X-Git-Url: https://git.llucax.com/z.facultad/75.10/miklolife.git/blobdiff_plain/ab7522b0e4406bb2bc5879c2888d32c26023ac10..22b9b4517d3bbda8f2441bf59833fa416d5fa896:/carpeta/Decisiones.rtf?ds=sidebyside diff --git a/carpeta/Decisiones.rtf b/carpeta/Decisiones.rtf index a78684b..d309eac 100644 --- a/carpeta/Decisiones.rtf +++ b/carpeta/Decisiones.rtf @@ -1,287 +1,314 @@ -{\rtf1\ansi\deff1\adeflang1025 -{\fonttbl{\f0\froman\fprq2\fcharset0 Nimbus Roman No9 L{\*\falt Times New Roman};}{\f1\froman\fprq2\fcharset0 Times New Roman;}{\f2\fswiss\fprq2\fcharset0 Arial;}{\f3\froman\fprq2\fcharset0 Times New Roman;}{\f4\fmodern\fprq1\fcharset0 Courier New;}{\f5\fnil\fprq2\fcharset2 Wingdings;}{\f6\froman\fprq2\fcharset2 Symbol;}{\f7\fswiss\fprq2\fcharset0 Trebuchet MS{\*\falt Desyrel};}{\f8\fnil\fprq0\fcharset2 StarSymbol;}{\f9\fnil\fprq0\fcharset0 Tahoma{\*\falt Lucidasans};}} -{\colortbl;\red0\green0\blue0;\red0\green0\blue255;\red255\green0\blue0;\red128\green128\blue128;} 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-{\*\pgdscno0}\paperh15840\paperw12240\margl1701\margr1701\margt1417\margb1417\sectd\sbknone\pgwsxn12240\pghsxn15840\marglsxn1701\margrsxn1701\margtsxn1417\margbsxn1417\ftnbj\ftnstart1\ftnrstcont\ftnnar\aenddoc\aftnrstcont\aftnstart1\aftnnrlc -\pard\plain \ltrpar\s6\cf0\ul\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\aspalpha\rtlch\af7\afs20\lang3082\ab\ltrch\dbch\af7\afs20\langfe3082\ab\loch\f7\fs20\lang3082\b {\loch\f7\fs20\lang3082\i0\b Decisiones tomadas a partir del relevamiento} -\par \pard\plain \ltrpar\s6\cf0\ul\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\aspalpha\rtlch\af7\afs20\lang3082\ab\ltrch\dbch\af7\afs20\langfe3082\ab\loch\f7\fs20\lang3082\b -\par \pard\plain \ltrpar\s6\cf0\ul\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\aspalpha\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 Zona} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\aspalpha\rtlch\af7\afs20\lang3082\ab\ltrch\dbch\af7\afs20\langfe3082\ab\loch\f7\fs20\lang3082\b -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\aspalpha\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 Contiene un c\'f3digo y un campo descriptivo que refiere a la ubicaci\'f3n geogr\'e1fica de la misma.} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\aspalpha\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 -\par \pard\plain \ltrpar\s6\cf0\ul\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\aspalpha\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 CAP} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\aspalpha\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\aspalpha\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 En la estructura determinamos que hay un CAP por zona geogr\'e1fica, cada uno tiene asignado un grupo de promotores, si el solicitante se presenta directamente en el cap o en la sede central para afiliarse, lo atiende un operador que estar\'e1 encargado de carga -rlo al sistema como solicitante para que luego sea visitado por un promotor.} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\aspalpha\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 -\par \pard\plain \ltrpar\s6\cf0\ul\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\aspalpha\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 Promotor} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\aspalpha\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\aspalpha\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - Un promotor pertenece a un CAP.} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\aspalpha\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - El armado de la hoja de ruta que determina a quien visita cada promotor depende de un actor externo al sistema (Enrutador), el promotor solo recibe el listado ya confeccionado con un anexo con los planes a ofrecer al afiliado.} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\aspalpha\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 -\par \pard\plain \ltrpar\s6\cf0\ul\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\aspalpha\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 Planes} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\aspalpha\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\aspalpha\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - Las restricciones respecto al ingreso a un plan son determinadas fuera del sistema en el momento de establecer los planes a ofrecer a un solicitante.} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\aspalpha\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082{\loch\f7\fs20\lang3082\i0\b0{\cf1 - los planes est\'e1n divididos por categor\'edas. L}}{\loch\f7\fs20\lang3082a categor\'eda de un plan es asignada por el encargado de dar de alta un plan en el sistema} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\aspalpha\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - un plan de mejor categor\'eda tiene mejores prestaciones, las prestaciones del plan de menor cobertura se mantienen o expanden, nunca se quitan} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\aspalpha\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082{\loch\f7\fs20\lang3082\i0\b0\cf1 - {\ul Cambio de plan}: se tiene en cuenta la categor\'eda del plan} -\par \pard\plain {\listtext\pard\plain \li1080\ri0\lin1080\rin0\fi-360\cf1\f7\fs20\f7\fs20\f7\fs20\qj\f5\chcbpat1\f5\f5 \u61692 ?}\ilvl0 \ltrpar\s6\cf1\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\ls3\li1080\ri0\lin1080\rin0\fi-360\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 Si el afiliado se cambia a un plan mejor, se resetean todos los valores (carencias, etc)} -\par \pard\plain {\listtext\pard\plain \li1080\ri0\lin1080\rin0\fi-360\cf1\f7\fs20\f7\fs20\f7\fs20\qj\f5\chcbpat1\f5\f5 \u61692 ?}\ilvl0 \ltrpar\s6\cf1\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\ls3\li1080\ri0\lin1080\rin0\fi-360\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 Si el afiliado se cambia a un plan de menor categor\'eda, se consideran los datos almacenados hasta el momento para el plan anterior.} -\par \pard\plain \ltrpar\s6\cf1\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - Las carencias se resetean al a\'f1o de inscripci\'f3n} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - existe un tiempo de permanencia m\'ednima en un plan para acceder a determinadas prestaciones, este tiempo de permanencia m\'ednima est\'e1 especificado en el plan.} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - Cuando se da de baja un plan, se almacena como fecha de baja la fecha actual, de esta manera, no se toman nuevos afiliados a dicho plan pero si se mantienen los afiliados existentes.} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 -\par \pard\plain \keepn\f7\fs20\ul\f7\fs20\f7\fs20\qj \ltrpar\s8\cf0\ul\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\keepn\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 Solicitante} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ab\ltrch\dbch\af7\afs20\langfe3082\ab\loch\f7\fs20\lang3082\b -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082{\loch\f7\fs20\lang3082\i0\b{\b - }}{\loch\f7\fs20\lang3082Se asocia a un promotor que estar\'e1 encargado de visitarlo, el atributo pendiente estar\'e1 en true mientras el solicitante no haya sido visitado por un promotor y ser\'e1 false cuando se le haya asignado alguno. } -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - Cuando el promotor termina con sus visitas del d\'eda, informa:} -\par \pard\plain {\listtext\pard\plain \li1080\ri0\lin1080\rin0\fi-360\f7\fs20\f7\fs20\f7\fs20\qj\f5\chcbpat1\f5\f5 \u61692 ?}\ilvl0 \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\ls1\li1080\ri0\lin1080\rin0\fi-360\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 a qui\'e9n visit\'f3: aceptaci\'f3n / rechazo afiliaci\'f3n} -\par \pard\plain {\listtext\pard\plain \li1080\ri0\lin1080\rin0\fi-360\f7\fs20\f7\fs20\f7\fs20\qj\f5\chcbpat1\f5\f5 \u61692 ?}\ilvl0 \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\ls1\li1080\ri0\lin1080\rin0\fi-360\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 a qui\'e9n no visit\'f3: el campo pendiente del solicitante en cuesti\'f3n vuelve al valor true y se reasignar\'e1 un nuevo promotor al d\'eda siguiente.} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\li720\ri0\lin720\rin0\fi0\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 -\par \pard\plain \ltrpar\s6\cf0\ul\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 Afiliados} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - se almacena la fecha de afiliaci\'f3n a la OS para establecer la antig\'fcedad;} -\par \pard\plain \ltrpar\s6\cf1\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - se almacena el historial de planes del afiliado: una lista de planes + fecha de ingreso y fecha de egreso (esta \'faltima en null para el plan actual)} -\par \pard\plain \ltrpar\s6\cf1\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - en la lista los planes se guardan desde el m\'e1s antiguo hasta el actual.} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - se establecen 2 tipos de antig\'fcedad: fecha de afiliaci\'f3n y fecha de ingreso al plan actual para controlar carencias} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 -Para ver la situaci\'f3n del afiliado se usan tres atributos: } -\par \pard\plain {\listtext\pard\plain \li1080\ri0\lin1080\rin0\fi-360\f7\fs20\f7\fs20\f7\fs20\qj\f5\chcbpat1\f5\f5 \u61692 ?}\ilvl0 \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\ls5\li1080\ri0\lin1080\rin0\fi-360\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082{\loch\f7\fs20\lang3082\i0\b{\b moroso}}{\loch\f7\fs20\lang3082: entero que indica la cantidad de cuotas adeudadas.} -\par \pard\plain {\listtext\pard\plain \li1080\ri0\lin1080\rin0\fi-360\f7\fs20\f7\fs20\f7\fs20\qj\f5\chcbpat1\f5\f5 \u61692 ?}\ilvl0 \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\ls5\li1080\ri0\lin1080\rin0\fi-360\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082{\loch\f7\fs20\lang3082\i0\b{\b fechaBaja}}{\loch\f7\fs20\lang3082: queda en null mientras que al afiliado no sea dado de baja.} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - una vez afiliado un cliente el solicitante que se correspond\'eda con el nuevo afiliado es dado de baja.} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - cuando el afiliado que se ingresa es el titular de un grupo familiar o es un afiliado independiente el campo titular = null;} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 -\par \pard\plain \ltrpar\s6\cf0\ul\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 Grupos familiares} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - todos los integrantes del grupo familiar tienen igual plan;} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - cuando el afiliado que se ingresa es un adherente el campo titular contiene una referencia al afiliado designado como titular del grupo;} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - Cambio de titular: se le pregunta a alg\'fan integrante del grupo familiar qui\'e9n ser\'e1 el nuevo titular o bien si se da de baja al grupo completo} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 -\par \pard\plain \ltrpar\s6\cf0\ul\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 Autorizaciones} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ab\ltrch\dbch\af7\afs20\langfe3082\ab\loch\f7\fs20\lang3082\b -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082{\loch\f7\fs20\lang3082\i0\b{\b - }}{\loch\f7\fs20\lang3082Las autorizaciones, a lo largo de su ciclo de vida pasan por diferentes estados:} -\par \pard\plain {\listtext\pard\plain \li720\ri0\lin720\rin0\fi-360\f7\fs20\f7\fs20\f7\fs20\qj\f5\chcbpat1\f5\f5 \u61692 ?}\ilvl0 \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\ls2\li720\ri0\lin720\rin0\fi-360\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082{\loch\f7\fs20\lang3082\i0\b{\b Pendiente}}{\loch\f7\fs20\lang3082 (s\'f3lo para la manual): est\'e1 pendiente de aprobaci\'f3n o rechazo;} -\par \pard\plain {\listtext\pard\plain \li720\ri0\lin720\rin0\fi-360\f7\fs20\f7\fs20\f7\fs20\qj\f5\chcbpat1\f5\f5 \u61692 ?}\ilvl0 \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\ls2\li720\ri0\lin720\rin0\fi-360\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082{\loch\f7\fs20\lang3082\i0\b{\b Aprobada}}{\loch\f7\fs20\lang3082: la autorizaci\'f3n fue aprobada, por lo tanto el afiliado puede realizar la prestaci\'f3n;} -\par \pard\plain {\listtext\pard\plain \li720\ri0\lin720\rin0\fi-360\f7\fs20\f7\fs20\f7\fs20\qj\f5\chcbpat1\f5\f5 \u61692 ?}\ilvl0 \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\ls2\li720\ri0\lin720\rin0\fi-360\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082{\loch\f7\fs20\lang3082\i0\b{\b Rechazada}}{\loch\f7\fs20\lang3082: la autorizaci\'f3n fue rechazada. Se registra para los posteriores informes a enviar al director y al m\'e9dico para que tenga mayor informaci\'f3n a la hora de aceptar una autorizaci\'f3n manual;} -\par \pard\plain {\listtext\pard\plain \li720\ri0\lin720\rin0\fi-360\f7\fs20\f7\fs20\f7\fs20\qj\f5\chcbpat1\f5\f5 \u61692 ?