Held on March 1, the 92nd Meeting of the Committee for the Standardization of Information on Supplementary Health - COPISS, dealt with various matters of interest to the College and other entities present.
One of the main topics discussed at the meeting was “Security and Privacy Requirements - Beneficiary Authentication Mechanisms”. Due to the delay in standardizing beneficiary identification methods, health operators are implementing and requiring some providers to use tokens, biometrics and/or facial recognition.
The CBR highlighted that there should be no cost for providers, regardless of the solutions adopted, and that such solutions cannot increase the service time for beneficiaries. It was reported that there are already operators requiring two forms of patient identification (Token and Biometrics, for example) and that this has an impact on care.
The Brazilian Society of Health Informatics (SBIS) was responsible, at the time, for bringing a standardization proposal within 60 days for forwarding the COPISS. One month before this stipulated deadline, SBIS will meet with health operators to analyze the experiences already implemented by some operators.
Another topic discussed at the meeting was “Denunciation of health insurance companies that do not adopt the TISS standard - Exchange of Information in Supplementary Health”. Within this topic, CBR reported that large operators have not provided providers with the option of "Authorizer and Eligibility" via webservice and "Demonstrativos de Payas e Glosas" in XML format, items of the TISS standard that enable automation and cost reduction and glosses for clinics.
It was suggested to the National Supplementary Health Agency (ANS) to initiate a complaint process, hiding the names of providers to preserve them from possible retaliation. ANS agreed and explained that, based on the complaint, the operator in question will receive an audit to prove that a group of providers selected by the Agency use such functionalities.
It is under discussion to redo a consultation held in 2014 on the adoption of the TISS and forward the responses to the ANS, in the form of a complaint.
With regard to the Improvement of the TISS Standard, the 2018 agenda was presented, consisting of the topics below:
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- Beneficiary authentication mechanisms;
- Information correction flow – revision of gloss process;
- Alteration of the billing process for the unambiguous identification of charged procedures and for linking care items to the procedures;
- Identification of care for pregnant women and pre- and postoperative care;
- Audit message;
- Message between operators – service sharing;
- Adequacy to include Promotion and Prevention programs;
- Message for continuity of care.