The central segment of the unified register of insured persons leads. Service for integration with subsystems rs erzl and pump ais oms oms insured register

According to general director "RINTECH" Sergey Kuptsov, "the creation of ERZ was another major step towards formalizing the budgetary component of the informatization of medicine. A unified base has been created, uniform formats for interaction between systems have been developed, uniform requirements have been formulated. The issuance of electronic compulsory medical insurance policies has begun, which will soon be combined with universal electronic Such a systematic approach, developed in the process of creating new compulsory medical insurance policies, can become a "driver" for the development of informatization in medicine. "

Integration service - with subsystems RS ERZL and PUMP AIS OMS

The exchange of data between the participants of the CHI system includes legally significant document flow using the web services of the Personalized registration of medical care system - PUMP AIS CHI, the information system of medical organizations - IS MO and the information system of medical insurance organizations - IS SMO when using the Regional segment of the Unified Register of Insured Persons ( RS ERZL).

IMPORTANT! On reconciliation - the Unified Register of Insured Persons - for compulsory medical insurance in e

To resume insurance in Moscow in accordance with the federal law "On compulsory health insurance in the Russian Federation" dated November 29, 2010 N 326-FZ, a citizen must submit an application to any insurance organization the city of Moscow about replacing the old policy of the 1998 model with a policy uniform sample.

Compulsory health insurance policy

In order to obtain a policy of compulsory health insurance, the insured person submits a standard application to the medical insurance organization (MCO) about the choice (or replacement) of the insurer. After that, the MCO transfers information about the insured person who submitted the application to the territorial fund, where, within 2 working days, a check is made against the unified register of insured persons that there is already current policy from the insured person. If confirming information is revealed, the medical insurance organization that received the application sends a refusal to the insured within 5 working days.

Nfi 144 from 29

In the event of a change in the place of residence or place of stay, 3JT MO, when registering a repeated application within a year (the date of the repeated application should not be previously registered in the PC EPZL), sends an electronic copy of the application for attachment to the MO with the note “change of residence / stay ЗЛ "in the upper field of the application.

Letter - FFOMS dated N 3960

After updating the data of the regional consolidated register of insured persons in accordance with paragraphs 3.1 - 3.4 of these Methodical recommendations each current SRZ record must be assigned (matched) a unique unified compulsory medical insurance policy (UNP) number in accordance with the Rules for the formation of a single insurance number medical policy compulsory health insurance.

MGFOMS reliable protection of the rights of Muscovites who have a compulsory medical insurance policy

Electronic policy is a document that no one except the owner can use, which is due to the presence of a chip, personal signature and a photo of the insured. The document number is displayed on the front side. The reverse side contains full information about the owner of the policy with his signature, as well as the validity period of the document.

On approval of the Regulations for attaching and registering citizens insured under compulsory medical insurance to medical organizations of the state health system of the city of Moscow, providing primary health care and included in the register of medical organizations operating in the field of compulsory medical insurance of the city of Moscow, using UMIAS

2.9. In the event that the insured person at the time of filing the application had an attachment to a medical organization providing primary health care within the framework of the program of state guarantees for the provision of free medical care to citizens that is not part of the Moscow state health system, the medical organization that accepted the application interacts with the specified medical organization in the manner determined in the order of the Ministry of Health and social development Russian Federation dated May 26, 2012 N 406n "On approval of the Procedure for choosing a medical organization by a citizen when providing him with medical care within the framework of the program of state guarantees of free provision of medical care to citizens."

Registered in the regional segment of the unified register of insured persons of the city of Moscow

The main excess is formed due to the non-working population, which is associated with the complexity of working with this group - there are no lists of non-working residents of the Samara region either in the passport and visa service, or in the registry office, or in local government bodies.

Order of the Territorial Compulsory Health Insurance Fund

Every month, the CMO, within the time period established by these Regulations, sends to MGFOMS an individual entrepreneur with the appropriate message code and an attached archive file (zip), which includes the file-register of the PL attached to the MO according to applications during the reporting period (table 3 of Appendix 1 to this Regulation) dbf and the corresponding "Summary report of information on the attachment of the insured for _______", signed by the responsible representative of the CMO (electronic version of the text document - Appendix 2) in pdf format. IP message codes:

Unified register of insured persons oms

Regional segments are formed by TFOMI on the basis of information provided by medical insurance organizations. This is done at least once a day (if there are changes in the data). Information is received around the clock. For violation of these terms, the insurers are fined.

