From: Guillermo Rugilo Date: Tue, 26 Apr 2005 00:05:32 +0000 (+0000) Subject: especificación actualizada. Falta refinar los datos a pedirle a la Clínica, pero... X-Git-Tag: svn_import~619 X-Git-Url: https://git.llucax.com/z.facultad/75.10/miklolife.git/commitdiff_plain/b62143433fe68fa105c3d565d9995057fa1df3b1?ds=sidebyside;hp=7f5422c5be9fabfabe9c53b3ae9028014e581c8d especificación actualizada. Falta refinar los datos a pedirle a la Clínica, pero la base está. :) --- diff --git a/especificaciones/recibir_y_cotejar_consumos_ y_prestaciones.rtf b/especificaciones/recibir_y_cotejar_consumos_ y_prestaciones.rtf index 93cd569..744b47b 100644 --- a/especificaciones/recibir_y_cotejar_consumos_ y_prestaciones.rtf +++ b/especificaciones/recibir_y_cotejar_consumos_ y_prestaciones.rtf @@ -1,18 +1,26 @@ {\rtf1\ansi\ansicpg1252\uc1\deff0\stshfdbch0\stshfloch0\stshfhich0\stshfbi0\deflang1033\deflangfe1033{\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;}{\f10\fnil\fcharset2\fprq2{\*\panose 05000000000000000000}Wingdings;} -{\f37\fswiss\fcharset0\fprq2{\*\panose 020b0603020202020204}Trebuchet MS;}{\f124\froman\fcharset238\fprq2 Times New Roman 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+\jexpand\viewkind1\viewscale100\pgbrdrhead\pgbrdrfoot\splytwnine\ftnlytwnine\htmautsp\nolnhtadjtbl\useltbaln\alntblind\lytcalctblwd\lyttblrtgr\lnbrkrule\nobrkwrptbl\snaptogridincell\allowfieldendsel\wrppunct\asianbrkrule\rsidroot4072389 \fet0\sectd +\linex0\headery708\footery708\colsx708\endnhere\sectlinegrid360\sectdefaultcl\sftnbj {\*\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 \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid4072389 \fs24\lang1024\langfe1024\cgrid\noproof\langnp2058\langfenp2058 {\f37\noproof0\insrsid4072389 \par }\trowd \irow0\irowband0\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw5\brdrcf1 \clbrdrl \brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid227399 {\b\f37\fs20\noproof0\insrsid4072389 @@ -50,15 +76,15 @@ Caso de uso: }{\f1\fs20\insrsid9206653 Analizar Consumos y Prestaciones}{\f37\no \f37\noproof0\insrsid4072389 \trowd \irow1\irowband1\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid227399 {\f37\noproof0\insrsid4072389 -\par }{\b\f37\fs20\noproof0\insrsid4072389 Precondiciones: }{\f37\fs20\noproof0\insrsid1194460 Existe alg\'fan tipo de comunicaci\'f3n entre }{\f37\fs20\noproof0\insrsid331756 el}{\f37\fs20\noproof0\insrsid1194460 }{\f37\fs20\noproof0\insrsid331756 Prestador - y el Sistema, que permita a}{\f37\fs20\noproof0\insrsid1194460 l }{\f37\fs20\noproof0\insrsid331756 Prestador}{\f37\fs20\noproof0\insrsid1194460 enviar informaci\'f3n hacia \'e9ste \'faltimo.}{\f1\fs20\insrsid4072389\charrsid1194460 \cell }\pard -\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f37\noproof0\insrsid4072389 \trowd \irow2\irowband2\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 -\trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\pard -\ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid227399 {\f37\noproof0\insrsid4072389 +\par }{\b\f37\fs20\noproof0\insrsid4072389 Precondiciones: }{\f37\fs20\noproof0\insrsid1194460 Existe alg\'fan tipo de comunicaci\'f3n entre }{\f37\fs20\noproof0\insrsid331756 el}{\f37\fs20\noproof0\insrsid1194460 }{\f37\fs20\noproof0\insrsid331756 +Prestador y el Sistema, que permita a}{\f37\fs20\noproof0\insrsid1194460 l }{\f37\fs20\noproof0\insrsid331756 Prestador}{\f37\fs20\noproof0\insrsid1194460 enviar informaci\'f3n hacia \'e9ste \'faltimo}{\f37\fs20\noproof0\insrsid10759101 ; as\'ed como + entre el Sistema y Pagos.