}\ilvl0 \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\ls2\li720\ri0\lin720\rin0\fi-360\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082{\loch\f7\fs20\lang3082\i0\b{\b Vencida:}}{\loch\f7\fs20\lang3082 la autorizaci\'f3n nunca fue realizada y venci\'f3 su vigencia, se establecen dos meses de vigencia a partir de la fecha de Solicitud en el caso de las autom\'e1ticas y la fecha de resoluci\'f3n en el caso de las manuales;} -\par \pard\plain {\listtext\pard\plain \li720\ri0\lin720\rin0\fi-360\f7\fs20\f7\fs20\f7\fs20\qj\f5\chcbpat1\f5\f5 \u61692 ?}\ilvl0 \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\ls2\li720\ri0\lin720\rin0\fi-360\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082{\loch\f7\fs20\lang3082\i0\b{\b Realizada:}}{\loch\f7\fs20\lang3082 la autorizaci\'f3n fue realizada, se carga cuando el prestador env\'eda el listado de prestaciones realizadas en el per\'edodo.} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ab\ltrch\dbch\af7\afs20\langfe3082\ab\loch\f7\fs20\lang3082\b -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082{\loch\f7\fs20\lang3082\i0\b0{\ul Nota}}{\loch\f7\fs20\lang3082: para m\'e1s detalle de estados, eventos y transiciones, ver los {\b diagramas de estado de la autorizaci\'f3n manual y de la autom\'e1tica}.} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 Los estados se determinar\'e1n a partir de un m\'e9todo que lo calcula a partir de las fechas y de un atributo booleano \ldblquote aprobada\rdblquote } -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - {\ul Fechas relacionadas a la autorizaci\'f3n}:} -\par \pard\plain {\listtext\pard\plain \li1080\ri0\lin1080\rin0\fi-360\f7\fs20\f7\fs20\f7\fs20\qj\chcbpat1 1)}\ilvl0 \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\ls4\li1080\ri0\lin1080\rin0\fi-360\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082{\loch\f7\fs20\lang3082\i0\b{\b Solicitud}}{\loch\f7\fs20\lang3082: fecha en que el \ldblquote Solicitador de Autorizaciones\rdblquote solicita la autorizaci\'f3n} -\par \pard\plain {\listtext\pard\plain \li1080\ri0\lin1080\rin0\fi-360\f7\fs20\f7\fs20\f7\fs20\qj\chcbpat1 2)}\ilvl0 \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\ls4\li1080\ri0\lin1080\rin0\fi-360\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082{\loch\f7\fs20\lang3082\i0\b{\b Resoluci\'f3n}}{\loch\f7\fs20\lang3082: fecha en que se aprob\'f3/rechaz\'f3 la autorizaci\'f3n manual (acompa\'f1ado de un campo para describir el motivo de la decisi\'f3n)} -\par \pard\plain {\listtext\pard\plain \li1080\ri0\lin1080\rin0\fi-360\f7\fs20\f7\fs20\f7\fs20\qj\chcbpat1 3)}\ilvl0 \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\ls4\li1080\ri0\lin1080\rin0\fi-360\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082{\loch\f7\fs20\lang3082\i0\b{\b Realizaci\'f3n}}{\loch\f7\fs20\lang3082: fecha en que el afiliado se realiz\'f3 la presataci\'f3n.} -\par \pard\plain {\listtext\pard\plain \li1080\ri0\lin1080\rin0\fi-360\f7\fs20\f7\fs20\f7\fs20\qj\chcbpat1 4)}\ilvl0 \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\ls4\li1080\ri0\lin1080\rin0\fi-360\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082{\loch\f7\fs20\lang3082\i0\b{\b Vencimiento}}{\loch\f7\fs20\lang3082: fecha en que vence la prestaci\'f3n. Se calcula a partir de la fecha de resoluci\'f3n (ej: 2 meses) en manuales; y a partir de la fecha de solicitud en autom\'e1ticas.} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\li720\ri0\lin720\rin0\fi0\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - {\ul Atributos descriptivos:}} -\par \pard\plain {\listtext\pard\plain \li720\ri0\lin720\rin0\fi-360\f7\fs20\f7\fs20\f7\fs20\qj\f5\chcbpat1\f5\f5 \u61692 ?}\ilvl0 \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\ls2\li720\ri0\lin720\rin0\fi-360\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082{\loch\f7\fs20\lang3082\i0\b{\b observaciones}}{\loch\f7\fs20\lang3082 (solo manual): Se utilizar\'e1 para que un m\'e9dico pueda ampliar los motivos por los que pide la autorizaci\'f3n (ej: enfermedad grave, etc.);} -\par \pard\plain {\listtext\pard\plain \li720\ri0\lin720\rin0\fi-360\f7\fs20\f7\fs20\f7\fs20\qj\f5\chcbpat1\f5\f5 \u61692 ?}\ilvl0 \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\ls2\li720\ri0\lin720\rin0\fi-360\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082{\loch\f7\fs20\lang3082\i0\b{\b fundamentosResolucion}}{\loch\f7\fs20\lang3082: Es para que el auditor JUSTIFIQUE por que aprob\'f3/rechazo la autorizaci\'f3n. Tambi\'e9n se completar\'e1 de forma autom\'e1tica en caso de rechazo en autorizaci\'f3n autom\'e1tica.} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - Dado que para una autorizaci\'f3n AUTOM\'c1TICA, la fecha de resoluci\'f3n es la misma que la de solicitud, s\'f3lo dispone de fecha de solicitud.\~\~Por eso, se sobreentiende que cuando hablamos de fecha de resoluci\'f3n en una AUTOM\'c1TICA, es lo mismo que fecha de solic -itud. } -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - A partir de la fecha de aprobaci\'f3n de la autorizaci\'f3n, la cl\'ednica tiene 2 meses para reclamar los pagos (fecha de vencimiento).} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - La fecha de vencimiento queda por si se cambia la pol\'edtica de los 2 meses (punto anterior), y \'e9ste cambio se establece una vez que las autorizaciones ya han sido aprobadas.} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - No se aplican pol\'edticas especiales en caso de que el auditor m\'e9dico tarde m\'e1s de 24hs en aprobar/rechazar una autorizaci\'f3n manual. Quedan almacenadas las fechas de solicitud y aprobaci\'f3n, las cuales pueden ser usadas para determinar si alg\'fan auditor m\'e9di -co tard\'f3 m\'e1s de lo debido.} -\par \pard\plain \ltrpar\s10\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - en la autorizaci\'f3n manual se almacena el c\'f3digo de prestador en el cual el afiliado se realizar\'e1 la prestaci\'f3n;} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - en la autorizaci\'f3n se almacena el porcentaje de cobertura sobre la prestaci\'f3n, en caso de que el afiliado se cambie de plan se registr\'f3 en el sistema el porcentaje que se cubre sobre la prestaci\'f3n para el plan a la que el afiliado pertenec\'eda a la hora de - {\ul aprobar} la autorizaci\'f3n y despu\'e9s poder comparar con las prestaciones realizadas;} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - si un afiliado se da de baja, las autorizaciones manuales aprobadas hasta el d\'eda de baja se cubren.} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 -\par \pard\plain \keepn\f7\fs20\ul\f7\fs20\f7\fs20\qj \ltrpar\s8\cf0\ul\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\keepn\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 Cobertura} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ab\ltrch\dbch\af7\afs20\langfe3082\ab\loch\f7\fs20\lang3082\b -\par \pard\plain {\listtext\pard\plain \li283\ri0\lin283\rin0\fi-283\f7\fs20\f7\fs20\f7\fs20\qj\f8\fs18\f8\fs18\f8\fs18 \endash }\ilvl0 \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\ls0\li283\ri0\lin283\rin0\fi-283\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 Se guardan los datos de coberturas de determinada prestaci\'f3n para determinado plan en el caso de que sea mayor a cero.