The insured person can have only one compulsory health insurance policy. When applying for help to a medical institution, the insured citizen must present an insurance policy. Payment for rendered medical services (within cHI programs) is undertaken by the insurance medical companythat issued the OMS policy to this person.

Unified register of insured persons oms moscow

According to the law on compulsory health insurance (MHI) in the Russian Federation, all citizens of the country have the right to provide medical care anywhere and in any institution. Not so long ago, it was not easy to identify a patient from another city. Medical assistance was sometimes provided without understanding whether a person exists in the CHI database or not. Each territory had its own procedures and features of health insurance, its own registers of attached citizens.

Obtaining a policy

You can see the list of documents required to obtain an electronic compulsory health insurance policy here. What you need to know about the new e-policy 1. The e-policy of compulsory health insurance is a document that no one but you can use! Instead of a barcode, a chip is embedded in the policy, like bank card; it will have your personal signature and photograph, which makes it impossible for outsiders to use your personal data!

Unified register of insured persons oms moscow

An insurance medical organization transfers files with changes to the territorial fund as necessary, but at least once a day if there are changes in the information about the insured persons, in accordance with the agreement on financial support compulsory health insurance. The territorial fund provides round-the-clock reception and processing of files with changes received from insurance medical organizations.

Editing date:27.11.2019

Maintaining the regional segment of the unified register of insured persons

9. Information about each insured person specified in paragraph 3 of this Procedure shall be entered in the unified register of insured persons.

10. Maintaining the regional segment of the unified register of insured persons is carried out by the territorial fund on the basis of information about insured persons provided by an insurance medical organization.

11. The medical insurance organization and the territorial fund by orders determine the employees admitted to work with the regional segment of the unified register of insured persons, and comply with the requirements of the legislation of the Russian Federation on the protection of personal data.

12. When entering information about the insured person in the regional segment of the unified register of insured persons, the medical insurance organization ensures the accuracy and correctness of the information entered and carries out checks to prevent duplicate entries from appearing in the regional segment of the unified register of insured persons:

1) for the presence of repetitions by last name, first name, patronymic, date and place of birth;

2) for the presence of repetitions according to the data of the identity document;

3) the correctness of the indication of the sex of the insured person;

4) for the presence of repetitions by date of birth and registration address at the place of residence;

5) for the presence of repetitions of the last name, first name and patronymic and registration address at the place of residence;

6) for the presence of repetitions according to the insurance number of the individual personal account (SNILS).

13. In order to update the regional segment of the unified register of insured persons and enter information about insured persons into it, an insurance medical organization forms and transfers information files with changes in information about insured persons provided for in paragraph 3 of this Procedure (hereinafter - files with changes) to the territorial fund as necessary, but at least once a day if there are changes in the information about the insured persons, in accordance with the contract on the financial support of compulsory health insurance.

The files with changes include all newly entered and changed information about the insured persons since the last submission.

Instructions for working with RS ERZ YNAO

• It is imperative for each event or citizen's appeal to the CMO, first to do the RFP in the CA ERZ.
• Only on the basis of a response from the CA EPZ and / or RS EPZ (web request), take further actions. Indicate the received data in the previous information.
• It is necessary to take copies and / or scans of all documents required for compulsory medical insurance insurance from a citizen. The basis is clauses 5 and 6 of the Order of the Ministry of Health and Social Development of the Russian Federation of 25.01.2011 N 29n "On approval of the Procedure for maintaining personalized records in the field of compulsory health insurance."
• If the CMO is changed according to the policy from another territory, it is necessary to send us an event about the CMO change with the data with which the AP came. If the RFP came empty, it is necessary to clarify the data with which the AP was registered in another territory. Only after changing the CMO (CA response) make changes to the AP, if necessary.
• Cancellation of the DPSF is carried out by the CMO on the basis of an application by the LP
• For the first number, the DPS that are not included in the CA ERZ will not be included in the PVS. The CMO is obliged to timely make changes to the RS ERZ (CA ERZ) and work out the sent protocols.
• In event-guided changes RS ERZ CMO is obliged:

• Indicate the code of the insurance medical organization (head), in accordance with the unified register of insurance medical organizations operating in the field of compulsory health insurance (F002.xml). Valid values \u200b\u200bare "83001", "83005", and "83008".
• Be sure to fill in the RF region code of the place of registration and the RF region code of the place of residence. The RF region code of the place of residence must belong to the Yamalo-Nenets Autonomous Okrug.