}{\f1\fs20\insrsid4072389\charrsid1194460 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f37\noproof0\insrsid4072389 \trowd \irow2\irowband2\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 +\trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 +\cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid227399 {\f37\noproof0\insrsid4072389 \par }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid9206653 {\b\f37\fs20\noproof0\insrsid1275109 Poscondiciones}{\b\f37\fs20\noproof0\insrsid4072389 : }{\b\f37\fs20\noproof0\insrsid9206653 \par }{\f1\fs20\insrsid9206653 Historia cl\'ednica de los a}{\f1\fs20\insrsid5514698 filiados afectados actualizada.}{\f1\fs20\insrsid9206653 -\par \'c1rea de Pagos notificada acerca de las aprobaciones/rechazos de prestaciones. -\par \'c1rea de Pagos dispone de los reportes de consumo. +\par \'c1rea de Pagos notificada acerca de las aprobaciones/rechazos de }{\f1\fs20\insrsid10759101 la info enviada por el prestadort acerca de }{\f1\fs20\insrsid9206653 prestaciones}{\f1\fs20\insrsid10759101 realizadas.}{\f1\fs20\insrsid9206653 +\par \'c1rea de Pagos dis}{\f1\fs20\insrsid662813 pone de los reportes de consumo de los afiliados.}{\f1\fs20\insrsid9206653 \par }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid227399 {\f37\noproof0\insrsid4072389 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f37\noproof0\insrsid4072389 \trowd \irow3\irowband3 \ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb \brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid227399 {\f37\noproof0\insrsid4072389 @@ -67,52 +93,72 @@ Caso de uso: }{\f1\fs20\insrsid9206653 Analizar Consumos y Prestaciones}{\f37\no \pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls1\rin0\lin720\pararsid9206653 \fs24\lang2058\langfe2058\cgrid\langnp2058\langfenp2058 {\f1\fs20\insrsid331756 El Prestador}{\f1\fs20\insrsid9206653 env\'eda }{ \b\f1\fs20\insrsid9206653\charrsid1194460 informaci\'f3n de prestaciones e intervenciones}{\f1\fs20\insrsid9206653 de los afiliados.}{\f37\insrsid7029692\charrsid9206653 \par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid9206653 \hich\af1\dbch\af0\loch\f1 2\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0 -\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls1\rin0\lin720\pararsid9206653 {\f1\fs20\insrsid9206653 El Sistema registra la informaci\'f3n recibida}{\f37\insrsid9206653\charrsid9206653 +\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls1\rin0\lin720\pararsid9206653 {\f1\fs20\insrsid9206653 El Sistema }{\f1\fs20\insrsid10759101 valida cada linea de la informaci\'f3n recibida; si la linea pasa la validaci\'f3n, se }{ +\f1\fs20\insrsid9206653 registra }{\f1\fs20\insrsid10759101 en el sistema la prestaci\'f3n realizada por el afiliado.}{\f37\insrsid9206653\charrsid9206653 \par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid9206653\charrsid9206653 \hich\af1\dbch\af0\loch\f1 3\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0 -\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls1\rin0\lin720\pararsid9206653 {\f1\fs20\insrsid9206653\charrsid9206653 El Sistema, en base a \'e9stos datos, construye un }{\b\f1\fs20\insrsid9206653\charrsid8981056 informe de aprobaciones/rechazos - de prestaciones}{\f1\fs20\insrsid9206653\charrsid9206653 y lo env\'eda a Pagos -\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid9206653 \hich\af1\dbch\af0\loch\f1 4\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0 -\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls1\rin0\lin720\pararsid9206653 {\f1\fs20\insrsid9206653 El Sistema genera un }{\b\f1\fs20\insrsid9206653\charrsid8981056 reporte de consumo de los afiliados}{\f1\fs20\insrsid9206653 y lo env\'eda a -Pagos +\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls1\rin0\lin720\pararsid9206653 {\f1\fs20\insrsid9206653\charrsid9206653 El Sistema, en base a \'e9stos datos}{\f1\fs20\insrsid10759101 y el resultado de la validaci\'f3n}{ +\f1\fs20\insrsid9206653\charrsid9206653 , construye un }{\b\f1\fs20\insrsid9206653\charrsid8981056 informe de aprobaciones/rechazos de prestaciones}{\f1\fs20\insrsid9206653\charrsid9206653 }{\b\f1\fs20\insrsid10759101\charrsid10759101 realizadas}{ +\f1\fs20\insrsid10759101 }{\f1\fs20\insrsid9206653\charrsid9206653 y lo env\'eda a Pagos +\par {\pntext\pard\plain\s15 \intbl\f1\fs20\lang2058\langfe2058\langnp2058\langfenp2058\insrsid10759101 \hich\af1\dbch\af0\loch\f1 4\tab}}\pard \s15\ql \fi-431\li720\ri0\nowidctlpar\intbl{\*\pn \pnlvlbody\ilvl0\ls1\pnrnot0 +\pndec\pnstart1\pnindent360\pnsp120\pnhang }\faauto\ls1\rin0\lin720\pararsid9206653 {\f1\fs20\insrsid10759101 Se llama al Caso de Uso \'93Generar Reporte de Consumo\'94}{\f1\fs20\insrsid9206653 \par }\pard \s15\ql \li289\ri0\nowidctlpar\intbl\faauto\rin0\lin289\pararsid9206653 {\f37\insrsid9206653 \cell }\pard\plain \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 \fs24\lang1024\langfe1024\cgrid\noproof\langnp2058\langfenp2058 {\f37\insrsid4072389 \trowd \irow4\irowband4\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\pard\plain \s15\ql \li289\ri0\nowidctlpar\intbl\faauto\rin0\lin289\pararsid7029692 \fs24\lang2058\langfe2058\cgrid\langnp2058\langfenp2058 {\f37\insrsid4072389 -\par }\pard\plain \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid9206653 \fs24\lang1024\langfe1024\cgrid\noproof\langnp2058\langfenp2058 {\b\f37\fs20\noproof0\insrsid4072389 Flujos Alternativos:}{\b\f37\fs20\noproof0\insrsid7029692\charrsid9206653 -\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f37\noproof0\insrsid4072389 \trowd \irow5\irowband5\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr -\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row -}\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid227399 {\f37\noproof0\insrsid4072389 -\par }{\b\f37\fs20\noproof0\insrsid4072389 Flujos de Excepci\'f3n: +\par }\pard\plain \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid9206653 \fs24\lang1024\langfe1024\cgrid\noproof\langnp2058\langfenp2058 {\b\f37\fs20\noproof0\insrsid4072389 Flujos Alternativos:}{\b\f37\fs20\noproof0\insrsid10759101 }{ +\f37\fs20\noproof0\insrsid10759101\charrsid10759101 No hay}{\f37\fs20\noproof0\insrsid10759101 .}{\b\f37\fs20\noproof0\insrsid7029692\charrsid9206653 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 { +\f37\noproof0\insrsid4072389 \trowd \irow5\irowband5\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 +\clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid227399 {\f37\noproof0\insrsid4072389 + +\par }{\b\f37\fs20\noproof0\insrsid4072389 Flujos de Excepci\'f3n:}{\b\f37\fs20\noproof0\insrsid10759101 }{\f37\fs20\noproof0\insrsid10759101\charrsid10759101 No hay}{\f37\fs20\noproof0\insrsid10759101 .