Rejeição de NF-e por Falta de Autorização de Seguro Saúde
Definition
In referral intake, delays in obtaining insurance pre-authorization prevent timely NF-e issuance, triggering SEFAZ rejections and fines. SUS coverage for home care is fragmented, forcing private providers to navigate complex operator authorizations before billing.
Key Findings
- Financial Impact: R$1.500 a R$5.000 por NF-e rejeitada; 2-5% das faturas afetadas em saúde suplementar
- Frequency: Per rejected invoice; common in manual processes
- Root Cause: Manual verification of insurance auth before NF-e XML generation
Why This Matters
The Pitch: Home Health Care Services in Brasil waste R$10.000+ em multas anuais por rejeições NF-e. Automation of insurance authorization validation eliminates this risk.
Affected Stakeholders
Faturistas, Contadores, Coordenadores de Intake
Deep Analysis (Premium)
Financial Impact
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Current Workarounds
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Methodology & Sources
Data collected via OSINT from regulatory filings, industry audits, and verified case studies.
Related Business Risks
Perda de Clientes por Demora em Autorização
Serviços Não Faturados por Falha em Autorização
Atraso no Recebimento por Autorização de Planos de Saúde
Atraso no Faturamento por Treinamento Manual OASIS
Atraso no recebimento por divergências entre EVV e contas médicas
Sobrecusto administrativo com correções manuais de registros EVV
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