2. Information of interest

 

Membership:It is the act of entering the General System of Social Security in Health that is carried out through registration in the Transactional Affiliation System, for a single time, and registration in a Health Promotion Entity - EPS - or Entity Obliged to Compensate – E.O.C.

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Affiliate:It is the quality that the person acquires once they have registered and that grants the right to the health services of the benefit plan provided by the General System of Social Security in Health and when they contribute to economic benefits.

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Additional Affiliate: is the person who, due to not meeting the requirements to be a contributor or beneficiary in the contributory regime, in accordance with the provisions of this part, registers in the family nucleus of a contributing member by paying an additional UPC.

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Basic data:are the data referring to the member's identification: surnames, first names, date of birth, sex, type and number of identification document and survival condition.

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Benefit plan:It is the set of health technologies to which members of the General Social Security Health System are entitled, defined in accordance with current regulations, which will be modified and will have the scope determined in the regulations issued by the Ministry of Health and Protection. Social in development of what is established in article 15 of Law 1751 of 2015.

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Special populations:They are the people who, due to their conditions of vulnerability, marginality, discrimination or in a situation of manifest weakness, according to the provisions of the law or by this Part, must belong to the subsidized regime.

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Health care:is defined as the set of services that are provided to the user within the framework of the insurance processes, as well as the activities, procedures and assistance interventions in the phases of promotion and prevention, diagnosis, treatment and rehabilitation that are provided to all the population.

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Benefit Plan Administration Companies, EAPB:The Health Promotion Entities of the Contributory Regime and the Subsidized Regime, Adapted Entities and Prepaid Medicine Companies are considered as such.

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Health Service Providers:Institutions that Provide Health Services, Independent Health Professionals and Special Patient Transportation Services are considered as such.

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Mandatory Quality Assurance System for Health Care of the General System of Social Security in Health, SOGCS:It is the set of institutions, norms, requirements, mechanisms, and deliberate and systematic processes that the health sector develops to generate, maintain, and improve the quality of health services in the country.

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Accessibility:It is the possibility that the user has of using the health services guaranteed by the General System of Social Security in Health.

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Chance:It is the possibility that the user has of obtaining the services he requires, without delays that put his life or health at risk. This characteristic is related to the organization of the supply of services in relation to the demand and to the level of institutional coordination to manage access to services.

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Security:It is the set of structural elements, processes, instruments and methodologies based on scientifically proven evidence that tend to minimize the risk of suffering an adverse event in the health care process or to mitigate its consequences.

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Relevance: It is the degree to which users obtain the services they require, with the best use of resources according to scientific evidence and their side effects are less than the potential benefits.

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Continuity:It is the degree to which users receive the required interventions, through a logical and rational sequence of activities, based on scientific knowledge.

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Comprehensive Care:Set of promotion, prevention and care services (diagnosis, treatment, rehabilitation and readaptation), including the required medicines, which are provided to a person or a group of them in their biopsychosocial environment, to guarantee the protection of individual and collective health .

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Source: Decree 780 of 2016 (single regulatory decree for the health and social protection sector)

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