}{\b\f37\fs20\noproof0\insrsid4072389 \par }\pard \ql \fi-360\li646\ri0\nowidctlpar\intbl\faauto\rin0\lin646\pararsid8586758 {\f37\noproof0\insrsid8586758\charrsid8586758 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f37\noproof0\insrsid4072389 \trowd \irow6\irowband6\ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw5\brdrcf1 \clbrdrb\brdrs\brdrw5\brdrcf1 \clbrdrr\brdrs\brdrw5\brdrcf1 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\trowd \irow7\irowband7\lastrow \ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\pard \ql \li0\ri0\nowidctlpar\intbl\faauto\rin0\lin0\pararsid227399 {\f1\noproof0\insrsid4072389\charrsid9206653 -\par }{\b\f1\fs20\noproof0\insrsid4072389\charrsid9206653 Notas:}{\b\f1\fs20\noproof0\insrsid6974674\charrsid9206653 }{\cs16\f1\fs20\insrsid9206653\charrsid9206653 \~\~\~ El reporte de consumo que genera el sistema... \'bflo genera y env\'ed -a a Pagos inmediatamente despu\'e9s de haber recibido la info del }{\cs16\f1\fs20\insrsid331756 Prestador}{\cs16\f1\fs20\insrsid9206653\charrsid9206653 ? (entra}{\f1\fs20\insrsid9206653\charrsid9206653 }{\cs16\f1\fs20\insrsid9206653\charrsid9206653 -todo dentro del mismo CU)}{\f1\fs20\insrsid9206653\charrsid9206653 \line }{\cs16\f1\fs20\insrsid9206653\charrsid9206653 \'bf \'f3 el actor Pagos en alg\'fan momento posterior pedir\'e1 el informe? (ser\'edan 2}{\cs16\f1\fs20\insrsid9206653 }{ -\cs16\f1\fs20\insrsid9206653\charrsid9206653 Casos de Uso: Recibir info de Cl\'ednica y Generar Reporte de Consumo)}{\f1\fs20\insrsid9206653\charrsid9206653 \line }{\cs16\f1\fs20\insrsid9206653\charrsid9206653 -El enunciado, por supuesto, no lo especifica claramente (ver los \'faltimos}{\cs16\f1\fs20\insrsid9206653 }{\f1\fs20\insrsid9206653 2}{\cs16\f1\fs20\insrsid9206653\charrsid9206653 renglones de la 1er}{\cs16\f1\fs20\insrsid5514698 }{ -\cs16\f1\fs20\insrsid9206653\charrsid9206653 p\'e1gina}{\cs16\f1\fs20\insrsid5514698 )}{\f1\noproof0\insrsid6974674\charrsid9206653 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f37\noproof0\insrsid4072389 -\trowd \irow7\irowband7\lastrow \ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 -\clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\insrsid4072389 +\par }{\b\f1\fs20\noproof0\insrsid4072389\charrsid9206653 Notas:}{\b\f1\fs20\noproof0\insrsid6974674\charrsid9206653 }{\cs16\f1\fs20\insrsid9206653\charrsid9206653 \~\~\~ }{\cs16\f1\fs20\insrsid10759101 - La comunicaci\'f3n Prestador-Sistema podr\'eda ser +\'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\noproof0\insrsid6974674\charrsid9206653 \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\f37\noproof0\insrsid4072389 \trowd \irow7\irowband7\lastrow \ts11\trgaph7\trleft-113\trbrdrt\brdrs\brdrw10 \trbrdrl +\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trftsWidth1\trpaddl7\trpaddr7\trpaddfl3\trpaddfr3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 +\cltxlrtb\clftsWidth3\clwWidth8936\clshdrawnil \cellx8823\row }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\insrsid4072389 \par }{\insrsid15751489 Especificaci\'f3n de Datos:}{\insrsid1194460 \par }{\insrsid15751489 \par }{\f1\fs20\insrsid8981056\charrsid8981056 1) }{\b\f1\fs20\insrsid1194460 I}{\b\f1\fs20\insrsid1194460\charrsid1194460 nformaci\'f3n de prestaciones e intervenciones}{\b\f1\fs20\insrsid1194460 -\par }\pard \ql \li708\ri0\nowidctlpar\faauto\rin0\lin708\itap0\pararsid3805781 {\insrsid12537211 a) C\'f3digo de autorizaci\'f3n relacionada a la }{\insrsid12537211\charrsid1275109 prestaci\'f3n/intervenci\'f3n}{\insrsid12537211 .