Quais os tipos de guias TISS?

Por

A ANS – Agência Nacional de Saúde estabeleceu o Padrão TISS, para Troca de Informações em Saúde Suplementar, em 26 de outubro de 2005, através da Resolução Normativa nº 114 que, entre outras coisas, padronizou os modelos de Guias TISS para faturamento médico e odontológico.

Os novos modelos de Guias TISS foram adotados gradualmente. Inicialmente foram utilizadas as guias em papel, em 2006. A partir de maio de 2007, os prestadores de serviço iniciaram o envio das guias também em formato digital (arquivos XML) para as operadoras de saúde.

Quer saber mais sobre todos os modelos de Guias TISS e em quais situações são utilizados? Continue lendo este artigo para aprender.

Tipos de Guias TISS

As Guias TISS são modelos formais de representação e descrição documental do padrão TISS sobre os eventos de saúde realizados no beneficiário de plano privado de assistência à saúde, enviados pelo prestador para a operadora.

Os principais tipos de Guias TISS são:

  • guia de consulta
  • guia de solicitação de serviços profissionais/serviço de apoio diagnóstico e terapêutico (SP/SADT)
  • guia serviços profissionais/serviço de apoio diagnóstico e terapêutico (SP/SADT)
  • guia solicitação de internação
  • guia resumo de internação
  • guia honorário individual
  • guia tratamento odontológico
  • guia outras despesas

Guias de Consulta

As Guias de Consulta são o tipo mais simples de guias médicas. São utilizadas por clínicas e consultórios para faturamento das consultas realizadas em beneficiários de planos de saúde privados.

Nestas guias devem ser informados os dados do prestador de serviços, pessoa física ou jurídica, o CRM do médico, os dados do paciente e do atendimento, incluindo a data, o código do procedimento e o valor da consulta. Lembrando que o retorno, se realizado dentro do prazo de 30 dias, não poderá ser cobrado.

Também é possível faturar através deste tipo de guia as consultas ambulatoriais, realizadas em hospitais, e consultas realizadas por outros tipos de profissionais de saúde, como psicólogos, fonoaudiólogos, fisioterapeutas, etc.

Guias de SP/SADT

As Guias de SP/SADT são as mais comuns e mais utilizadas no setor de saúde suplementar. Através delas são faturados os Serviços Profissionais (SP) e os Serviço de Apoio à Diagnose e Terapia (SADT), tais como exames de laboratórios de análises clínicas, exames de imagem,  remoções, pequenas cirurgias, terapias, consultas com procedimentos, atendimentos domiciliares, quimioterapias, radioterapias ou terapias renais substitutivas (TRS).

Guias de Honorário Individual

As Guias de Honorário Individual são normalmente utilizadas para faturamento de serviços de auxílio, prestados por profissionais que participaram de algum procedimento. Auxiliares em cirurgias, anestesistas, pediatras de sala de parto, são alguns exemplos de médicos que recebem honorários através deste modelo de guia.

Guias de Resumo de Internação

As Guias de Resumo de Internação são utilizadas para faturamento dos procedimentos mais complexos, que necessitam de internação hospitalar para a sua realização.

Na maioria das internações, os pacientes recebem alta com menos de 30 dias, e o seu faturamento pode ser realizado de forma total através de apenas 1 guia. Entretanto, caso o quadro do paciente se agrave, e ele fique internado por um período muito extenso, é possível realizar cobranças parciais, em geral a cada 30 dias.

Guias de Tratamento Odontológico (GTO)

As Guias de Tratamento Odontológico, ou simplesmente GTOs, são utilizadas por dentistas para faturamento dos tratamentos odontológicos.

Outras Despesas

As Guias de Outras Despesas são complementares aos demais tipos de guias tiss e nunca poderão ser faturadas sozinhas. Seu objetivo é permitir a cobrança de despesas adicionais com materiais, medicamentos, gases, aluguéis, diárias e taxas utilizados em procedimentos médico-hospitalares.

Elas podem ser anexadas às guias de SP/SADT, ao Resumo de Internação e ao Tratamento Odontológico (GTO).

Caso seja necessário efetuar a cobrança de despesas e os serviços já tenham sido faturados, é possível enviá-los anexados a uma guia vazia (sem procedimentos).

Guias Associadas

Muitas vezes, um procedimento gera a necessidade de realizar outros serviços e, portanto, são criadas guias adicionais relacionadas a um evento inicial. Necessitam de guia principal. Neste caso, é necessário associar as novas guias à guia inicial, o que é feito pelo campo Número da Guia Principal. Preencher este campo corretamente garantirá o relacionamento adequado entre os eventos, produzindo uma conta médica consistente com a realidade.

