How SaluPro works, step by step
A case moves through five clear states across the clinic, the TPA manager and the insurer. At each one, something is done and something is recorded. Here's what happens inside.
Apertura del caso
La clínica abre el caso y elige su tipo —APS, Emergencia o Electiva—. Quedan asociados el paciente, la fecha y los datos administrativos que dan inicio a la gestión.
Carga de soportes clínicos
Se suben los documentos médicos que respaldan el caso, clasificados por tipo. Cada soporte queda disponible para los demás perfiles sin necesidad de correos ni llamadas.
Auditoría y ciclo de revisión
El gestor TPA revisa documentos y prefacturas dentro de un ciclo de revisión: puede aprobar, observar o solicitar correcciones. El caso vuelve a la clínica si algo falta, sin perder el hilo.
Prefactura revisada
La prefactura se genera y revisa dentro del mismo flujo, sin duplicar trabajo en hojas externas. Una vez conforme, el caso queda listo para la decisión de la aseguradora.
Liquidación y cierre
La aseguradora revisa el caso completo —soportes, auditoría y prefactura— y liquida con todo el historial a la vista. El caso se cierra, trazable de punta a punta.
The same flow, five starting points
Each case type enters the same traceable cycle; the clinical context changes, not the order or the control.
PHC
Primary health care: consultations and follow-ups coordinated across clinic, TPA manager and insurer.
Emergency
Critical urgent care: the case is opened, documented and managed with full traceability, without losing speed.
Elective
Scheduled surgical procedures: AVAL letter, budget, documents and pre-invoice ordered from start to close.
Urgency
Fast-resolution care without prolonged hospitalization: intermediate SLA between PHC and Emergency.
Surgical RFQ
Quotation requests for complex surgeries: compare clinic budgets before authorizing the procedure.
Approve, flag or return — without losing the thread
The audit isn't a yes or no: it's a cycle. The manager can request corrections and the case returns to the clinic with its context intact.
Review
The TPA manager reviews documents and pre-invoice.
Flag
If something is missing, it's flagged and the case returns to the clinic.
Correction
The clinic corrects and resubmits, all within the same case.
Approval
Once approved, the case advances to settlement.
Ready to see the flow in your organization?
We'll show you how SaluPro organizes case management across your clinics, managers and insurers.