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Configurando

Passos para Implantação

  1. Realizar cadastros iniciais do SIGAPLS
  2. Configurar parâmetros
  3. Cadastrar obrigação
  4. Importar beneficiários
  5. Validar beneficiários
  6. Importar produtos
  7. Validar produtos
  8. Importar expostos
  9. Importar despesas
  10. Validar despesas
  11. Sintetizar despesas
  12. Sintetizar beneficiários
  13. Gerar arquivo de envio

Os processos de validação e sintetização podem ser realizados manualmente ou via Schedule. Ambas as formas são descritas abaixo.

Realizar cadastros iniciais do SIGAPLS

Cadastras Naturezas de saúde

Realizar o cadastro de Natureza de saúde (BF0) conforme modelo inficado na IN 21 para o grupo gerencial (BSB) do SIP. O grupo gerencial padrão deve ser informado no parâmetro MV_PLGRSIP (Default "0001")

  • Acessar o SIGAPLS menu Atualizações > SIP Gerencial > Natureza de Saúde e realizar o cadastro das naturezas de saúde do SIP. A tabela abaixo é apenas um exemplo de como as naturezas devem ficar ao término do cadastro:

    BF0_CODIGOBF0_DESCRIBF0_CLASSEBF0_NIVELBF0_IMPRIMBF0_IDADE1BF0_IDADE2BF0_SEXOBF0_BENEFBF0_DESSIP
    A      CONSULTAS MEDICAS                                                                         1110999
    1consultasMedicas                                            
    A1     Consultas medicas ambulatoriais                                                           2210999
    1consultasMedicasAmb                                         
    A11    Alergia e Imunologia                                                                      2310999
    1alergiaImunologia                                           
    A12    Angiologia                                                                                2310999
    1angiologia                                                  
    A13    Cardiologia                                                                               2310999
    1cardiologia                                                 
    A14    Cirurgia geral                                                                            2310999
    1cirurgiaGeral                                               
    A15    Clinica medica                                                                            2310999
    1clinicaMedica                                               
    A16    Dermatologia                                                                              2310999
    1dermatologia                                                
    A17    Endocrinologia                                                                            2310999
    1endocrinologia                                              
    A18    Gastroenterologia                                                                         2310999
    1gastroenterologia                                           
    A19    Geriatria                                                                                 2310999
    1geriatria                                                   
    A110   Ginecologia e Obstetricia                                                                 2310999
    1GinecologiaObstetricia                                      
    A111   Hematologia                                                                               2310999
    1hematologia                                                 
    A112   Mastologia                                                                                2310999
    1mastologia                                                  
    A113   Nefrologia                                                                                2310999
    1nefrologia                                                  
    A114   Neurocirurgia                                                                             2310999
    1neurocirurgia                                               
    A115   Neurologia                                                                                2310999
    1neurologia                                                  
    A116   Oftalmologia                                                                              2310999
    1oftalmologia                                                
    A117   Oncologia                                                                                 2310999
    1oncologia                                                   
    A118   Otorrinolaringologia                                                                      2310999
    1otorrinolaringologia                                        
    A119   Pediatria                                                                                 2310999
    1pediatria                                                   
    A120   Proctologia                                                                               2310999
    1proctologia                                                 
    A121   Psiquiatria                                                                               2310999
    1psiquiatria                                                 
    A122   Reumatologia                                                                              2310999
    1reumatologia                                                
    A123   Tisiopneumologia                                                                          2310999
    1tisiopneumologia                                            
    A124   Traumatologia-ortopedia                                                                   2310999
    1traumatologiaOrtopedica                                     
    A125   Urologia                                                                                  2310999
    1urologia                                                    
    A2     Consultas medicas em Pronto Socorro                                                       1210999
    1consultaMedProntSoc                                         
    B      OUTROS ATENDIMENTOS AMBULATORIAIS                                                         1110999
    1outrosAtendAmb                                              
    B1     Consultas/sessoes com Fisioterapeuta                                                      2210999
    1consultaSessaoFisio                                         
    B2     Consultas/sessoes com Fonoaudiologo                                                       2210999
    1consultaSessaoFono                                          
    B3     Consultas/sessoes com Nutricionista                                                       2210999
    1consultaSessaoNutri                                         
    B4     Consultas/sessoes com Terapeuta ocupacional                                               2210999
    1consultaSessaoTerap                                         
    B5     Consultas/sessoes com Psicologo                                                           2210999
    1consultaSessaoPsico                                         
    C      EXAMES                                                                                    1110999
    1exames                                                      
    C1     Ressonancia magnetica                                                                     2210999
    1ressonanciaMagnet                                           
    C2     Tomografia computadorizada                                                                2210999
    1tomografiaComputa                                           
    C3     Procedimento diagnostico em citopatologia cervico-vaginal oncotica em mulheres de 25 a 59 221255921procedDiagnCitopat                                          
    C4     Densitometria ossea – qualquer segmento                                                   2210999
    1densitometriaOssea                                          
    C5     Ecodopplercardiograma transtoracico                                                       2210999