To add DPSF to the CA and RS, you must first complete the following steps:

1) Check if there were any errors on the event you sent and, if they did, then correct the specified error and repeat the event.

2) Check the sign of registration, the period of validity of the DPS on the website. It is also necessary to check the notifications from the CA (Events sent to the CA by the fund), if there are no errors or the error "The terms of submission are violated ...", then the aircraft has been added to the CA.

3) If an aircraft is added to the CA, but the request has not been sent to GOZNAK, event P010 must be sent for this aircraft, and it will be automatically sent.

Now more about errors received from the CA.

“An attempt to significantly change the age and gender group of the insured person” arises in connection with a change in the sex or age of the AP. It can also occur when the wrong gender or date of birth was specified. It is necessary to check / correct the data of the RFP and send P040. Then repeat the event.

"An error in the" birthday and gender "UMP facet", "Incorrectly calculated the" birth month "facet in the UMB", "Incorrectly calculated the" year of birth "facet in the UPC" occurs when the age and gender were changed, but the UMN was not changed ... This error may also occur if the DPSF was originally received for one date of birth or gender, and a duplicate is issued for another. It is necessary to check / correct the data on the ZL and send P040. Then repeat the event.

"An error in the number or series and number of the identity document" occurs when the series or number of the UDL was indicated incorrectly, it can also occur if the type of document is specified incorrectly. It is necessary to correct and send P040. Then repeat the event.

"Error in check number SNILS" SNILS is incorrectly specified. It is necessary to correct and send P040. Then repeat the event.

"Invalid date of issue of a passport" arises when an expired passport is indicated, the replacement period is 14, 20 and 45 years. Then repeat the event.

"It is impossible to create an insured person with an insurance policy, the action, which is equal to 0 days" occurs when the DPFS is not correctly added to the RS. It is necessary to check the period of validity of the DPSF for the FSP in the CA and / or RS, you also need to make sure that in the RS this AP does not have insurance with a start date greater than the one you add. If the CA has insurance that belongs to another CMO, and the start date of which is higher than the added one, you need to cancel your aircraft and call the CMO, whose DPS was canceled because of you, so that they can restore their aircraft.

"Invalid documents for a given citizen" occurs when the documents of a foreign citizen are indicated, but the citizenship is of the Russian Federation or vice versa, when the documents of a citizen of the Russian Federation are indicated, and foreign citizenship is affixed. It can also occur if the age and the document do not match (for example, a birth certificate is affixed to a PL who is more than 14 years old). It is necessary to check / correct the data and send P040. Then repeat the event.

"The parameters of the document are not specified or specified incorrectly" occurs if the UDL is not specified, or if the start or end date of the validity of the documents is incorrectly specified (Usually occurs when the expiration date of foreign documents is not filled in).

"The identity document of the insured person is not specified" occurs when the UDL is not specified, or the document was entered incorrectly in the database. It is necessary to add the document to our database with the P040 event. Then repeat the event.

"It was not possible to unambiguously identify the insured person" in the CA there are two unconnected insurances that belong to one AP. To resolve this conflict, it is necessary:

1) Clarify whether the insured received the policy in another territory

2) To clarify whether the SP has changed personal data.

3) It is necessary to check / correct the data and send P040 (If there were changes in the personal data).

4) Send the list according to paragraph "Error handling RS EPZ" Instructions for working with RS EPZ.

"The start date of the policy to be replaced is greater than the start date of the new one" is added by DPS with a start date less than that of DPS located in the CA. It is necessary to check the ZSP of the insurance that is in the CA and send us the changes with the correct dates. Then repeat the event.

"As part of the new data of the insured person, the UDL number is indicated, which, according to the CA data, is assigned to another insured person." The CA contains an SP with the same documents as your SP. You need to check if there were any data errors during the previous registration of your PO. It is also necessary to check the documents of your AP. Send p040 if necessary. Then repeat the event.

"In1 segment incorrectly specified information about insurance" Often occurs when the CMO sends events and indicates in the previous information data that is different from those contained in the CA (it is necessary to send in the previous information those that are returned upon request from the CA). Either when several aircrafts are entered into the RS on the same day with the same onset of action, or the CMO is changed and on the same day an aircraft is added with the same onset of action. Aircraft and policies cannot be issued with the same period; the beginning of the action can coincide with the policy and the aircraft only when the policy is issued. It is necessary to correct the beginning of the DPSF action, or issue a new DPSF and add it to the CA / RS.