} -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 -\par \pard\plain \ltrpar\s6\cf0\ul\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 Requerimientos al sector Cobranzas} -\par -\par \pard\plain \ltrpar\s6\cf0\qj{\*\hyphen2\hyphlead2\hyphtrail2\hyphmax0}\rtlch\af7\afs20\lang3082\ltrch\dbch\af7\afs20\langfe3082\loch\f7\fs20\lang3082 {\loch\f7\fs20\lang3082\i0\b0 - Se requiere que en el env\'edo de estado de morosidad de los afiliados se env\'eden los datos de todos los afiliados, sin distinguir si son titulares o familiares. Si el familiar quiere pasar a ser titular ya se tiene toda la informaci\'f3n de morosidad sin tene -r que depender del estado del titular.} -\par } \ No newline at end of file +{\rtf1\ansi\ansicpg1252\uc1 \deff0\deflang3082\deflangfe3082{\fonttbl{\f0\froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman;}{\f1\fswiss\fcharset0\fprq2{\*\panose 020b0604020202020204}Arial;} +{\f2\fmodern\fcharset0\fprq1{\*\panose 02070309020205020404}Courier New;}{\f3\froman\fcharset2\fprq2{\*\panose 05050102010706020507}Symbol;}{\f14\fnil\fcharset2\fprq2{\*\panose 05000000000000000000}Wingdings;} +{\f27\fswiss\fcharset0\fprq2{\*\panose 020b0604030504040204}Tahoma{\*\falt Lucidasans};}{\f28\fswiss\fcharset0\fprq2{\*\panose 020b0603020202020204}Trebuchet MS{\*\falt Desyrel};}{\f30\fnil\fcharset0\fprq0{\*\panose 00000000000000000000}StarSymbol;} +{\f85\froman\fcharset238\fprq2 Times New Roman CE;}{\f86\froman\fcharset204\fprq2 Times New Roman Cyr;}{\f88\froman\fcharset161\fprq2 Times New 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}{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow2 +\levelstartat1\levelspace0\levelindent0{\leveltext\'01\'96;}{\levelnumbers;}\f30\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1 \fi-283\li849 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow2\levelstartat1\levelspace0\levelindent0 +{\leveltext\'01\'96;}{\levelnumbers;}\f30\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1 \fi-283\li1132 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow2\levelstartat1\levelspace0\levelindent0{\leveltext\'01\'96;}{\levelnumbers;} +\f30\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1 \fi-283\li1415 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow2\levelstartat1\levelspace0\levelindent0{\leveltext\'01\'96;}{\levelnumbers;}\f30\chbrdr\brdrnone\brdrcf1 +\chshdng0\chcfpat1\chcbpat1 \fi-283\li1698 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+\leveljc0\leveljcn0\levelfollow2\levelstartat1\levelspace0\levelindent0{\leveltext\'01o;}{\levelnumbers;}\f2\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1 \fi-360\li1440 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow2 +\levelstartat1\levelspace0\levelindent0{\leveltext\'01\u-3929 ?;}{\levelnumbers;}\f14\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1 \fi-360\li2160 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow2\levelstartat1\levelspace0 +\levelindent0{\leveltext\'01\u-3913 ?;}{\levelnumbers;}\f3\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1 \fi-360\li2880 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow2\levelstartat1\levelspace0\levelindent0{\leveltext +\'01o;}{\levelnumbers;}\f2\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1 \fi-360\li3600 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow2\levelstartat1\levelspace0\levelindent0{\leveltext\'01\u-3929 ?;}{\levelnumbers;}\f14\chbrdr +\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1 \fi-360\li4320 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow2\levelstartat1\levelspace0\levelindent0{\leveltext\'01\u-3913 ?;}{\levelnumbers;}\f3\chbrdr\brdrnone\brdrcf1 +\chshdng0\chcfpat1\chcbpat1 \fi-360\li5040 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow2\levelstartat1\levelspace0\levelindent0{\leveltext\'01o;}{\levelnumbers;}\f2\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1 \fi-360\li5760 } +{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow2\levelstartat1\levelspace0\levelindent0{\leveltext\'01\u-3929 ?;}{\levelnumbers;}\f14\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1 \fi-360\li6480 }{\listname RTF_Num 11;}\listid5} +{\list\listtemplateid6{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow2\levelstartat1\levelspace0\levelindent0{\leveltext\'01\u-3844 ?;}{\levelnumbers;}\f14\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1 \fi-360\li1080 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RTF_Num 3;}\listid8}{\list\listtemplateid9{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow2\levelstartat1\levelspace0\levelindent0{\leveltext\'01\'96;}{\levelnumbers;}\f30\chbrdr\brdrnone\brdrcf1 +\chshdng0\chcfpat1\chcbpat1 \fi-283\li283 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow2\levelstartat1\levelspace0\levelindent0{\leveltext\'01\'96;}{\levelnumbers;}\f30\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1 +\fi-283\li566 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow2\levelstartat1\levelspace0\levelindent0{\leveltext\'01\'96;}{\levelnumbers;}\f30\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1 \fi-283\li849 }{\listlevel\levelnfc23 +\levelnfcn23\leveljc0\leveljcn0\levelfollow2\levelstartat1\levelspace0\levelindent0{\leveltext\'01\'96;}{\levelnumbers;}\f30\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1 \fi-283\li1132 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0 +\levelfollow2\levelstartat1\levelspace0\levelindent0{\leveltext\'01\'96;}{\levelnumbers;}\f30\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1 \fi-283\li1415 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow2\levelstartat1\levelspace0 +\levelindent0{\leveltext\'01\'96;}{\levelnumbers;}\f30\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1 \fi-283\li1698 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow2\levelstartat1\levelspace0\levelindent0{\leveltext +\'01\'96;}{\levelnumbers;}\f30\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1 \fi-283\li1981 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow2\levelstartat1\levelspace0\levelindent0{\leveltext\'01\'96;}{\levelnumbers;}\f30\chbrdr +\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1 \fi-283\li2264 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow2\levelstartat1\levelspace0\levelindent0{\leveltext\'01\'96;}{\levelnumbers;}\f30\chbrdr\brdrnone\brdrcf1 +\chshdng0\chcfpat1\chcbpat1 \fi-283\li2547 }{\listname RTF_Num 