}{\insrsid5050019 }{ -\insrsid5050019\charrsid1275109 (\'93Pr\'e1ctica\'94, en el nomenclador)}{\insrsid8981056\charrsid1275109 -\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\insrsid3948734\charrsid1275109 \tab b) Identificador de prestaci\'f3n Realizada \'f3 }{\insrsid3805781 NO }{\insrsid3948734\charrsid1275109 Re}{\insrsid3805781 alizada}{ -\insrsid3948734\charrsid1275109 (flag)}{\insrsid3805781 }{\insrsid3805781 {\field{\*\fldinst SYMBOL 224 \\f "Wingdings" \\s 12}{\fldrslt\f10\fs24}}}{\insrsid3805781 ANALIZAR SI HACE FALTA}{\insrsid3948734\charrsid1275109 -\par \tab c) Fecha de R}{\insrsid3805781 ealizaci\'f3n}{\insrsid3948734\charrsid1275109 de la prestaci\'f3n/intervenci\'f3n -\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid3948734 {\insrsid3948734\charrsid1275109 \tab d) N\'famero de afiliado +\par }\pard \ql \li708\ri0\nowidctlpar\faauto\rin0\lin708\itap0\pararsid3805781 {\insrsid1720812 a) Identificaci\'f3n de Prestador (n\'famero de CUIT) }{\insrsid1720812 {\field{\*\fldinst SYMBOL 224 \\f "Wingdings" \\s 12}{\fldrslt\f10\fs24}}}{\insrsid1720812 + es posible no incluirlo +\par b}{\insrsid12537211 ) C\'f3digo de autorizaci\'f3n relacionada a la }{\insrsid12537211\charrsid1275109 prestaci\'f3n/intervenci\'f3n}{\insrsid12537211 .}{\insrsid5050019 }{\insrsid8981056 +\par }{\insrsid1720812 c) C\'f3digo de prestaci\'f3n/intervenci\'f3n }{\insrsid1720812\charrsid1720812 (\'93Pr\'e1ctica\'94, en el nomenclador)}{\insrsid1720812\charrsid1275109 +\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\insrsid3948734\charrsid1275109 \tab }{\insrsid1720812 c}{\insrsid3948734\charrsid1275109 ) Fecha de R}{\insrsid3805781 ealizaci\'f3n}{\insrsid3948734\charrsid1275109 de la prestaci\'f3n/intervenci +\'f3n }{\insrsid3948734 +\par }{\insrsid1720812 \tab d) Porcentaje de cobertura a cubrir por la Obra Social.}{\insrsid1720812\charrsid1275109 +\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid3948734 {\insrsid3948734\charrsid1275109 \tab }{\insrsid1720812 e}{\insrsid3948734\charrsid1275109 ) N\'famero de afiliado}{\insrsid1720812 . }{\insrsid1720812 {\field{\*\fldinst SYMBOL + 224 \\f "Wingdings" \\s 12}{\fldrslt\f10\fs24}}}{\insrsid1720812 es posible no incluirlo}{\insrsid3948734\charrsid1275109 \par }{\insrsid3948734 \par 2) }{\b\f1\fs20\insrsid3948734\charrsid986895 I}{\b\f1\fs20\insrsid3948734\charrsid8000756 nforme de aprobaciones/rechazos de prestaciones}{\b\f1\fs20\insrsid3948734 -\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid15751489 {\b\insrsid15751489\charrsid1275109 \tab }{\insrsid15751489\charrsid1275109 a) C\'f3digo de prestaci\'f3n/intervenci\'f3n (\'93Pr\'e1ctica\'94, en el nomenclador) -\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid3948734 {\insrsid15751489\charrsid1275109 \tab b) Cantidad }{\insrsid16676310\charrsid1275109 total }{\insrsid15751489\charrsid1275109 de aprobaciones}{\insrsid16676310\charrsid1275109 de la -prestaci\'f3n/intervenci\'f3n}{\insrsid15751489\charrsid1275109 -\par \tab c) Cantidad }{\insrsid16676310\charrsid1275109 total }{\insrsid15751489\charrsid1275109 de rechazos}{\insrsid16676310\charrsid1275109 de la prestaci\'f3n/intervenci\'f3n}{\insrsid15751489\charrsid1275109 -\par }{\b\f1\fs20\insrsid8000756 \tab }{\b\f1\fs20\insrsid3886421 -\par }{\insrsid3886421\charrsid3886421 3)}{\f1\fs20\insrsid3886421 }{\b\f1\fs20\insrsid3886421\charrsid3886421 R}{\b\f1\fs20\insrsid3886421\charrsid8981056 eporte de consumo de los afiliados}{\insrsid3948734 -\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\insrsid3886421\charrsid1275109 \tab a) N\'famero de afiliado}{\insrsid3948734\charrsid1275109 -\par }{\insrsid3886421\charrsid1275109 \tab b) C\'f3digo de prestaci\'f3n/intervenci\'f3n REALIZADA +\par }{\insrsid1720812\charrsid6241672 \tab a) Identificaci\'f3n del Prestador +\par \tab b) Nombre del Prestador +\par }\pard \ql \li708\ri0\nowidctlpar\faauto\rin0\lin708\itap0\pararsid6241672 {\insrsid1720812\charrsid6241672 c) C\'f3digo de autorizaci\'f3n }{\insrsid1720812\charrsid6241672 relacionada a la prestaci\'f3n/intervenci\'f3n}{\insrsid6241672 , enviada por el + Prestador.