Integration service with subsystems rs erzl and pump ais oms. The central segment of the unified register of insured persons maintains The central segment of the unified register of insured persons maintains

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

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

An error occurred.

Unified register of insured persons

Segments

The central segment of the unified register of insured persons maintains

Integration service - with subsystems RS ERZL and PUMP AIS OMS

IMPORTANT! On reconciliation - Unified register of the insured - for CHI in e

Compulsory health insurance policy

Nfi 144 from 29

Letter - FFOMS from N 3960

MGFOMS reliable protection of the rights of Muscovites with compulsory medical insurance policy

On approval of the Regulations for attaching and registering citizens insured under compulsory medical insurance to medical organizations of the state healthcare 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 in Moscow, using UMIAS

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

Order of the Territorial Compulsory Medical Insurance Fund g

Unified register of insured persons OMS

Unified register of insured persons OMS Moscow

Getting a policy

Unified register of insured persons OMS Moscow

Document overview

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

I. General provisions

II. Organization of personalized accounting

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

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

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

ERZL about unidentified. 2 5.6 Linking records. 2 APPENDIX 1. STRUCTURE OF DIRECTORIES .. 2 APPENDIX 2. Rules and restrictions when working with attachments 2 APPENDIX 3. Format-logical control .. 2 LIST OF ABBREVIATIONS AND DEFINITIONS Abbreviation Definition of AIS - Automated information system AIS OMS MGFOMS - Automated information system of compulsory medical insurance of the Moscow City Compulsory Medical Insurance Fund ARM - Automated workplace AS - Automated system DB - Database VS - Interim certificate of GOZNAK Federal State Unitary Enterprise "Goznak" VMI - Voluntary medical insurance DPFS - Document confirming the fact of insurance ( compulsory medical insurance policy, temporary certificate) DUDL - Identity Document EMIAS - Unified Medical Information Analytical System of Moscow.

Main processes: 1) receiving information about APs from MO/SMO and entering them into RS ERZL; 2) acceptance, accounting and execution of HMO applications for the issuance of CHI policies; interaction with GOZNAK; accounting of issued CHI policies, including their status; 3) accounting for the attachment of IPs to medical organizations in Moscow, including maintaining a register of scanned documents-applications of IPs for attachment to the Moscow Region; 4) registration of newborns born in Moscow; 5) registration of unidentified persons who received medical care in the Moscow Region.
Moscow; 6) registration of non-resident APs (third-party TFOMS) who received medical care in the Moscow Region; 7) registration of data on IPs, such as: — address of IPs; — contact details of the IP; – citizenship of the AP; — social status, disability, AP benefits; — information about documents proving the identity of the IP; - SNILS ZL; — information about compulsory medical insurance policies of APs, incl.

Project Summary

A highly loaded system that really works in 24x365 mode;
Fault-tolerant geographically distributed infrastructure of more than 150 servers and more than 200 virtual machines that ensure the uninterrupted operation of GIS OMC application systems at sites in the regions of the Russian Federation;
Hundreds of thousands of transactions per record per day, and at the time of downloading 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 coverage) per day in normal mode;
Terabytes of data with access optimization in operational storage;
Territorially distributed data bus;
Service and technical support in all regions of the Russian Federation.

UKL - Unique identity code in the AIS OMS MGFOMS UEC - Universal electronic card Full name - Surname First name Patronymic FLC - Format-logical control FFOMS - Federal Compulsory Medical Insurance Fund CA - Central segment CA ERZL Central segment unified register of insured persons ECMP – Quality Expertise medical care HTTPS - Hypertext Transfer Transport Protocol Security - a secure protocol for transferring hypertext information SOAP - Simple Object Access Protocol - a simple object access protocol - a 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 - a web services description language based on XML XML - eXtensible Markup Language - extensible markup language 1.

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

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

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

Project results Today, health insurance policies of a new type are issued using the URZ, while the applications of territorial funds for the issuance of policies are digitally signed.

When processing files with changes, it is ensured that the insured person has a previously issued valid 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 about state registration death and information about the status of the insured persons (employed, unemployed), sent territorial funds for persons whose information is not available 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.

29.
Project IS ERZ Project objectives According to the law on mandatory health insurance(CHM) in Russian Federation, all citizens of the country have the right to receive medical care anywhere and in any medical institution. Not so long ago, it was not easy to identify a non-resident patient. Medical assistance was sometimes provided without understanding whether a person exists in the MHI database or not.