2;}\listid9}}{\*\listoverridetable{\listoverride\listid1\listoverridecount0\ls1}{\listoverride\listid2\listoverridecount0\ls2}{\listoverride\listid3\listoverridecount0\ls3} +{\listoverride\listid4\listoverridecount0\ls4}{\listoverride\listid5\listoverridecount0\ls5}{\listoverride\listid6\listoverridecount0\ls6}{\listoverride\listid7\listoverridecount0\ls7}{\listoverride\listid8\listoverridecount0\ls8}{\listoverride\listid9 +\listoverridecount0\ls9}}{\info{\author Nombre}{\operator Nombre}{\creatim\yr2005\mo6\dy15\hr1\min23}{\revtim\yr2005\mo6\dy15\hr1\min24}{\version2}{\edmins1}{\nofpages4}{\nofwords1188}{\nofchars6772}{\*\company Organizacion}{\nofcharsws8316}{\vern8249}} +\margl1701\margr1701\margt1417\margb1993 \widowctrl\ftnbj\aenddoc\hyphhotz425\noxlattoyen\expshrtn\noultrlspc\dntblnsbdb\nospaceforul\hyphcaps0\horzdoc\dghspace120\dgvspace120\dghorigin1701\dgvorigin1984\dghshow0\dgvshow3 +\jcompress\viewkind1\viewscale100\nolnhtadjtbl \fet0\sectd \sbknone\linex0\footery1417\sectdefaultcl {\footer \pard\plain \s24\qr \li0\ri0\nowidctlpar\tqc\tx4419\tqr\tx8838\faauto\rin0\lin0\itap0 \fs24\lang11274\langfe255\cgrid\langnp11274\langfenp255 { +\fs16\lang3082\langfe255\langnp3082 Decisiones}{\field{\*\fldinst {\lang3082\langfe255\langnp3082 \\page\\* ARABIC}}{\fldrslt {\lang3082\langfe255\langnp3082 4}}}{\lang3082\langfe255\langnp3082 +\par }}{\*\pnseclvl1\pnucrm\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl2\pnucltr\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl3\pndec\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl4\pnlcltr\pnstart1\pnindent720\pnhang{\pntxta )}} +{\*\pnseclvl5\pndec\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}{\*\pnseclvl6\pnlcltr\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}{\*\pnseclvl7\pnlcrm\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}{\*\pnseclvl8 +\pnlcltr\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}{\*\pnseclvl9\pnlcrm\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}\pard\plain \qj \li0\ri0\nowidctlpar\aspalpha\faauto\rin0\lin0\itap0 \fs24\lang3082\langfe3082\cgrid\langnp3082\langfenp3082 +{\b\f28\fs20\ul\lang3082\langfe255\langfenp255 Decisiones tomadas a partir del relevamiento +\par }{\b\f28\fs20\ul\lang11274\langfe255\langnp11274\langfenp255 +\par }{\f28\fs20\ul\lang3082\langfe255\langfenp255 Zona +\par }{\b\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }{\f28\fs20\lang3082\langfe255\langfenp255 Contiene un c\'f3digo y un campo descriptivo que refiere a la ubicaci\'f3n geogr\'e1fica de la misma. +\par }{\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }{\f28\fs20\ul\lang3082\langfe255\langfenp255 CAP +\par }{\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }{\f28\fs20\lang3082\langfe255\langfenp255 En la estructura determinamos que hay un CAP por zona geogr\'e1 +fica, cada uno tiene asignado un grupo de promotores, si el solicitante se presenta directamente en el cap o en la sede central para afiliarse, lo atiende un operador que estar\'e1 + encargado de cargarlo al sistema como solicitante para que luego sea visitado por un promotor. +\par }{\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }{\f28\fs20\ul\lang3082\langfe255\langfenp255 Promotor +\par }{\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }{\f28\fs20\lang3082\langfe255\langfenp255 - Un promotor pertenece a un CAP. +\par - El armado de la hoja de ruta que determina a quien visita cada promotor depende de un actor externo al sistema (Enrutador), el promotor solo recibe el listado ya confeccionado con un anexo con los planes a ofrecer al afiliado. +\par }{\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }{\f28\fs20\ul\lang3082\langfe255\langfenp255 Planes +\par }{\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }{\f28\fs20\lang3082\langfe255\langfenp255 - Las restricciones respecto al ingreso a un plan son determinadas fuera del sistema en el momento de establecer los planes a ofrecer a un solicitante. +\par }{\fs20\cf1\lang3082\langfe255\loch\af28\langfenp255 \hich\af0\dbch\af0\loch\f28 - Los pla\hich\af0\dbch\af0\loch\f28 nes est}{\fs20\cf1\lang3082\langfe255\loch\af28\langfenp255 \loch\af28\dbch\af0\hich\f0 \'e1}{ +\fs20\cf1\lang3082\langfe255\loch\af28\langfenp255 \hich\af0\dbch\af0\loch\f28 n divididos por categor}{\fs20\cf1\lang3082\langfe255\loch\af28\langfenp255 \loch\af28\dbch\af0\hich\f0 \'ed}{\fs20\cf1\lang3082\langfe255\loch\af28\langfenp255 +\hich\af0\dbch\af0\loch\f28 as. L}{\fs20\lang3082\langfe255\loch\af28\langfenp255 \hich\af0\dbch\af0\loch\f28 a categor}{\fs20\lang3082\langfe255\loch\af28\langfenp255 \loch\af28\dbch\af0\hich\f0 \'ed}{\fs20\lang3082\langfe255\loch\af28\langfenp255 +\hich\af0\dbch\af0\loch\f28 a de un plan es asignada por el encargado de dar de alta un plan en el sistema. +\par }{\f28\fs20\lang3082\langfe255\langfenp255 - Un plan de mejor categor\'eda tiene mejores prestaciones, las prestaciones del plan de menor cobertura se mantienen o expanden, nunca se quitan. +\par }{\f28\fs20\cf1\lang3082\langfe255\langfenp255 - }{\f28\fs20\ul\cf1\lang3082\langfe255\langfenp255 Cambio de plan}{\f28\fs20\cf1\lang3082\langfe255\langfenp255 : se tiene en cuenta la categor\'eda del plan +\par {\listtext\pard\plain\f14\fs20\cf1\lang3082\langfe255\langfenp255 \loch\af14\dbch\af0\hich\f14 \'fc\tab}}\pard \qj \fi-360\li1080\ri0\nowidctlpar\faauto\ls6\rin0\lin1080\itap0 {\f28\fs20\cf1\lang3082\langfe255\langfenp255 +Si el afiliado se cambia a un plan mejor, se resetean todos los valores (carencias, etc) +\par {\listtext\pard\plain\f14\fs20\cf1\lang3082\langfe255\langfenp255 \loch\af14\dbch\af0\hich\f14 \'fc\tab}Si el afiliado se cambia a un plan de menor categor\'eda, se consideran los datos almacenados hasta el momento para el plan anterior. +\par }\pard \qj \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\f28\fs20\cf1\lang3082\langfe255\langfenp255 - Las carencias se resetean al a\'f1o de inscripci\'f3n +\par }{\f28\fs20\lang3082\langfe255\langfenp255 - Existe un tiempo de permanencia m\'ednima en un plan para acceder a determinadas prestaciones, este tiempo de permanencia m\'ednima est\'e1 especificado en el plan. +\par - Cuando se da de baja un plan, se almacena como fecha de baja la fecha actual, de esta manera, no se toman nuevos afiliados a dicho plan pero si se mantienen los afiliados existentes. +\par }{\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }\pard\plain \s2\qj \li0\ri0\keepn\nowidctlpar\faauto\outlinelevel1\rin0\lin0\itap0 \b\f1\fs20\lang11274\langfe255\cgrid\langnp11274\langfenp255 {\b0\f28\ul\lang3082\langfe255\langnp3082 Solicitante +\par }\pard\plain \qj \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 \fs24\lang3082\langfe3082\cgrid\langnp3082\langfenp3082 {\b\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }{\b\f28\fs20\lang3082\langfe255\langfenp255 - }{\f28\fs20\lang3082\langfe255\langfenp255 Se asocia a un promotor que estar\'e1 encargado de visitarlo, el atributo pendiente estar\'e1 en }{\i\f28\fs20\lang3082\langfe255\langfenp255 true}{ +\f28\fs20\lang3082\langfe255\langfenp255 mientras el solicitante no haya sido visitado por un promotor y ser\'e1 }{\i\f28\fs20\lang3082\langfe255\langfenp255 false}{\f28\fs20\lang3082\langfe255\langfenp255 cuando se le haya asignado alguno. +\par - Cuando el promotor termina con sus visitas del d\'eda, informa: +\par {\listtext\pard\plain\f14\fs20\lang3082\langfe255\langfenp255 \loch\af14\dbch\af0\hich\f14 \'fc\tab}}\pard \qj \fi-360\li1080\ri0\nowidctlpar\faauto\ls4\rin0\lin1080\itap0 {\f28\fs20\lang3082\langfe255\langfenp255 a qui\'e9n visit\'f3: aceptaci\'f3 +n / rechazo afiliaci\'f3n +\par {\listtext\pard\plain\f14\fs20\lang3082\langfe255\langfenp255 \loch\af14\dbch\af0\hich\f14 \'fc\tab}a qui\'e9n no visit\'f3: el campo }{\i\f28\fs20\lang3082\langfe255\langfenp255 pendiente}{\f28\fs20\lang3082\langfe255\langfenp255 + del solicitante en cuesti\'f3n vuelve al valor }{\i\f28\fs20\lang3082\langfe255\langfenp255 true}{\f28\fs20\lang3082\langfe255\langfenp255 y se reasignar\'e1 un nuevo promotor al d\'eda siguiente. +\par }\pard \qj \li720\ri0\nowidctlpar\faauto\rin0\lin720\itap0 {\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }\pard \qj \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\f28\fs20\ul\lang11274\langfe255\langnp11274\langfenp255 +\par \page }{\f28\fs20\ul\lang3082\langfe255\langfenp255 Afiliados +\par }{\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }{\f28\fs20\lang3082\langfe255\langfenp255 - Se almacena la fecha de afiliaci\'f3n a la OS para establecer la antig\'fcedad. +\par }{\f28\fs20\cf1\lang3082\langfe255\langfenp255 - Se almacena el historial de planes del afiliado: una lista de planes + fecha de ingreso y fecha de egreso (esta \'faltima en null para el plan actual). +\par - En la lista los planes se guardan desde el m\'e1s antiguo hasta el actual. +\par }{\f28\fs20\lang3082\langfe255\langfenp255 - Se establecen 2 tipos de antig\'fcedad: }{\i\f28\fs20\lang3082\langfe255\langfenp255 fecha de afiliaci\'f3n}{\f28\fs20\lang3082\langfe255\langfenp255 y }{\i\f28\fs20\lang3082\langfe255\langfenp255 +fecha de ingreso}{\f28\fs20\lang3082\langfe255\langfenp255 al plan actual para controlar carencias. +\par - Para ver la situaci\'f3n del afiliado se usan dos atributos: +\par {\listtext\pard\plain\f14\fs20\lang3082\langfe255\langfenp255 \loch\af14\dbch\af0\hich\f14 \'fc\tab}}\pard \qj \fi-360\li1080\ri0\nowidctlpar\faauto\ls8\rin0\lin1080\itap0 {\b\f28\fs20\lang3082\langfe255\langfenp255 moroso}{ +\f28\fs20\lang3082\langfe255\langfenp255 : entero que indica la cantidad de cuotas adeudadas. +\par {\listtext\pard\plain\f14\fs20\lang3082\langfe255\langfenp255 \loch\af14\dbch\af0\hich\f14 \'fc\tab}}{\b\f28\fs20\lang3082\langfe255\langfenp255 fechaBaja}{\f28\fs20\lang3082\langfe255\langfenp255 : queda en }{\i\f28\fs20\lang3082\langfe255\langfenp255 +null}{\f28\fs20\lang3082\langfe255\langfenp255 mientras que al afiliado no sea dado de baja. +\par }\pard \qj \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }\trowd \trhdr\trftsWidth1\trpaddl55\trpaddt55\trpaddb55\trpaddr55\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw5\brdrcf1 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrnone +\clcbpat1\cltxlrtb\clftsWidth3\clwWidth2946 \cellx2946\clvertalt\clbrdrt\brdrs\brdrw5\brdrcf1 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrnone \clcbpat1\cltxlrtb\clftsWidth3\clwWidth2946 \cellx5892\clvertalt\clbrdrt +\brdrs\brdrw5\brdrcf1 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \clcbpat1\cltxlrtb\clftsWidth3\clwWidth2946 \cellx8838\pard\plain \s23\qc \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0 +\b\i\fs24\lang11274\langfe255\cgrid\langnp11274\langfenp255 {\lang3082\langfe255\langnp3082 moroso\cell fechabaja\cell estado\cell }\pard\plain \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0 \fs24\lang3082\langfe3082\cgrid\langnp3082\langfenp3082 { +\trowd \trhdr\trftsWidth1\trpaddl55\trpaddt55\trpaddb55\trpaddr55\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw5\brdrcf1 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrnone +\clcbpat1\cltxlrtb\clftsWidth3\clwWidth2946 \cellx2946\clvertalt\clbrdrt\brdrs\brdrw5\brdrcf1 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrnone \clcbpat1\cltxlrtb\clftsWidth3\clwWidth2946 \cellx5892\clvertalt\clbrdrt +\brdrs\brdrw5\brdrcf1 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \clcbpat1\cltxlrtb\clftsWidth3\clwWidth2946 \cellx8838\row }\trowd +\trftsWidth1\trpaddl55\trpaddt55\trpaddb55\trpaddr55\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2946 \cellx2946\clvertalt +\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2946 \cellx5892\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr +\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth2946 \cellx8838\pard\plain \s22\qc \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0 \fs24\lang11274\langfe255\cgrid\langnp11274\langfenp255 {\lang3082\langfe255\langnp3082 menor o igual a 2\cell null\cell +activo\cell }\pard\plain \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0 \fs24\lang3082\langfe3082\cgrid\langnp3082\langfenp3082 {\trowd \trftsWidth1\trpaddl55\trpaddt55\trpaddb55\trpaddr55\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\clbrdrt +\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2946 \cellx2946\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrnone +\cltxlrtb\clftsWidth3\clwWidth2946 \cellx5892\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth2946 \cellx8838\row }\trowd +\trftsWidth1\trpaddl55\trpaddt55\trpaddb55\trpaddr55\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2946 \cellx2946\clvertalt +\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2946 \cellx5892\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr +\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth2946 \cellx8838\pard\plain \s22\qc \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0 \fs24\lang11274\langfe255\cgrid\langnp11274\langfenp255 {\lang3082\langfe255\langnp3082 3\cell -\cell inactivo\cell +}\pard\plain \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0 \fs24\lang3082\langfe3082\cgrid\langnp3082\langfenp3082 {\trowd \trftsWidth1\trpaddl55\trpaddt55\trpaddb55\trpaddr55\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalb\clbrdrt\brdrnone \clbrdrl +\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2946 \cellx2946\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrnone +\cltxlrtb\clftsWidth3\clwWidth2946 \cellx5892\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth2946 \cellx8838\row }\trowd +\trftsWidth1\trpaddl55\trpaddt55\trpaddb55\trpaddr55\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2946 \cellx2946\clvertalt +\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2946 \cellx5892\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr +\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth2946 \cellx8838\pard\plain \s22\qc \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0 \fs24\lang11274\langfe255\cgrid\langnp11274\langfenp255 {\lang1033\langfe255\langnp1033 -\cell not null\cell inactivo\cell +}\pard\plain \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0 \fs24\lang3082\langfe3082\cgrid\langnp3082\langfenp3082 {\lang1033\langfe3082\langnp1033 \trowd \trftsWidth1\trpaddl55\trpaddt55\trpaddb55\trpaddr55\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 +\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2946 \cellx2946\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr +\brdrnone \cltxlrtb\clftsWidth3\clwWidth2946 \cellx5892\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth2946 \cellx8838\row }\pard +\qj \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\f28\fs20\lang1033\langfe255\langnp1033\langfenp255 +\par }{\f28\fs20\lang3082\langfe255\langfenp255 - Una vez afiliado un cliente el solicitante que se correspond\'eda con el nuevo afiliado es dado de baja. +\par {\listtext\pard\plain\f30\fs20\lang3082\langfe255\langfenp255 \loch\af30\dbch\af0\hich\f30 \'96\tab}}\pard \qj \fi-283\li283\ri0\nowidctlpar\faauto\ls9\rin0\lin283\itap0 {\f28\fs20\lang3082\langfe255\langfenp255 +Cuando el afiliado que se ingresa es el titular de un grupo familiar o es un afiliado independiente el campo titular = }{\i\f28\fs20\lang3082\langfe255\langfenp255 null}{\f28\fs20\lang3082\langfe255\langfenp255 +. Si es un familiar, este campo se utiliza para referenciar al titular. +\par {\listtext\pard\plain\f30\fs20\lang3082\langfe255\langfenp255 \loch\af30\dbch\af0\hich\f30 \'96\tab}Si un afiliado que ten\'ed +a una deuda menor a 3 meses (p.e: moroso = 2 ) quiere volver a afiliarse se le permite volver a hacerlo pero se le mantiene la morosidad. +\par }\pard \qj \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }{\f28\fs20\ul\lang3082\langfe255\langfenp255 Grupos familiares +\par }{\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }{\f28\fs20\lang3082\langfe255\langfenp255 - Todos los integrantes del grupo familiar tienen igual plan. +\par - Cuando el afiliado que se ingresa es un adherente el campo titular contiene una referencia al afiliado designado como titular del grupo; +\par }{\f28\fs20 - Cambio de titular: se le pregunta a alg\'fan integrante del grupo familiar qui\'e9n ser\'e1 el nuevo titular o bien si se da de baja al grupo completo. El sistema no realizar\'e1 ninguna validaci\'f3n respecto a la elecci\'f3 +n del nuevo titular, sino que ser\'e1 responsabilidad del operador y del grupo familiar en cuesti\'f3n la designaci\'f3n de una persona capacitada para tal responsabilidad +\par }{\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }{\f28\fs20\ul\lang3082\langfe255\langfenp255 Autorizaciones +\par }{\b\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }{\b\f28\fs20\lang3082\langfe255\langfenp255 - }{\f28\fs20\lang3082\langfe255\langfenp255 Las autorizaciones, a lo largo de su ciclo de vida pasan por diferentes estados: +\par {\listtext\pard\plain\f14\fs20\lang3082\langfe255\langfenp255 \loch\af14\dbch\af0\hich\f14 \'fc\tab}}\pard \qj \fi-360\li720\ri0\nowidctlpar\faauto\ls5\rin0\lin720\itap0 {\b\f28\fs20\lang3082\langfe255\langfenp255 Pendiente}{ +\f28\fs20\lang3082\langfe255\langfenp255 (s\'f3lo para la manual): est\'e1 pendiente de aprobaci\'f3n o rechazo; +\par {\listtext\pard\plain\f14\fs20\lang3082\langfe255\langfenp255 \loch\af14\dbch\af0\hich\f14 \'fc\tab}}{\b\f28\fs20\lang3082\langfe255\langfenp255 Aprobada}{\f28\fs20\lang3082\langfe255\langfenp255 : la autorizaci\'f3 +n fue aprobada, por lo tanto el afiliado puede realizar la prestaci\'f3n; +\par {\listtext\pard\plain\f14\fs20\lang3082\langfe255\langfenp255 \loch\af14\dbch\af0\hich\f14 \'fc\tab}}{\b\f28\fs20\lang3082\langfe255\langfenp255 Rechazada}{\f28\fs20\lang3082\langfe255\langfenp255 : la autorizaci\'f3 +n fue rechazada. Se registra para los posteriores informes a enviar al director y al m\'e9dico para que tenga mayor informaci\'f3n a la hora de aceptar una autorizaci\'f3n manual; +\par {\listtext\pard\plain\f14\fs20\lang3082\langfe255\langfenp255 \loch\af14\dbch\af0\hich\f14 \'fc\tab}}{\b\f28\fs20\lang3082\langfe255\langfenp255 Vencida:}{\f28\fs20\lang3082\langfe255\langfenp255 la autorizaci\'f3n nunca fue realizada y venci\'f3 + su vigencia, se establecen dos meses de vigencia a partir de la fecha de Solicitud en el caso de las autom\'e1ticas y la fecha de resoluci\'f3n en el caso de las manuales; +\par {\listtext\pard\plain\f14\fs20\lang3082\langfe255\langfenp255 \loch\af14\dbch\af0\hich\f14 \'fc\tab}}{\b\f28\fs20\lang3082\langfe255\langfenp255 Realizada:}{\f28\fs20\lang3082\langfe255\langfenp255 la autorizaci\'f3 +n fue realizada, se carga cuando el prestador env\'eda el listado de prestaciones realizadas en el per\'edodo. +\par }\pard \qj \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\b\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }{\f28\fs20\ul\lang3082\langfe255\langfenp255 Nota}{\f28\fs20\lang3082\langfe255\langfenp255 : para m\'e1s detalle de estados, eventos y transiciones, ver los }{\b\f28\fs20\lang3082\langfe255\langfenp255 diagramas de estado de la autorizaci\'f3 +n manual y de la autom\'e1tica}{\f28\fs20\lang3082\langfe255\langfenp255 . +\par Los estados se determinar\'e1n a partir de un m\'e9todo que lo calcula a partir de las fechas y de un atributo booleano \'93aprobada\'94. +\par }{\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }{\f28\fs20\lang3082\langfe255\langfenp255 - }{\f28\fs20\ul\lang3082\langfe255\langfenp255 Fechas relacionadas a la autorizaci\'f3n}{\f28\fs20\lang3082\langfe255\langfenp255 : +\par {\listtext\pard\plain\b\f28\fs20\lang3082\langfe255\langfenp255 \hich\af28\dbch\af0\loch\f28 1)\tab}}\pard \qj \fi-360\li1080\ri0\nowidctlpar\faauto\ls7\rin0\lin1080\itap0 {\b\f28\fs20\lang3082\langfe255\langfenp255 Solicitud}{ +\f28\fs20\lang3082\langfe255\langfenp255 : fecha en que el \'93Solicitador de Autorizaciones\'94 solicita la autorizaci\'f3n +\par {\listtext\pard\plain\b\f28\fs20\lang3082\langfe255\langfenp255 \hich\af28\dbch\af0\loch\f28 2)\tab}}{\b\f28\fs20\lang3082\langfe255\langfenp255 Resoluci\'f3n}{\f28\fs20\lang3082\langfe255\langfenp255 : fecha en que se aprob\'f3/rechaz\'f3 la autorizaci +\'f3n manual (acompa\'f1ado de un campo para describir el