    1ecodopplerTranstora                                         
    C6     Broncoscopia com ou sem biopsia                                                           2210999
    1broncoscopiabiopsia                                         
    C7     Endoscopia digestiva alta                                                                 2210999
    1endoscopiaDigestiva                                         
    C8     Colonoscopia                                                                              2210999
    1colonoscopia                                                
    C9     Holter de 24 horas                                                                        2210999
    1holter24h                                                   
    C10    Mamografia convencional e digital                                                         2210999
    1mamografiaConvDig                                           
    C101   Mamografia em mulheres de 50 a 69 anos                                                    231506921mamografia50a69                                             
    C11    Cintilografia miocardica                                                                  2210999
    1cintilografiaMiocard                                        
    C12    Cintilografia renal dinamica                                                              2210999
    1cintilografiaRenal                                          
    C13    Hemoglobina glicada                                                                       2210999
    1hemoglobinaGlicada                                          
    C14    Pesquisa de sangue oculto nas fezes                                                       2210999
    1pesqSangueOculto                                            
    C15    Radiografia                                                                               2210999
    1radiografia                                                 
    C16    Teste ergometrico                                                                         2210999
    1testeErgometrico                                            
    C17    Ultra-sonografia diagnostica de abdome total                                              2210999
    1ultraSonAbdoTotal                                           
    C18    Ultra-sonografia diagnostica de abdome inferior                                           2210999
    1ultraSonAbdoInfer                                           
    C19    Ultra-sonografia diagnostica de abdome superior                                           2210999
    1ultraSonAbdoSuper                                           
    C20    Ultra-sonografia obstetrica morfologica                                                   2210999
    1ultraSonObstMorfo                                           
    D      TERAPIAS                                                                                  1110999
    1terapias                                                    
    D1     Transfusao ambulatorial                                                                   2210999
    1transfusaoAmbulatorial                                      
    D2     Quimioterapia sistemica                                                                   2210999
    1quimioSistemica                                             
    D3     Radioterapia megavoltagem                                                                 2210999
    1radioterapiaMegavolt                                        
    D4     Hemodialise aguda                                                                         2210999
    1hemodialiseAguda                                            
    D5     Hemodialise cronica                                                                       2210999
    1hemodialiseCronica                                          
    D6     Implante de dispositivo intrauterino – DIU                                                2210999
    1implanteDispIntrauterino                                    
    E      INTERNACOES                                                                               1110999
    1internacoes                                                 
    E11     Clinica                                                                                   2210999
    1clinica                                                     
    E12     Cirurgica                                                                                 2210999
    1cirurgica                                                   
    E121    Cirurgia bariatrica                                                                       2310999
    1cirurgiaBariatrica                                          
    E122    Laqueadura tubaria                                                                        2310999
    1laqueaduraTubaria                                           
    E123    Vasectomia                                                                                2310999
    1vasectomia                                                  
    E124    Fratura de femur (60 anos ou mais)                                                        23160999
    1fraturaFemur60                                              
    E125    Revisao de artroplastia                                                                   2310999
    1revisaoArtroplastia                                         
    E126    Implante de CDI (cardio desfibrilador implantavel)                                        2310999
    1implanteCdi                                                 
    E127    Implantacao de marcapasso                                                                 2310999
    1implantacaoMarcap                                           
    E13     Obstetrica                                                                                2210999
    1obstetrica                                                  
    E131    Parto normal                                                                              2310999
    1partoNormal                                                 
    E132    Parto cesareo                                                                             2310999
    1partoCesareo                                                
    E14     Pediatrica                                                                                2210999
    1pediatrica                                                  
    E141    Internacao de 0 a 5 anos de idade por doencas respiratorias                               23105
    1internacaoRespira                                           
    E142    Internacao em UTI no periodo neonatal                                                     231028
    1internacaoUtiNeo                                            
    E1421   Internacoes em UTI no periodo neonatal por ate 48 horas                                   23106
    1internacoesUtiNeo48                                         
    E15     Psiquiatrica                                                                              2210999
    1psiquiatrica                                                
    E151    Hospitalar                                                                                2310999
    1hospitalar                                                  
    E152    Hospital-dia                                                                              2210999
    1hospitalDia                                                 
    E1521   Hospital-dia para saude mental                                                            2310999
    1hospitalSaudeMental                                         
    E153    Domiciliar                                                                                2310999
    1domiciliar                                                  
    F      CAUSAS SELECIONADAS DE INTERNACAO                                                         1110999