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

Info

Appendix to the order of the Moscow City Compulsory Medical Insurance Fund No. 000 dated August 08, 2016 Description of the web services of the system of the Regional Segment of the Unified Register of Insured Persons of the Automated Information System of Compulsory Medical Insurance Version 2.0 dated 01/01/2001 Effective from 08/08/2016 Moscow 2016 Contents 1……… GENERAL DESCRIPTION PRINCIPLE OPERATION OF WEB SERVICES RS ERP AIS OMC 2 1.1 Purpose of the System..

2 2……… Requirements for data exchange formats.. 2 3……… Interaction procedure.. 2 3.1 General information. 2 3.2 Reading data from RS ERZL.. 2 3.3 Writing data to RS ERZL.. 2 3.4 List of data fields of RS ERZL web service.. 2 3.5 Diagnostic codes and messages. 2 4……… Restrictions on access to certain methods for different categories of users. 2 4.1 Users and categories of users. 2 4.2 Access Matrix. 2 4.3 Features of access to historical data.. 2 5………
GENERAL DESCRIPTION OF OPERATING PRINCIPLES OF RS ERPLE AIS OMS WEB SERVICES Get the full text Web services of RS ERPLE AIS OMS (hereinafter referred to as the System) are organized in the SOAP paradigm according to the SOAP Version 1.2 specification using the Client-Server technology. The work of AS-clients with the System is based on the concept of synchronous "request-response" interaction. The asynchronous request mechanism is not used. The regional segment of the Unified Register of Insured Persons is designed to collect, store, process and provide data on persons insured in Moscow.

Moscow, as well as about persons who applied for medical assistance to medical organizations in Moscow. MGFOMS, as part of its activities, maintains RS ERZL, and also ensures, within its competence, the protection of information constituting restricted access information. Maintenance of RS ERZL includes main and auxiliary processes.

Date edited: 27.11.2019

Maintenance of the regional segment of the unified register of insured persons

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

10. The maintenance of the regional segment of the unified register of insured persons is carried out by the territorial fund on the basis of information about the insured persons provided by the 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 insurance medical organization ensures the reliability and correctness of the entered information and performs 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 identity document;

3) the correctness of the gender of the insured person;

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

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

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

13. In order to update the regional segment of the unified register of insured persons and enter information about the insured persons into it, the insurance medical organization generates and transfers information files with changes in the information about the insured persons provided for in paragraph 3 of this Procedure (hereinafter referred to as the files with changes) to the territorial fund as necessary, but at least 1 time per day if there are changes in the information about the insured persons, in accordance with the agreement on the financial provision of compulsory medical insurance.

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

Instructions for working with RS ERZ YNAO

It is obligatory for each event or appeal of a citizen to the CMO to first make a ZSP in the ERZ CA.
Only based on the response from the ERZ CA and / or ERZ RS (web request), take further actions. Indicate the received data in the previous information.
It is necessary to take copies and / or make scans of all documents necessary for compulsory medical insurance from a citizen. The reason is paragraphs 5 and 6 of the Order of the Ministry of Health and Social Development of the Russian Federation of January 25, 2011 N 29n "On approval of the Procedure for maintaining personalized records in the field of compulsory medical insurance."
If the CMO is changed under the policy from another territory, it is necessary to send us an event about the change of the CMO with the data - with which the SP came. If the ZSP came empty, it is necessary to clarify the data with which the AP was registered in another territory. Only after changing the CMO(response to the CA) make changes to the IP, if necessary.
Cancellation of the DPFS is carried out by the CMO on the basis of the application of the IP.
In the PVS, the DFPS that are absent in the ERZ CA will not be included on the first day. CMO is obliged to timely make changes to RS ERZ (TSS ERZ) and work out the sent protocols.
In the directed events of changes of RS ERZThe CMO is required to:

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 medical insurance (F002.xml). Valid values are "83001", "83005", and "83008".
Be sure to fill in the code of the region of the Russian Federation of the place of registration and the code of the region of the Russian Federation of the place of residence. The code of the region of the Russian Federation of the place of residence must belong to the Yamalo-Nenets Autonomous Okrug.

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

1) Check if errors came to the event you sent and, if they did, then fix them specified error and repeat the event.

