A utilização de sistema de informação para gestão das demandas dos beneficiários de operadoras de saúde suplementar, como estratégia frente à regulação do setor e a Notificação de Intermediação Preliminar (NIP)

Abstract

The Active Conflict Mediation was defined as a concept and a method of conflict resolution that seeks consensus and facilitating dialogue between the parties. With this point of vision the Nacional Agency of Suplementary Health of Brazil (ANS) established a procedure called Intermediation Preliminary Notification (NIP), which allows the regulatory agency intermediate conflicts between beneficiaries and health care providers more quickly. From the perspective of healthcare companies these notifications can mean a high cost if not answered promptly. The aim of this work is to present a solution through the implementation of a computerized system requests management and workflow, so that healthcare companies can have ways to ensure the process of responding to requests with a quick information retrieval, allowing answers to ANS, others agencies and the media, timely whenever necessary. This work demonstrates that the implementation of a computerized system contributed to the efficiency of service and improvement of the quality of the services provided by the health care company, presenting significant results in quantitative terms, as well as providing indicators that allow managers to perform real-time monitoring, historical reporting, and quick retrieval of documents. It was used the methodology of action research (Martins & Theóphilo, 2009) in this work and it could contribute to the improvement of services and reduction of risks arising from primary intermediation notifications in healthcare companies.