"Invalid revocation" means that this DPSF has expired and cannot be added to the CA. It is necessary to issue a new DPS.

If the site has a sign of registration with the CA, then you need to check the EPP and the date of issue of your DPFS and EPP, which is displayed on our website and, if necessary, change it and send the RFP. After receiving a response to the RFP, you should have a sign of registration with the CA, and you can (should) send an application to GOZNAK. Do not forget to indicate the correct reason for re-issuing the DPS.

P040 must be sent indicating the previous and current data, including the EPP.

In the DVIZIT field, it is necessary to indicate the date of the application of the insured person (Application for choice (replacement) insurancemedicalorganizations, etc.).

When transferring information about a temporary certificate in an event from the CMO, if the issued policy has a limited validity period, the DSTOP field is used as the expiration date of the policy when sending an application to GOZNAK.

On the cancellation of military personnel.

Based on part 3 of Art. 49.1 Federal law of November 29, 2010 N 326-FZ and clause 10 of the Order of the Ministry of Health and Social Development of Russia of January 25, 2011 N 29n (as amended on 12/08/2016) "On approval of the Procedure for maintaining personalized records in the field of compulsory medical insurance" (Registered at the Ministry of Justice of Russia on 02/08/2011 N 19742), upon receipt of a relevant application from the insured specified in part 1 of Art. 49.1 of the Federal Law of November 29, 2010 N 326-FZ or through its representative by an insurance medical organization (hereinafter referred to as CMO), CMO must cancel the compulsory medical insurance policy (event P02).

About sending letters to work with RS ERZ and CA ERZ.

Official letters (without personal data) must be sent to the address. Applications containing Persian data must be sent via VipNet to the user "89 (TFOMS YNAO) Administrator (VPN-2021)".

Error handling RS EPZ

If it is impossible to process the PL protocol by an insurance medical organization, it is necessary to write a letter to the TFOMS YNAO, describing the reason why independent processing is not possible, and also send personal data about the PL via a secure VipNet channel to the network node "89 (TFOMS YNAO) Administrator" with indicating the subject of the letter "RSEPZ".

Sample application for providing information about AP.

In accordance with Article 43 of the Federal Law of November 29, 2010 No. 326-FZ "On Compulsory Medical Insurance in the Russian Federation" (Collected Legislation of the Russian Federation, 2010, No. 49, Art. 6422) I order:

Approve the attached Procedure for maintaining personalized records in the field of compulsory health insurance.

Registration number 19742

The procedure for maintaining personalized records in the field of compulsory health insurance

I. General provisions

1. This Procedure determines the rules for maintaining personalized records of information about each insured person in the field of compulsory health insurance, including:

1) the organization of personalized accounting in the field of compulsory health insurance;

2) maintaining a unified register of insured persons;

3) maintaining personalized records of information about medical care provided to insured persons;

4) the technology of information exchange when maintaining personalized records in the field of compulsory health insurance.

2. The goals of personified accounting in the field of compulsory health insurance are:

1) creation of conditions for ensuring guarantees of the rights of insured persons to free provision of medical care of adequate quality and volume within the framework of the basic and territorial programs compulsory health insurance;

2) creating conditions for exercising control over the use of compulsory health insurance funds;

3) determination of the need for the volume of medical care in order to form the basic and territorial programs of compulsory medical insurance.

II. Organization of personalized accounting

3. Personalized accounting of information about insured persons is maintained in the form of a unified register of insured persons, which is a combination of its central and regional segments, and includes the collection, processing, transfer and storage of the following information about the insured persons:

1) surname, name, patronymic;

3) date of birth;

4) place of birth;

5) citizenship;

6) data of the identity document;

7) place of residence;

8) place of registration;

9) date of registration;

10) insurance number of an individual personal account (SNILS), adopted in accordance with the legislation of the Russian Federation on individual (personified) accounting in the compulsory pension insurance system;

11) number of the policy of compulsory medical insurance of the insured person;

12) data on the medical insurance organization chosen by the insured person;

13) the date of registration as an insured person;

14) the status of the insured person (employed, unemployed).