2) Check the sign of registration, the validity period of the DPFS on the site site. 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 "Delivery deadlines violated ...", then the CA has been added to the CA.

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

Now more about the errors received from the CA.

"An attempt at a significant change age group of the insured person" occurs due to a change in the IP's gender or age. It may also occur when an incorrect gender or date of birth was specified. It is necessary to check/correct the IP's data and send P040. Then repeat the event.

"Error in UBP birthday and gender facet", "Birth month facet in UPP is incorrectly calculated", "Birth year facet in UNP is incorrectly calculated" occurs when the age and sex were changed, but the UNP was not changed. It may also occur given error if the DPFS 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 SP and send P040. Then repeat the event.

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

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

"Invalid passport issue date" occurs when an expired passport is indicated, the replacement periods are 14, 20 and 45 years. Then repeat the event.

"It is impossible to create an insured person with an insurance policy whose validity is equal to 0 days" occurs when the DPFS is incorrectly added to the RS. It is necessary to check the period of validity of the DPFS for the ZSP 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 owned by another CMO, and the start date of which is higher than the one being added, you need to cancel your VC and call back the CMO whose DPFS was canceled because of you so that they can restore their VC.

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

"Document parameters are not specified or incorrect" occurs if the LTC is not specified, or when the start or end date 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 LTC is not specified, or the document was entered incorrectly into the database. We need to add a document to our database by event P040. Then repeat the event.

"It was not possible to uniquely identify the insured person" in the CA there are two non-combined insurances that belong to the same IP. To resolve this conflict, you need:

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

2) Clarify whether the IP has changed personal data.

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

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

"Start date of the replaced policy is greater than the start date of the new one" is added by the BPFS with a start date less than that of the BPFS located in the CA. It is necessary to check against the CAP of the insurances that are 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 LTC number is indicated, which, according to the data of the CA, is assigned to another insured person." There is an AP in the CA with the same documents as your AP. It is necessary to check whether there were any data errors during the previous registration of your IP. It is also necessary to check the documents of your IP. If necessary, send p040. Then repeat the event.

"The in1 segment contains incorrect information about the insurance affiliation" Often occurs when the CMO sends events and indicates data in the old information that is different from those contained in the CA (it is necessary to send in the old information those that are returned upon request of the CSP from the CA). Either when several BCs are entered into the RS on the same day with the same onset of action, or an SMO is changed and BCs with the same onset of action are added on the same day. Aircraft and policies cannot be issued with the same period; It is necessary to correct the start of the DFPS or issue a new DFPS and add it to the CA/RS.

"Invalid change age" means that this DPFS has expired and cannot be added to the CA. You need to issue a new DPFS.

If the site has a sign of registration with the CA, then you need to check the ETP and the date of issue of your DFFS and ETP, which is displayed on our site and, if necessary, change it on your site and send the ZSP. 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 reissuing the DPFS.

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

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

When transmitting 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 annulment of military personnel.

Based on part 3 of Art. 49.1 federal law dated November 29, 2010 N 326-FZ and paragraph 10 of the Order of the Ministry of Health and Social Development of Russia dated January 25, 2011 N 29n (as amended on December 8, 2016) "On approval of the Procedure for maintaining personalized records in the field of compulsory medical insurance" (Registered with the Ministry of Justice of Russia on February 8, 2011 N 19742), upon receipt of the 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 a medical insurance organization (hereinafter referred to as the CMO), the CMO must cancel the CHI policy (event P02).

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

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

Error handling RS ERZ

If it is impossible to process the IP protocol by the medical insurance organization, it is necessary to write a letter to the TFOMS YNAO, describing the reason why self-processing is not possible, and also send personal data about the IP via a secure VipNet channel to the network node “89 (TFOMS YNAO) Administrator” indicating the subject of the letter “RSERZ”.

An example of an application for providing information about APs.

According to CEO"RINTECH" by Sergey Kuptsov, "the creation of the ERZ was another major step towards the formalization of the budgetary component of informatization of medicine. Created single base, unified formats of system interaction have been developed, unified requirements have been formulated. The issuance of electronic compulsory health insurance policies has begun, which will soon be combined with universal electronic card. Such a systematic approach, developed in the process of creating new CHI policies, can become a “driver” for the development of informatization in medicine.”

The exchange of data between the participants of the MHI system includes a legally significant document flow using the web services of the Personalized Medical Care Accounting System - PUMP AIS OMS, the information system of medical organizations - IS MO and the information system of insurance medical organizations - IS SMO when using the Regional Segment of the Unified Register of Insured Persons (RS ERZL).