Por que escolher a guia correta é importante?

A utilização inadequada do tipo de guia pode gerar:

  • Rejeição do XML TISS
  • Inconsistência no faturamento
  • Glosa administrativa
  • Atraso no pagamento pela operadora

Por isso, entender os tipos de guia definidos pelo padrão TISS é essencial para garantir conformidade com as regras estabelecidas pela Agência Nacional de Saúde Suplementar e manter o fluxo financeiro saudável.

Software para Faturamento das Guias TISS

tipos-guias-tiss-1000x423-1 Quais os tipos de guias TISS?

Agora que você já conhece todos os modelos de guias, precisa ter um software para gerar os arquivos XML de faturamento. Você pode utilizar um sistema completo para gestão da sua clínica, consultório, laboratório ou hospital, que seja compatível com o padrão TISS.

Entretanto, se você deseja apenas realizar o faturamento médico ou odontológico, a melhor opção seria um sistema desenvolvido especificamente para esta finalidade. O TISSXML é um sistema web criado exatamente para isto. Ele possui um período de avaliação gratuita e a sua equipe de suporte fornece todo o apoio necessário para o sucesso do seu faturamento. Aproveite a oportunidade e Experimente agora mesmo!

Gostou deste artigo? Curta a nossa Página no Facebook e deixe seus comentários.

429 comentários em “Quais os tipos de guias TISS?”

  4. I have been exploring different platforms and this one really stands out for its simplicity. Getting started only takes a few minutes and the interface feels so intuitive. I love how the promotions are clearly explained and the withdrawals go through without any hassle. It feels like a place that actually cares about its regular players. Give happy88login a try and let me know what you think.

  5. Logging in here feels like coming home to a well organized gaming lounge. The security measures give me peace of mind while the interface keeps things simple and fun. I particularly enjoy how the loyalty rewards stack up over time and how easy it is to redeem them. My withdrawals have been processed faster than expected every single time. Stop by tng66login and experience it for yourself.

  6. This place completely rewired my weekend routine in the best possible way. The live tables run so cleanly that I forget I am behind a screen and the betting options fit every mood I bring. The moderators keep the energy high while making sure everyone feels safe and respected. ecbetwarrior

  7. Hey there! I have been testing out different gaming apps lately and this one really stands out. The interface is super clean and withdrawals are always on time. Definitely my go to spot for evening fun. coberpley

  9. I have been chasing different betting sites for a while and this community really feels like home. The live updates are sharp and the odds are refreshingly honest. Customer service responds within minutes and treats you like a valued guest instead of just another account. Ready to join the fun and grab some great rewards. phpulibet

  10. I switched from my old provider and the difference is night and day. Transactions process in seconds and I actually get notified immediately when my balance updates. The game providers partnered with them are all certified so I know every spin is completely fair. It is refreshing to find an operator that puts player satisfaction first. fv99game

  11. Playing at all hours suits my schedule and this site never fails to be fully operational. The variety of table games keeps things fresh and the live dealer streams are crystal clear. I appreciate how they handle responsible gaming tools without making it feel intrusive. Reliable performance and honest gameplay make it stand out from the crowd. 24casinologin

  12. Downloading the app was the best decision I made for my gaming routine. Everything runs buttery smooth and I can keep track of my bets on the go without any lag. The VIP program rewards loyal users nicely and I never feel rushed to deposit. It is refreshing to find a brand that actually values long term players. luxebetapp

  13. This platform completely changed how I unwind after long work days. The game library is massive and runs buttery smooth on any device. I genuinely feel like a valued member rather than just another account number. Their support crew is always ready with a warm handshake and a quick solution. Try it out and feel the difference 111xgame

  14. Wow, I did not expect such a top notch experience right from the start. The mobile app works flawlessly on my phone and I love the variety of sports markets available. Transactions are fast and the VIP program actually rewards loyal players. Highly recommend checking it out. bd7v777

  17. Hey there fellow players I just stumbled upon this amazing platform and had to share my experience. The registration process was super smooth and I got my bonus within minutes. Customer support actually responds fast which is rare these days. I have been playing slots and live table games for a couple of weeks now and the withdrawals hit my account quicker than I expected. Definitely worth checking out if you want a reliable place to spin and win. mmmym66

  18. This site completely changed how I enjoy online gaming. The welcome package gave me plenty of extra spins and I hit a nice bonus round on my third day. UI is clean and dark mode makes it easy on the eyes during late sessions. Deposit options cover all the major wallets and crypto too. Friendly staff and fair rules make this my new favorite destination. mxwildrobin

  19. I stumbled upon this community by chance and it quickly became my favorite spot for sports insights. The discussions are always lively and the advice from experienced members has helped me improve my strategy significantly. A truly welcoming space for both newcomers and veterans. sellatuparley