4. Personalized accounting of information on medical care provided to insured persons includes collection, processing, transfer and storage of the following information:

1) the number of the policy of compulsory medical insurance of the insured person;

2) a medical organization that has provided the relevant services;

3) types of medical care provided;

4) conditions for the provision of medical care;

5) terms of rendering medical assistance;

6) the volume of medical care provided;

7) the cost of the provided medical care;

8) diagnosis;

9) profile of medical care;

10) medical services provided to the insured person and medicinal products used;

11) applied medical and economic standards;

12) the specialty of the medical worker who provided medical assistance;

13) the result of seeking medical help;

14) the results of the carried out control of volumes, terms, quality and conditions of medical care provision.

5. Information about the insured person and about the medical care provided to him can be provided both in the form of documents in writing and in electronic form, provided there are guarantees of their reliability (authenticity), protection from unauthorized access and distortions in accordance with the requirements established by the legislation of the Russian Federation on the protection of personal data. In this case, the legal force of the submitted documents is confirmed by an electronic digital signature in accordance with the legislation of the Russian Federation. The decision on the possibility of submitting information in electronic form is made jointly by the participants in the information exchange.

6. Insurance medical organizations and medical organizations store copies of paper documents and electronic archives containing personalized information about insured persons and the medical care provided to them, submitted to the territorial compulsory medical insurance fund (hereinafter - the territorial fund) for personalized accounting, according to the rules for organizing state archival affairs.

7. After the expiration of the period established for storing copies of documents on paper and electronic media in an insurance medical organization, they are subject to destruction in accordance with the legislation of the Russian Federation on the basis of an act on their destruction, approved by the head of the insurance medical organization.

8. Information about the insured person and about the medical care provided to him refers to information with limited access and is subject to protection in accordance with the legislation of the Russian Federation.

III. Maintaining the regional segment of the unified register of insured persons

9. Information about each insured person specified in paragraph 3 of this Procedure shall be entered in the unified register of insured persons.

10. Maintaining the regional segment of the unified register of insured persons is carried out by the territorial fund on the basis of information about insured persons provided by an insurance medical organization.

11. The medical insurance organization and the territorial fund by orders determine the employees admitted to work with the regional segment of the unified register of insured persons, and comply with the requirements of the legislation of the Russian Federation on the protection of personal data.

12. When entering information about the insured person in the regional segment of the unified register of insured persons, the medical insurance organization ensures the accuracy and correctness of the information entered and carries out checks to prevent duplicate entries from appearing in the regional segment of the unified register of insured persons:

1) for the presence of repetitions by last name, first name, patronymic, date and place of birth;

2) for the presence of repetitions according to the data of the identity document;

3) the correctness of the indication of the sex of the insured person;

4) for the presence of repetitions by date of birth and registration address at the place of residence;

5) for the presence of repetitions of the last name, first name and patronymic and registration address at the place of residence;

6) for the presence of repetitions according to the insurance number of the individual personal account (SNILS).

13. In order to update the regional segment of the unified register of insured persons and enter information about insured persons into it, an insurance medical organization generates and transfers information files with changes in information about insured persons, under paragraph 3 of this Procedure (hereinafter referred to as the files with changes), to the territorial fund as necessary, but at least once a day if there are changes in the information about the insured persons, in accordance with the contract on financial support of compulsory medical insurance.

14. The territorial fund provides round-the-clock reception and processing of files with changes received from medical insurance organizations.

15. When processing files with changes in the territorial fund, format-logical data control, identification of records for the regional segment of the unified register of insured persons, entering information about insured persons is carried out.

16. After processing files with changes in the territorial fund, files of confirmation and / or rejection of changes are generated, which are sent to the relevant medical insurance organizations to correct the information about the insured persons.

17. The territorial body of the Pension Fund of the Russian Federation on a quarterly basis no later than the 15th day of the second month following the reporting period, in accordance with the Agreement on information exchange between the Pension Fund of the Russian Federation and the Federal Fund of Compulsory Medical Insurance, to the relevant territorial fund, information on the working insured persons to enter them into the regional segment of the unified register of insured persons.