To renew insurance in Moscow in accordance with the federal law "On Compulsory Medical Insurance in the Russian Federation" dated November 29, 2010 N 326-FZ, a citizen must submit an application to any insurance organization of Moscow on replacing the old policy of the 1998 model with a policy of a single sample.

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

In the event of a change in the place of residence or place of stay of the 3JT MO, when registering a re-application within a year (the date of the re-application must not be previously registered in the ERZL RS), sends to the CMO an electronic copy of the application for attachment to the MO marked "change of residence / stay of the AP" in the upper field of the application.

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

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 photograph of the insured. The document number is displayed on the front side. On the reverse side there is full information about the owner of the policy with his signature, as well as the validity period of the document.

2.9. If the insured person at the time of application was attached to a medical organization providing primary health care under the program state guarantees free provision of medical care to citizens that is not part of the state healthcare system of the city of Moscow, the medical organization that accepted the application interacts with the specified medical organization in the manner specified in the order of the Ministry of Health and Social Development of the 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."

The main excess is formed at the expense of 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 governments.

On a monthly basis, within the period established by these Regulations, the health insurance company sends IP to the MGFOMS IP with the appropriate message code and an attached archive file (zip), which includes the registry file of APs attached to the medical organization on applications during the reporting period (Table 3 of Annex 1 to this Regulation) of the dbf structure and the corresponding "Summary report of information on attaching insured persons for _______", signed by the responsible representative of the health insurance organization ( electronic version text document - Appendix 2) in pdf format. IP message codes:

Regional segments are formed by TFOMS on the basis of information provided by insurance medical organizations. This is done at least once a day (if there are changes in the data). Information is received around the clock. Penalties are imposed on the insurers for violating these deadlines.

An insured person may have only one compulsory health insurance policy. Asking for help in medical institution, the insured citizen is obliged to present an insurance policy. payment for rendered medical services(within the CHI program) is covered by the insurance medical company that issued the compulsory medical insurance policy to this person.

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

You can find the list of documents required to obtain an electronic compulsory health insurance policy here. What you need to know about the new electronic policy 1. An electronic compulsory medical insurance policy 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 contain your personal signature and photo, which makes it impossible for outsiders to use your personal data!

The insurance medical organization transfers files with changes to the territorial fund as necessary, but at least 1 time per day if there are changes in the information about the insured persons, in accordance with the agreement on the financial provision of compulsory medical insurance. The Territorial Fund provides a round-the-clock mode for receiving and processing files with changes received from insurance medical organizations.

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

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

Registration number 19742

1. This Procedure defines the rules for maintaining a personalized record of information about each insured person in the field of compulsory medical insurance, including:

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

2) maintaining a unified register of insured persons;

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

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

2. The goals of personalized accounting in the field of compulsory medical insurance are:

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

2) creation of conditions for exercising control over the use of compulsory medical insurance funds;

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

3. Personalized accounting of information about insured persons is maintained in the form of a single 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 insured persons:

1) last name, first name, patronymic;

3) date of birth;

4) place of birth;

5) citizenship;

6) details of the identity document;

7) place of residence;

8) place of registration;

9) date of registration;

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

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

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

13) date of registration as an insured person;

14) the status of the insured person (working, not working).

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

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

2) a medical organization that provided the relevant services;

3) types of medical care provided;

4) conditions for the provision of medical care;

5) the timing of the provision of medical care;

6) the volume of medical care provided;

7) the cost of medical care provided;

8) diagnosis;

9) profile of medical care;

10) medical services rendered to the insured person and medicines used;

11) applied medical and economic standards;

12) specialty medical worker who provided medical assistance;

13) the result of applying for medical care;

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

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 if there are guarantees of their reliability (authenticity), protection against unauthorized access and distortion in accordance with the requirements established by the legislation of the Russian Federation for 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 presenting information in electronic form is taken jointly by the participants in the information exchange.

6. Insurance medical organizations and medical organizations keep copies of paper documents and electronic archives, containing personalized information about the insured persons and the medical care provided to them, submitted to the territorial fund of compulsory medical insurance (hereinafter referred to as the territorial fund) for personalized accounting, in accordance with the rules for organizing state archives.