  36. 8okwin is a solid option if you’re looking for something straightforward. The interface is simple, and the games load quickly. Nothing fancy, but it gets the job done. Plus, I like the name: 8okwin

  52. Those late night spins hit different when you know the engine behind them actually pays out. I tested a handful of places this month and the audio and graphics here keep me coming back. The team even sends a quick note on special weekends that makes the whole thing feel warm. My favorite way to blow off steam after work. bmk88slot

  110. This app has honestly become my little daily joy. The design is so welcoming that I forget I am on my phone for hours. Support always chats with me politely and the promotions actually make sense. If you want a platform that treats you like family just start here 339betapp

  115. What stands out the most is how welcoming the whole community feels around here. Daily events are actually fun to participate in and the staff responds with genuine care whenever I hit a snag. I do not usually leave reviews but the consistent quality of service here deserves recognition. Try it out and you will see what I mean. tamashabetin

  129. I have tried quite a few sites over the years but this one keeps me coming back. The variety of table games is impressive and the graphics look stunning on both desktop and mobile. I also noticed they update their promotions frequently which means there is always something new to grab. The withdrawal process is straightforward and my funds arrived without any bumps. A genuinely player friendly platform. npgameroom

  143. Downloaded the 79clubapp, and I’m already hooked! The app is super user-friendly, and I love that I can play all my favorite games right from my phone. Recommend it if you want some quick fun. Try it out here: 79clubapp

  148. I found a wonderful community here and the daily rewards never disappoint. The support crew is always ready to help with a genuine smile and the games run without any lag. Highly recommend for anyone looking for consistent entertainment. ta7777

  169. Playing cricket and football matches here feels so natural. The withdrawal speed is lightning fast and I never worry about hidden fees. Feels like home whenever I log in and place my picks. bd3k333

  191. My weekends are complete the moment I log into my account. The slot collection is massive and the daily reload bonuses keep my bankroll smiling. I love how smooth the mobile experience is even on older phones. It really feels like a community where regulars are treated like family. vnvb9

  193. Excelente artigo para quem trabalha com faturamento médico! A distinção entre os diferentes tipos de guias TISS é fundamental para evitar glosas e erros no envio às operadoras. Vale destacar que a guia SP/SADT costuma ser a mais complexa, pois precisa conciliar solicitação e execução de procedimentos, o que gera muitas dúvidas na prática. Também é importante lembrar que a obrigatoriedade do envio em formato XML desde 2007 exigiu dos prestadores uma reestruturação significativa dos seus sistemas de faturamento. Gostaria de ver um aprofundamento sobre o preenchimento correto do campo de código de procedimento na guia de consulta, já que esse é um dos pontos que mais gera inconsistências. No geral, é um conteúdo muito útil para consultórios e clínicas que estão iniciando no padrão TISS.

  199. Finding a place that balances excitement with genuine care is not easy these days but this site delivers exactly that. I love the huge selection of titles and the live dealer setups that bring the casino floor right to your screen. The team works tirelessly behind the scenes so you can simply relax and enjoy. Come say hello and let the good times begin. phoktt

  216. I was a bit hesitant at first but the trial balance gave me the confidence to deposit real funds. Now I am a regular visitor because the game selections are just unmatched. Every weekend they roll out fresh tournaments with solid prize pools. Head over to trextrabet and see for yourself

  223. Discovering a place that prioritizes comfort and fair play is a breath of fresh air in this busy digital world. I love how the team maintains such a chill environment while offering incredible variety across all game categories. Every visit leaves me feeling happy and truly appreciated as a valued member. aumrwin9

  276. I’ve been trying a few platforms lately and this one really stands out. The interface is smooth and the payouts are surprisingly fast. Definitely worth a try for anyone looking for a reliable spot. Check out bdmegapari for a great experience.

  306. I have been playing on this site for a few weeks now and the game selection is absolutely fantastic. Customer support helped me within minutes when I had a small question about my bonus. Highly recommend checking it out if you want a smooth and fun experience. vegas77slots

  322. Downloading the app was quick and it runs smoothly on both my tablet and phone. I love having instant access to all the tables and slots without needing a browser. The customer service team really goes the extra mile to make sure you have a great time. apuestatotalapk

  423. Downloading the app was quick and it runs smoothly on both my tablet and phone. I love having instant access to all the tables and slots without needing a browser. The customer service team really goes the extra mile to make sure you have a great time. apuestatotalapk

  429. Discovered this treasure trove while browsing and the VIP rewards program keeps getting better. Withdrawals hit my e wallet within hours and the game selection is constantly refreshed. Truly a premium experience. rich711

Deixe um comentário