18. Territorial fund on a monthly basis on the basis of information on the state registration of death provided by the civil registry authorities in accordance with Article 12 of the Federal Law of November 15, 1997 No. 143-FZ "On Acts of Civil Status" (Collected Legislation of the Russian Federation, 1997, No. 47, Art. 5340; 2001, No. 44, Art. 4149; 2003, No. 17, Art. 1553; No. 50, Art. 4855; 2009, No. 51, Art. 6154; 2010, No. 15, Art. 1748) , carries out updating of the regional segment of the unified register of insured persons, notifies medical insurance organizations on the territory of the constituent entity of the Russian Federation and sends information files with information on the state registration of death in the territory of the constituent entity of the Russian Federation for persons whose information is absent in the regional segment of the unified register of insured persons , in Federal fund compulsory health insurance (hereinafter referred to as the Federal Fund) to update the central segment of the unified register of insured persons.

19. The territorial fund quarterly updates the regional segment of the unified register of insured persons on the basis of information about the working insured persons and sends information files with information about the working insured persons, information about which is not available in the regional segment of the unified register of insured persons, to the Federal Fund to update the central segment of the unified register of insured persons.

20. The policyholder for non-working citizens on a monthly basis, no later than the 5th day of each month, provides the relevant territorial fund with information about non-working insured persons, provided for in subparagraphs 1-10, 14 of paragraph 3 of this Procedure, in accordance with agreements on information exchange between territorial funds and policyholders for non-working citizens in the constituent entities of the Russian Federation, and in the form approved by the Federal Fund and the Pension Fund of the Russian Federation.

21. The Territorial Fund updates the regional segment of the unified register of insured persons on the basis of information received from the Federal Fund from the central segment of the unified register of insured persons.

22. In case of violation of the terms for providing data on insured persons, as well as information on changes in these data, established by the contract on financial support of compulsory medical insurance, the medical insurance organization is obliged to pay the territorial fund at its own expense a fine in the amount established by part 10 of Article 38 of the Federal Law of 29 November 2010 No. 326-FZ "On compulsory health insurance in the Russian Federation" (hereinafter referred to as the Federal Law "On compulsory health insurance in the Russian Federation").

23. The Territorial Fund exercises general control over the regional segment of the unified register of insured persons. In case of detection of errors and inconsistencies, the territorial fund sends the relevant information to the medical insurance organization, indicating the list of inconsistencies and the timing of their correction.

IV. Maintaining the central segment of the unified register of insured persons

24. The territorial fund, when making changes to the regional segment of the unified register of insured persons, generates files with changes, which are sent to the Federal Fund for updating the central segment of the unified register of insured persons as necessary, but at least once a day if there are changes in the information about the insured faces.

The files with changes include all newly entered and changed information about the insured persons since the last submission.

25. The Federal Fund provides round-the-clock reception and processing of files with changes from territorial funds.

26. When processing files with changes, it is ensured that the insured person has a previously issued compulsory medical insurance policy of a single sample in the central segment of the unified register of insured persons.

27. In the central segment of the unified register of insured persons, information files are processed with information on the state registration of death and information on the status of insured persons (employed, unemployed) sent by territorial funds to persons who are not included in their regional segments of the unified register of insured persons, the results of which are sent to territorial funds at the place of insurance.

28. The Federal Fund maintains the central segment of the unified register of insured persons, provides general control over the updating and use of the unified register of insured persons.

29. The exchange of data between medical insurance organizations, territorial funds and the Federal Fund for the purpose of maintaining personalized records of information about insured persons is carried out in in electronic format through dedicated or open communication channels, including the Internet, using an electronic digital signature in accordance with the requirements for the protection of personal data established by the legislation of the Russian Federation.

V. Procedure for maintaining personalized records of information about medical care provided to insured persons

30. Personalized accounting of information about medical care provided to insured persons is kept in electronic form by medical organizations and medical insurance organizations operating in the compulsory health insurance system, and territorial funds.

31. A medical organization, an insurance medical organization and a territorial fund, by order, determine the employees admitted to work with personalized records of medical care provided to insured persons, and ensure their confidentiality in accordance with the requirements of the legislation of the Russian Federation on the protection of personal data.

32. Medical organizations submit information about medical care provided to insured persons, provided for in subparagraphs 1 - 13 of paragraph 4 of this Procedure, to the territorial fund.

33. The territorial fund within two working days on the basis of the regional segment of the unified register of insured persons carries out automated processing of information received from medical organizations about medical care provided to insured persons.