}{\insrsid1720812\charrsid6241672 +\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid15751489 {\insrsid15751489\charrsid6241672 \tab }{\insrsid6241672\charrsid6241672 d}{\insrsid15751489\charrsid6241672 ) C\'f3digo de prestaci\'f3n/intervenci\'f3n (\'93Pr\'e1ctica\'94 +, en el nomenclador) +\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid3948734 {\insrsid8000756\charrsid6241672 \tab }{\insrsid1720812\charrsid6241672 e) }{\insrsid6241672\charrsid6241672 Identificador de linea Aprobada/Rechazada}{\insrsid3886421\charrsid6241672 + +\par }{\insrsid6241672\charrsid6241672 \tab f) }{\insrsid6241672 C\'f3digo de afiliado +\par \tab g) % cobertura reclamado por el prestador +\par }\pard \ql \li708\ri0\nowidctlpar\faauto\rin0\lin708\itap0\pararsid6241672 {\insrsid6241672 h) % cobertura correspondiente al momento de aprobar la autorizaci\'f3n (si la autorizaci\'f3n existe en el sistema) +\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid3948734 {\insrsid6241672 \tab }{\insrsid662813 i) F}{\insrsid6241672 echa de aprobaci\'f3n de la autorizaci\'f3n (si la autorizaci\'f3n existe en el Sistema) +\par }\pard \ql \fi708\li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid6241672 {\insrsid6241672 j}{\insrsid662813 ) F}{\insrsid6241672 echa de vencimiento de la autorizaci\'f3n (si la autorizaci\'f3n existe en el Sistema) +\par }\pard \ql \li708\ri0\nowidctlpar\faauto\rin0\lin708\itap0\pararsid662813 {\insrsid662813 k) Motivo del rechazo de la linea (ej: \'93Autorizaci\'f3n recibida inexistente\'94, \'93Autorizaci\'f3n Vencida\'94, \'93% cobertura recibido inv\'e1lido\'94, etc)} +{\insrsid6241672 +\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid3948734 {\insrsid6241672 \tab }{\insrsid1720812\charrsid662813 +\par }{\insrsid3886421\charrsid6241672 3) }{\b\insrsid3886421\charrsid6241672 Reporte de consumo de los afiliados}{\b\insrsid3948734 +\par }{\b\insrsid662813 \tab Cada linea:}{\insrsid662813\charrsid6241672 +\par {\listtext\pard\plain\lang1024\langfe1024\noproof\langnp2058\langfenp2058\insrsid3886421\charrsid6241672 \hich\af0\dbch\af0\loch\f0 a)\tab}}\pard \ql \fi-360\li1065\ri0\nowidctlpar\jclisttab\tx1065\faauto\ls5\rin0\lin1065\itap0\pararsid662813 { +\insrsid3886421\charrsid6241672 N\'famero de afiliado}{\insrsid3948734 +\par {\listtext\pard\plain\lang1024\langfe1024\noproof\langnp2058\langfenp2058\insrsid662813 \hich\af0\dbch\af0\loch\f0 b)\tab}}{\insrsid662813 Nombre, apellido del afiliado +\par }\pard \ql \li1065\ri0\nowidctlpar\faauto\rin0\lin1065\itap0\pararsid662813 {\insrsid662813 Por cada afiliado: +\par }\pard \ql \fi708\li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0\pararsid662813 {\insrsid662813 c}{\insrsid3886421\charrsid6241672 ) C\'f3digo de prestaci\'f3n/intervenci\'f3n REALIZADA}{\insrsid3886421 +\par }\pard \ql \li0\ri0\nowidctlpar\faauto\rin0\lin0\itap0 {\insrsid662813 \tab d) Nombre de la prestaci\'f3n realizada +\par \tab e) C\'f3digo del plan del afiliado +\par \tab f) % Cobertura}{\insrsid662813\charrsid6241672 \par }} \ No newline at end of file