    1causaSelecInterna                                           
    F1     Neoplasias                                                                                2210999
    1neoplasias                                                  
    F11    Cancer de mama feminino                                                                   2310999
    1cancerMamaFem                                               
    F111   Tratamento cirurgico de cancer de mama feminino                                           2310999
    1tratCirurgCancerMam                                         
    F12    Cancer de colo de utero                                                                   2310999
    1cancerColoUtero                                             
    F121   Tratamento cirurgico de cancer de colo de utero                                           2310999
    1tratCirurgCancerColo                                        
    F13    Cancer de colon e reto                                                                    2310999
    1cancerColonReto                                             
    F131   Tratamento cirurgico de cancer de colon e reto                                            2310999
    1tratCirurgCancerColoReto                                    
    F14    Cancer de prostata                                                                        2310999
    1cancerProstata                                              
    F141   Tratamento cirurgico de cancer de prostata                                                2310999
    1tratCirurgCancerProst                                       
    F2     Diabetes mellitus                                                                         2210999
    1diabetesMellitus                                            
    F3     Doencas do aparelho circulatorio                                                          2210999
    1doencasAparelhoCirc                                         
    F31    Infarto agudo do miocardio                                                                2310999
    1infartoAgudoMiocardio                                       
    F32    Doencas hipertensivas                                                                     2310999
    1doencasHipertensivas                                        
    F33    Insuficiencia cardiaca congestiva                                                         2310999
    1insuficienciaCardCong                                       
    F34    Doencas cerebrovasculares                                                                 2310999
    1doencasCerebrovasc                                          
    F341   Acidente vascular cerebral                                                                2310999
    1acidenteVascularCere                                        
    F4     Doencas do aparelho respiratorio                                                          2210999
    1doencasAparelhoResp                                         
    F41    Doenca pulmonar obstrutiva cronica                                                        2310999
    1doencaPulmoObstrCron                                        
    F5     Causas externas                                                                           2210999
    1causasExternas                                              
    G      NASCIDO VIVO                                                                              1110999
    1nascidoVivo                                                 
    H      DEMAIS DESPESAS MEDICOHOSPITALARES                                                        1110999
    1demaisDespMedHosp                                           
    I      PROCEDIMENTOS ODONTOLOGICOS                                                               1110999
    1procedimentosOdonto                                         
    I1     Consultas odontologicas iniciais                                                          2210999
    1consultasOdontoInic                                         
    I2     Exames radiograficos                                                                      2210999
    1examesRadiograficos                                         
    I3     Procedimentos preventivos                                                                 2210999
    1procedimentosPrevent                                        
    I31    Atividade educativa individual                                                            2310999
    1atividadeEduIndividual                                      
    I32    Aplicacao topica profissional de fluor por hemi-arcada                                    2310999
    1aplicTopProfFluorHemi                                       
    I33    Selante por elemento dentario (menores de 12 anos)                                        231012
    1selanteElemDentario                                         
    I4     Raspagem supra-gengival por hemiarcada (12 anos ou mais)                                  22112999
    1raspSupraGengHemi                                           
    I5     Restauracao em dentes deciduos por elemento (menores de 12 anos)                          221012
    1restauraDenteDeciduo                                        
    I6     Restauracao em dentes permanentes por elemento (12 anos ou mais)                          22112999
    1restauraDentePerma                                          
    I7     Exodontias simples de permanentes (12 anos ou mais)                                       22112999
    1exodontiasSimplesPer                                        
    I8     Tratamento endodontico concluido em dentes deciduos por elemento (menores de 12 anos)     221012
    1trataEndoConclDentesD                                       
    I9     Tratamento endodontico concluido em dentes permanentes por elemento (12 anos ou mais)     22112999
    1trataEndoConclDentesP                                       
    I10    Proteses odontologicas                                                                    2310999
    1protesesOdontologicas                                       
    I11    Proteses odontologicas unitarias (Coroa Total e Restauracao Metalica Fundida)             2310999
    1protesesOdontoUnitarias                                     
  • Análise de especialidades médicas
    • As especialidades médicas (BAQ) precisam ter uma classificação SIP para consulta. Olhar na tabela BAQ se existe pelo menos uma especialidade com o campo BAQ_ESPSP2 preenchido para cada classificação de consulta (A11 até A125) conforme planilha em anexo. Essa regra é um alerta, pois a operadora pode não ter atendimento dessas especialidades. De qualquer forma, é indicado ter pelo menos uma especialidade para cada classificação.
  • Análise de classificação de procedimentos
    • Nenhum procedimento (BR8) pode ter o campo BR8_CLASIP ou BR8_CLASP2 igual a 'A'
    • Pelo menos 1 procedimento deve ter o campo BR8_CLASIP igual a 'B' e campo BR8_FCAREN igual a '1'
    • Pelo menos 1 procedimento deve ter o campo BR8_CLASIP igual a 'C' e campo BR8_FCAREN igual a '1'
    • Pelo menos 1 procedimento deve ter o campo BR8_CLASIP igual a 'D' e campo BR8_FCAREN igual a '1'
    • Pelo menos 1 procedimento deve ter o campo BR8_CLASP2 igual a 'E141' e campo BR8_FCAREN igual a '1'
    • Para operadoras com planos odontológicos: Pelo menos 1 procedimento deve ter o campo BR8_CLASIP igual a 'I' e campo BR8_FCAREN igual a '1'
  • Verificar se os procedimentos descritos na tabela De x Para TUSS estão com a classificação correta conforme planilha anexa.
  • Verificar se os procedimentos descritos na tabela De x Para TUSS estão com a classificação correta conforme planilha anexa.Corrigir os que estiverem errados conforme a tabela em questão (Aba classificação de procedimentos).

Parâmetros

Para que a integração entre o PLS e a Central funcione corretamente, é necessário configurar alguns parâmetros no configurador.

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