34. At the stage of automated processing of information from personalized records of medical care provided to insured persons in the territorial fund:

1) identification of the insured person by the regional segment of the unified register of insured persons, determination of the medical insurance organization responsible for paying the bill;

2) identification of insured persons who have been provided with medical assistance outside the insurance territory and determination of their insurance territory;

3) sending in electronic form the results obtained in accordance with subparagraphs 1 and 2 of this paragraph to the medical organization that provided medical assistance to the insured persons.

35. A medical organization, based on the results of automated processing of information about medical care provided to insured persons, carried out in accordance with paragraph 34 of this Procedure, submits them to insurance medical organizations in the amount and terms established by the contract for the provision and payment of medical care for compulsory medical insurance.

36. After monitoring the volumes, terms, quality and conditions for the provision of medical care in accordance with Article 40 of the Federal Law "On Compulsory Medical Insurance in the Russian Federation", the information specified in paragraph 4 of this Procedure is transferred by the medical insurance organization to medical organizations and the territorial fund within the time frames stipulated by the contract on financial provision of compulsory medical insurance.

37. In case of difficulties in determining the insurance territory of a person who received medical assistance outside the insurance territory, the territorial fund generates an electronic request to the central segment of the unified register of insured persons, where within 5 working days a check is carried out and a response is generated indicating the identified insurance territory and valid policy number of the insured person.

38. The exchange of data between medical organizations, medical insurance organizations, territorial funds and the Federal Fund in order to maintain a personalized record of information about medical care provided to insured persons is carried out in electronic form via dedicated or open communication channels, including the Internet, using electronic digital signatures in accordance with the requirements for the protection of personal data established by the legislation of the Russian Federation.

Order of the Ministry of Health and Social Development of the Russian Federation of January 25, 2011 No. 29n "On approval of the Procedure for maintaining personalized records in the field of compulsory health insurance"

Registration number 19742

Document overview

Since January 1, 2011, the CHI system has introduced personalized accounting of information about each insured person. The order of its conduct is regulated.

It is envisaged to create a unified register of insured persons, consisting of central and regional segments. A list of data on citizens included in the register has been determined.

Regional segments are formed by TFOMI on the basis of information provided by medical insurance organizations. This is done at least once a day (if there are changes in the data). Information is received around the clock. For violation of these terms, the insurers are fined.

Territorial fIU authorities quarterly submits data on working insured persons to TFOMS to be entered into the regional segment. Policyholders of unemployed citizens submit information about them to the register on a monthly basis. In addition, the TFOMS updates the register on a monthly basis based on information on the state registration of death from the registry offices. Data from the regional segment is sent to the central one every day.

The register also contains information about the medical assistance provided to the insured persons. Their list has been determined. Medical organizations submit this data to TFOMI. There they are processed (identify the insured person; determine the insurer responsible for paying the bill; identify persons who received medical assistance outside the insurance territory) and return them back. After that, the information is sent to the insurers. They check the volume, timing, quality and conditions for the provision of medical care. In the future, the data is transferred to medical organizations and TFOMS.

The exchange of information is carried out in electronic form via dedicated or open communication channels, including the Internet, using an EDS.

ERZL about unidentified. 2 5.6 Linking records. 2 APPENDIX 1. STRUCTURE OF DIRECTIONS .. 2 APPENDIX 2. Rules and restrictions when working with attachments 2 APPENDIX 3. Formatting and logical control .. 2 LIST OF ABBREVIATIONS and DEFINITIONS Abbreviation Definition AIS - Automated information system AIS OMC MGFOMS - Automated information system of compulsory medical insurance of the Moscow City Fund of Mandatory Medical Insurance AWP - Automated workstation AS - Automated DB system - Aircraft database - Temporary certificate GOZNAK Federal State Unitary Enterprise "Goznak" ) DUDL - Identity document UMIAS - Unified Medical Information Analytical System of St.

Iv. maintaining the central segment of the unified register of insured persons

Main processes: 1) reception of information about the AP from the MO / CMO and their entry into the RS ERZL; 2) Acceptance, accounting and execution of CMO applications for the production of compulsory medical insurance policies; interaction with GOZNAK; accounting of the issued compulsory medical insurance policies, including their status; 3) accounting for the AP's attachment to medical organizations in Moscow, including maintaining a register of scans of AP's application documents for attachment to the medical institution; 4) registration of newborns born in Moscow; 5) registration of unidentified persons who received medical care in the city of Moscow.
Moscow; 6) registration of nonresident ZL (third-party TFOMS) who received medical assistance in the Moscow region; 7) registration of data on AP, such as: - AP address; - contact details of the legal entity; - citizenship of LP; - social status, disability, benefits of AP; - information about the identity documents of the AP; - SNILS ZL; - information about compulsory medical insurance policies ЗЛ, incl.

