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Re: [Health] Insurance plans

From: Luis Falcon
Subject: Re: [Health] Insurance plans
Date: Wed, 17 Feb 2016 21:05:26 +0000

Hi Carlos !
On Wed, 17 Feb 2016 11:47:51 -0500
Carlos Eduardo Sotelo Pinto <address@hidden> wrote:

> Dear community
> I was reviewing the issue of insurance and health insurance in the
> gnuhealth, and I have some questions such as;
>    - When I create an insurance company, then I associate to a patient
>    association What affects her / his medical costs?
That is up to your localization rules. See below
>    - I have noticed that there are some products as "insurance plans"
> that it is not clear, because I understand that an insurance plan is
> not just a product if not all products with a specific cost-based
> insurer. Any suggest?

The insurance plan is associated to a product. For example, in public
health, many countries the "Social Security", where you pay a monthly
fee for both retirement and health insurance. So if you are the state,
you can also manage the insurances.

>    - When I create a new "insurance company", I assign insurance
> plans, how it affects the patient?

The first thing is that you know what is the status of that patient in
terms of health coverage, and what type(s) at any given point in time.
This is also quite useful to know how many people in the area / country
has proper coverage.

The second is that, once you have the insurance(s) associated to the
patient, you can then localize. For instance, you could play with price
lists depending on the type of the insurance. 

> Do these consultations, due in Peru is handled on a universal tariff
> called "SEGUS", and this is based on a formula, it creates specific
> products and services offered by clinic prices, which have not seen
> gnu health, by which built a module that allows me to allocate costs
> according to the insurer, but still do not get these prices are
> reflected in the billing issue when I create an invoice from the
> medical services. Did you experience this?
Other countries have similar rules. So, the price on a product /
medicament or medical service will depend on the insurance and
insurance plan of the patient.

Of course, that is part of the localization for each country and health

Hope it helps !


> ​Best regards​

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