Re: [Health] Insurance

[Carlos Eduardo Sotelo Pinto]

Hello Luis

2016-04-18 14:16 GMT-05:00 Luis Falcon <address@hidden>:

Hi Carlos !

On Mon, 18 Apr 2016 10:55:31 -0500
Carlos Eduardo Sotelo Pinto <address@hidden> wrote:

> Any update? or suggest?
>
> 2016-04-17 16:01 GMT-05:00 Carlos Eduardo Sotelo Pinto <
> address@hidden>:
>
> > Dear Coders
> >
> > About Insurance companies and their management, I have a lot of
> > questions on a implementation that I have done on my country since
> > the way it is working is far from the way that is works on my
> > country. I guess insurance must be a module by itself in order of
> > disabled it when is no needed, cause it generates a lot of
> > confusing on final users

Please try to be concise on what do you want to achieve, and we might be
able to help you. Also, please don't cross-post to multiple mailing
lists.

GNU Health core module provides the following insurance functionality :

* Insurance companies
* Type of insurance
* Insurance plans


* Associate the insurance and insurance plan to a product (Service)
* Associate the insurance and the validity period to a person
* Multiple insurances / plans per person

​Unfortunately this way doesn't work on Perú cause is far to how insurances companies and plans are managed​.

​Just for write something about it​.

• We have fixed and regular plans
  
• Fixed: anything service or product have a global amount in a period, as example, I could pay USD 100 per week, and all service in each week will be included ( invoiced to insurance company as insurance customer )
• Regular: a common invoice
• We have "co aseguro", "co pago", "deducido" as payment types for patients as they could be in
• fixed price
• percent of agerement value to the insurance company
• Prices are calculated from an agreement between insurance and institution
• Services, bases on SEGUS, the service authority for services prices on all the country
• Kairos, a punctuation for products that is something like price = kairos_number_product * kairos_punctuation_agreement
• Agreement, for some specific services like a bed
  

Now, invoicing this to the insurance company is a more complex process

Then, how is working health for insurance just make confusion on final users, that is the reason on I have disabled it on health for my country and the reason that I guess that insurance could be a independent module in order on use or no use it

Best regards

It is up to the localization for each country, insurance type,
insurance plan, for things such as to know which health services are
included, discounts on selected health services, etc...


All the best
Luis

--
Dr. Luis Falcon, M.D., BSc
President, GNU Solidario
GNU Health: Freedom and Equity in Healthcare
http://health.gnu.org

--

Carlos Eduardo Sotelo Pinto
    Senior Software Analyst Developer

    Claro RPC +51983265994 | MOV RPM( # ) +51 966110066

    GTalk: address@hidden | Skype: csotelop

    GNULinux RU #379182 | GNULinux RM #277661

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