7. After the expiration of the period established for the storage of 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 the medical care provided to him/her is classified as information of limited access and is subject to protection in accordance with the legislation of the Russian Federation.

9. Information about each insured person, specified in paragraph 3 of this Procedure, is entered in 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 identity document;

3) the correctness of the gender of the insured person;

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

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

6) for the presence of repetitions by the insurance number of an individual personal account (SNILS).

14. The Territorial Fund provides a round-the-clock mode for receiving and processing files with changes received from insurance medical organizations.

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

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 information about the insured persons.

17. The territorial body of the Pension Fund of the Russian Federation quarterly, no later than the 15th day of the second month following the reporting period, provides in accordance with the Agreement on information exchange between pension fund Russian Federation and Federal Fund of compulsory health insurance to the relevant territorial fund information about working insured persons for their inclusion in 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 offices in accordance with Article 12 of the Federal Law of November 15, 1997 No. 143-FZ "On acts of civil status" (Sobranie Zakonodatelstva Rossiyskoy Federatsii, 1997, No. 47, Art. 5340; 2001, No. 44, Art. 4149; 2003, No. 1 7, article 1553; No. 50, article 4855; 2009, No. 51, article 6154; 2010, No. 15, article 1748), updates the regional segment of the unified register of insured persons, notifies insurance medical organizations on the territory of a constituent entity of the Russian Federation and sends information files with information on state registration of death in the territory of a constituent entity of the Russian Federation for persons whose information is not available in the regional segment of the unified register of insured persons, to the Federal Compulsory Medical Insurance Fund (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 based on information about working insured persons and sends information files with information about 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 monthly, 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 insurers 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 established by the agreement on financial support of compulsory medical insurance for the provision of data on insured persons, as well as information on changes in these data, the insurance medical organization is obliged to pay to the territorial fund at the expense of own funds a fine in the amount established by Part 10 of Article 38 of the Federal Law of November 29, 2010 No. 326-FZ "On Compulsory Medical Insurance in the Russian Federation" (hereinafter referred to as the Federal Law "On Compulsory Medical 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.

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

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

25. The Federal Foundation provides a round-the-clock mode for receiving and processing files with changes from territorial funds.

26. When processing files with changes, it is ensured that the insured person has a previously issued valid 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 (working, non-working), sent by territorial funds for persons whose information is not available 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.

29. Data exchange between insurance companies medical organizations, territorial funds and the Federal Fund, in order to maintain personalized records of information about insured persons, is carried out electronically via dedicated or open communication channels, including the Internet, using electronic digital signature in accordance with the requirements established by the legislation of the Russian Federation for the protection of personal data.

30. Personalized records of information about medical care provided to insured persons are kept electronically by medical organizations and insurance medical organizations operating in the system of compulsory medical insurance, and territorial funds.

31. A medical organization, an insurance medical organization and a territorial fund determine by order 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 provide information on 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 personalized records of medical care provided to insured persons, the following is performed in the territorial fund:

1) identification of the insured person according to 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 received medical care outside the territory of insurance, and determination of their territory of insurance;

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 care to the insured persons.

35. The 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 transmitted in the form of information files by the medical insurance organization to medical organizations and the territorial fund within the time limits stipulated by the agreement on financial support for compulsory medical insurance.

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

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

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

Registration number 19742

Date of Birth

Previous Name, DR, LL

Cause of error

(describe the error in detail and indicate the previous data if there were changes in the PL)

From January 1, 2011 to CHI system a personalized account of information about each insured person has been introduced. The order of its conduct is regulated.

Creation of the uniform register of the insured, consisting of central and regional segments is provided. A list of data on citizens included in the register has been determined.

The territorial bodies of the Pension Fund of the Russian Federation quarterly submit to the TFOMS data on working insured persons for their inclusion in the regional segment. Insurers of non-working citizens submit information about them to the register on a monthly basis. In addition, the TFOMS monthly updates the register based on information about the state registration of death from the registry offices. Data from the regional segment is received daily by the central segment.

The register also contains information about medical care provided to insured persons. Their list is defined. Medical organizations submit these data to the TFOMS. They are processed there (the insured person is identified; the insurer responsible for paying the bill is determined; persons who received medical assistance outside the insurance territory are identified) and returned back. After that, the information is sent to the insurers. They check the volume, timing, quality and conditions of medical care. In the future, the data is transferred to medical organizations and TFOMS.

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