Iv. maintaining the central segment of the unified register of insured persons

Project summary

• Highly loaded system that actually works in 24x365 mode;
• Fault-tolerant geographically distributed infrastructure of more than 150 servers and more than 200 virtual machines, ensuring the uninterrupted operation of GIS OMC applied systems at sites in the regions of the Russian Federation;
• Hundreds of thousands of transactions per record per day, and at the time of loading information about the working population or reconciliation of data, two to three tens of millions per day;
• Millions of requests for reading (search and determination of insurance belonging) per day in a regular mode;
• Terabytes of data with optimization of access to online storage;
• Geographically distributed data bus;
• Service and technical support in all regions of the Russian Federation.

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UKL - Unique code persons in AIS OMC MGFOMS UEC - Universal electronic card Full name - Surname First name Patronymic FLC - Format and logical control FFOMS - Federal Fund of Mandatory Health Insurance CA - Central segment of CA URZL Central segment of the unified register of insured persons EKMP - Expertise of the quality of medical care HTTPS - Hypertext Transfer Transport Protocol Security - secure hypertext information transfer protocol SOAP - Simple Object Access Protocol - simple object access protocol - protocol for exchanging structured messages in a distributed computing environment UTF-8 Unicode Transformation Format, 8-bit - Unicode transformation format, 8-bit WSDL - Web Services Description Language - XML-based Web Services Description Language XML - eXtensible Markup Language - Extensible Markup Language 1.

Unified register of insured persons

When making changes to the regional segment of the unified register of insured persons, the territorial fund generates files with changes, which are sent to the Federal Fund to update the central segment of the unified register of insured persons as needed, but at least once a day if there are changes in the information about the insured persons. The files with changes include all newly entered and changed information about the insured persons since the last submission. 25. The Federal Fund provides round-the-clock reception and processing of files with changes from territorial funds.
26. When processing files with changes, it is ensured that the insured person has a previously issued compulsory medical insurance policy of a single sample in the central segment of the unified register of insured persons. 27.

Segments

The regional segments of the ERZ include specialized subsystems, in particular:

• The program complex of the territorial fund of compulsory medical insurance;
• Software package for medical insurance organizations;
• Software package for medical organizations;
• Subsystem of interaction with the system of issuance, personification and delivery of policies;
• Subsystem of interaction with the system of personalized accounting of medical care;
• A complex of reference services, providing the issuance of certificates of insurance affiliation;
• Administration subsystem for managing regional segments and ensuring information security.

Results of the project Today, new type of medical insurance policies are issued using the ERZ, while the applications of territorial funds for the issue of policies are signed with a digital signature.

When processing files with changes, it is ensured that the insured person has a previously issued compulsory medical insurance policy of a single sample in the central segment of the unified register of insured persons. 27. In the central segment of the unified register of insured persons, information files are processed with information on the state registration of death and information on the status of insured persons (employed, unemployed) sent by territorial funds to persons who are not included in their regional segments of the unified register of insured persons, the results of which are sent to the territorial funds at the place of insurance. 28. The Federal Fund maintains the central segment of the unified register of insured persons, provides general control over the updating and use of the unified register of insured persons.

Each territory had its own procedures and features of health insurance, its own registers of attached citizens. Of course, this system had to be streamlined and the discussion of how this should be done, how to organize the exchange of information was quite long.

The central segment of the unified register of insured persons leads

Info

Appendix to order MGFOMS No. 000 dated August 08, 2016. Description of web services of the system of the Regional Segment of the Unified Register of Insured Persons. Information System Mandatory Health Insurance Version 2.0 of 01/01/2001 Effective from 08/08/2016 Moscow 2016 Contents 1 ……… GENERAL DESCRIPTION OF THE OPERATING PRINCIPLES OF THE RS ERZL AIS OMS 2 WEB SERVICES 1.1 Purpose of the System ..

Moscow, as well as about people who have applied for medical help to medical organizations in Moscow. MGFOMS, within the framework of its activities, maintains the RS ERZL, and also provides, within its competence, the protection of information constituting information of limited access. Maintaining the RS ERPL includes the main and auxiliary processes.