motivo de la decisi\'f3n) +\par {\listtext\pard\plain\b\f28\fs20\lang3082\langfe255\langfenp255 \hich\af28\dbch\af0\loch\f28 3)\tab}}{\b\f28\fs20\lang3082\langfe255\langfenp255 Realizaci\'f3n}{\f28\fs20\lang3082\langfe255\langfenp255 : fecha en que el afiliado se realiz\'f3 la presataci +\'f3n. +\par {\listtext\pard\plain\b\f28\fs20\lang3082\langfe255\langfenp255 \hich\af28\dbch\af0\loch\f28 4)\tab}}{\b\f28\fs20\lang3082\langfe255\langfenp255 Vencimiento}{\f28\fs20\lang3082\langfe255\langfenp255 : fecha en que vence la prestaci\'f3 +n. Se calcula a partir de la fecha de resoluci\'f3n (ej: 2 meses) en manuales; y a partir de la fecha de solicitud en autom\'e1ticas. +\par }\pard \qj \li720\ri0\nowidctlpar\faauto\rin0\lin720\itap0 {\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }\pard \qj \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\f28\fs20\lang3082\langfe255\langfenp255 - }{\f28\fs20\ul\lang3082\langfe255\langfenp255 Atributos descriptivos:}{\f28\fs20\lang3082\langfe255\langfenp255 +\par {\listtext\pard\plain\f14\fs20\lang3082\langfe255\langfenp255 \loch\af14\dbch\af0\hich\f14 \'fc\tab}}\pard \qj \fi-360\li720\ri0\nowidctlpar\faauto\ls5\rin0\lin720\itap0 {\b\f28\fs20\lang3082\langfe255\langfenp255 observaciones}{ +\f28\fs20\lang3082\langfe255\langfenp255 (solo manual): Se utilizar\'e1 para que un m\'e9dico pueda ampliar los motivos por los que pide la autorizaci\'f3n (ej: enfermedad grave, etc.); +\par {\listtext\pard\plain\f14\fs20\lang3082\langfe255\langfenp255 \loch\af14\dbch\af0\hich\f14 \'fc\tab}}{\b\f28\fs20\lang3082\langfe255\langfenp255 fundamentosResolucion}{\f28\fs20\lang3082\langfe255\langfenp255 +: Es para que el auditor JUSTIFIQUE por que aprob\'f3/rechazo la autorizaci\'f3n. Tambi\'e9n se completar\'e1 de forma autom\'e1tica en caso de rechazo en autorizaci\'f3n autom\'e1tica. +\par }\pard \qj \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }{\f28\fs20\lang3082\langfe255\langfenp255 - Dado que para una autorizaci\'f3n AUTOM\'c1TICA, la fecha de resoluci\'f3n es la misma que la de solicitud, s\'f3lo dispone de fecha de solicitud.\~\~ +Por eso, se sobreentiende que cuando hablamos de fecha de resoluci\'f3n en una AUTOM\'c1TICA, es lo mismo que fecha de solicitud. +\par }{\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }{\f28\fs20\lang3082\langfe255\langfenp255 - A partir de la fecha de aprobaci\'f3n de la autorizaci\'f3n, la cl\'ednica tiene 2 meses para reclamar los pagos (fecha de vencimiento). +\par - La fecha de vencimiento queda por si se cambia la pol\'edtica de los 2 meses (punto anterior), y \'e9ste cambio se establece una vez que las autorizaciones ya han sido aprobadas. +\par - No se aplican pol\'edticas especiales en caso de que el auditor m\'e9dico tarde m\'e1s de 24hs en aprobar/rechazar una autorizaci\'f3n manual. Quedan almacenadas las fechas de solicitud y aprobaci\'f3n, las cuales pueden ser usadas para determinar +si alg\'fan auditor m\'e9dico tard\'f3 m\'e1s de lo debido. +\par }\pard\plain \s21\qj \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 \b\f1\fs20\cf6\lang11274\langfe255\cgrid\langnp11274\langfenp255 {\b0\f28\cf0\lang3082\langfe255\langnp3082 - En la autorizaci\'f3n manual se almacena el c\'f3 +digo de prestador en el cual el afiliado se realizar\'e1 la prestaci\'f3n}{\lang3082\langfe255\langnp3082 . +\par }\pard\plain \qj \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 \fs24\lang3082\langfe3082\cgrid\langnp3082\langfenp3082 {\f28\fs20\lang3082\langfe255\langfenp255 - En la autorizaci\'f3n se almacena el porcentaje de cobertura sobre la prestaci\'f3 +n, en caso de que el afiliado se cambie de plan se registr\'f3 en el sistema el porcentaje que se cubre sobre la prestaci\'f3n para el plan a la que el afiliado pertenec\'eda a la hora de }{\f28\fs20\ul\lang3082\langfe255\langfenp255 aprobar}{ +\f28\fs20\lang3082\langfe255\langfenp255 la autorizaci\'f3n y despu\'e9s poder comparar con las prestaciones realizadas; +\par - Si un afiliado se da de baja, las autorizaciones manuales aprobadas hasta el d\'eda de baja se cubren. +\par }{\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }\pard\plain \s2\qj \li0\ri0\keepn\nowidctlpar\faauto\outlinelevel1\rin0\lin0\itap0 \b\f1\fs20\lang11274\langfe255\cgrid\langnp11274\langfenp255 {\b0\f28\ul\lang3082\langfe255\langnp3082 Cobertura +\par }\pard\plain \qj \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 \fs24\lang3082\langfe3082\cgrid\langnp3082\langfenp3082 {\b\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par {\listtext\pard\plain\f30\fs20\lang3082\langfe255\langfenp255 \loch\af30\dbch\af0\hich\f30 \'96\tab}}\pard \qj \fi-283\li283\ri0\nowidctlpar\faauto\ls3\rin0\lin283\itap0 {\fs20\lang3082\langfe255\loch\af28\langfenp255 \hich\af0\dbch\af0\loch\f28 +Se guardan los datos de coberturas de determinada prestaci}{\fs20\lang3082\langfe255\loch\af28\langfenp255 \loch\af28\dbch\af0\hich\f0 \'f3}{\fs20\lang3082\langfe255\loch\af28\langfenp255 \hich\af0\dbch\af0\loch\f28 +n para determinado plan en el caso de que sea mayor a cero. +\par }\pard \qj \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\f28\fs20\lang11274\langfe255\langnp11274\langfenp255 +\par }{\f28\fs20\ul\lang3082\langfe255\langfenp255 +\par \page Requerimientos al sector Cobranzas +\par }{\f28\fs20\ul\lang11274\langfe255\langnp11274\langfenp255 +\par {\listtext\pard\plain\f30\fs18\lang3082\langfe255\langfenp255 \loch\af30\dbch\af0\hich\f30 \'96\tab}}\pard \qj \fi-283\li283\ri0\nowidctlpar\faauto\ls2\rin0\lin283\itap0 {\f28\fs20\lang3082\langfe255\langfenp255 Se requiere que en el env\'ed +o de estado de morosidad de los afiliados se env\'eden los datos de todos los afiliados, sin distinguir si son titulares o familiares. Si un familiar quiere pasar a ser titular ya se tiene toda la informaci\'f3 +n de morosidad sin tener que depender del estado del titular anterior. +\par }\pard \qj \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\f28\fs20\lang3082\langfe255\langfenp255 +\par }{\f28\fs20\ul\lang3082\langfe255\langfenp255 Reportes de Autorizaciones +\par }{\f28\fs20\lang3082\langfe255\langfenp255 +\par {\listtext\pard\plain\f28\fs20\lang3082\langfe255\langfenp255 \hich\af28\dbch\af0\loch\f28 -\tab}}\pard \qj \fi-283\li283\ri0\nowidctlpar\faauto\ls1\rin0\lin283\itap0 {\f28\fs20\lang3082\langfe255\langfenp255 +Los reportes de autorizaciones se generan en un archivo de texto plano separado por comas, y una vez finalizada su confecci\'f3 +n se envian por e-mail al Director de la obra social y se guarda en el directorio Reportes/Autorizaciones/[Rechazadas|Aprobadas]. +\par {\listtext\pard\plain\f28\fs20\lang3082\langfe255\langfenp255 \hich\af28\dbch\af0\loch\f28 -\tab} +\par }} \ No newline at end of file