Data exchange between jHIS™ and NFZ SZOI systems using NFZ messages

Data exchange between jHIS™ and NFZ SZOI systems using NFZ messages

Functionalities from submenu "Messages" in the "NHF" menu are used to support the exchange of information between the jHIS™ system and the NFZ SZOI system. The process of settlements with the NFZ is based on the exchange of files between the jHIS™ and the NFZ SZOI system - the jHIS system generates files which are imported (manually) into the NFZ SZOI system, and the NFZ SZOI system generates files that then are (manually) imported into the jHIS™ system. The exchanged files are in XML format with a strictly fixed structure compressed with ZIP algorithm with any name and extension appropriate to the type of file instead of the ".zip" extension (eg. Agreement_stomatology_2014.umx). The process of settlements with the NFZ from the point of view of the jHIS™ system is shown in the following diagram:

The settlement process begins by importing to the jHIS™ system agreement in form of a UMX file downloaded from NFZ SZOI system. The settlement process is divided into four separate subprocesses:

  • Settlement of declaration
    • Step I: Details of declaration are exported from the jHIS™ system to PDX files - the files should then be transferred to the NFZ SZOI system
    • Step II: After processing PDX files by the NFZ, from the NFZ SZOI system are downloaded files of confirmation of the declaration (PZP) and verification of the declaration (PZW) - these files should be imported into the jHIS™ system.
    • Step III: If the PZP and PZW files are imported to the jHIS™ system and declarations rejected by the NFZ exist in the jHIS™ system, then such declarations can be corrected and repeat the process of settlement of the declaration.
    • Step IV: When the day of settlement of the declaration passed, files of settlements of declaration (PZR) are exported from NFZ SZOI system - these files can be imported into the jHIS™ system.
  • Settlement of services
    • Step I: Realized visits are coded in jHIS™ system
    • Step II: Data of service are exported from the jHIS™ system to SWX files - the files should then be transferred to NFZ SZOI system
    • Step III: After processing the SWX file by the NFZ, files of confirmation of the services (SWZ) are downloaded from NFZ SZOI system - these files should be imported into the jHIS™ system.
    • Step IV: If the SWZ files are imported into the jHIS™ system and services rejected by the NFZ exist in the jHIS™ system, then these services can be corrected and repeat the process of accounting for these services.
    • Step V: When the day of settlement of services will pass, files of templates of bills (ZWZ) are downloaded from NFZ SZOI system - the files should be imported into the jHIS™ system.
    • Step VI: For each template of bill from jHIS™ system there are exported RFX files with bills (until 1st July 2018) or EFX files with e-invoices or ERX files with e-bills - the files should then be transferred to NFZ SZOI system.
  • Settlement of devices
    • Step I: Realized orders for provision with devices are coded in jHIS™ system
    • Step II: Data of devices are exported from the jHIS™ system to ZPX files - the files should then be transferred to NFZ SZOI system
    • Step III: After processing the ZPX file by the NFZ, files of confirmation of the devices (ZPZ) are downloaded from NFZ SZOI system - these files should be imported into the jHIS™ system.
    • Step IV: If the ZPZ files are imported into the jHIS™ system and devices rejected by the NFZ exist in the jHIS™ system, then these devices can be corrected and repeat the process of accounting (step II).
    • Step V: When the day of settlement of devices will pass, files of templates of bills (ZWZ) are downloaded from NFZ SZOI system - the files should be imported into the jHIS™ system.
    • Step VI: For each template of bill from jHIS™ system there are exported RFX files with bills (until 1st July 2018) or EFX files with e-invoices or ENX files with e-notes or ERX files with e-bills - the files should then be transferred to NFZ SZOI system.
  • Reporting waiting queues
    • Step I: Data of waiting queues are exported from the jHIS™ system to KLX file - this file should then be transferred to the NFZ SZOI system
    • Step II: After processing the KLX file by the NFZ, from the NFZ SZOI system is download file of queue states confirmations (KLZ / PLZ) - this file should be imported into the jHIS™ system.
    • Step III: If the NFZ SZOI showed errors of queues states then the process of reporting states of queues can be retried.
  • Reporting pooled data of POZ services
    • Step I: Pooled data of POZ services are exported from the jHIS™ system to PZX file - this file should then be transferred to the NFZ SZOI system
    • Step II: There is a possibility of recurrence of the process of reporting pooled data of POZ services.