri0\nowidctlpar\faauto\rin0\lin1065\itap0\pararsid2299470 {\fs20\insrsid2299470 Por cada afiliado: +\par }\pard \ql \fi708\li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid2299470 {\fs20\lang1024\langfe1024\langnp11274\insrsid2299470\charrsid7562310 c) C\'f3digo de prestaci\'f3n/intervenci\'f3n REALIZADA +\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid2299470 {\fs20\lang1024\langfe1024\langnp11274\insrsid2299470\charrsid7562310 \tab d) Nombre de la prestaci\'f3n realizada +\par \tab e) C\'f3digo del plan del afiliado +\par \tab }{\fs20\insrsid2299470 f) % Cobertura +\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\fs20\lang1024\langfe1024\langnp11274\insrsid2299470\charrsid7562310 \par }} \ No newline at end of file