These are routine practices complementary and diagnose test, such as clinical examination, x-rays, scan, tomography. 100% coverage with providers from the directory of APSOT. Previous authorization is not required to run these test. You may be assisted on any of specialized center of the Medical Staff, with your identification card, your national identity document, and the doctor's prescription.
The validity of the prescription is of 30 days.
If you have any doubts or inconvenient about said procedures/practices you may contact APSOT directly, call the
APSOT Beneficiary Attention Centre:
P: 0800-122-8778
P: 011-4018-2500
From Monday to Friday from 9 am. a to 7 p.m

These are high technology and low frequency practices such as: echo Doppler Tran esophagus, CAT Scan or Ultrasound Scan controlled biopsy, RMN, puncture, etc. 100% coverage with providers from the directory of APSOT.
All high complexity practices require previous authorization. You must obtain the authorization through APSOT directconnection.
We assist you with your questions on our Beneficiary Attention Centre:
P: 0800-122-8778
P: 011-4018-2500
From Monday to Friday from 9am. to 7 p.m.

ISURGICAL NATIONAL AND IMPORT PROSTHESES AND IMPLANTS.
Coverage: 100% on prostheses and implants nationals and imported provided directly by APSOT, previous Medical Audit examination.

INON SURGICAL NATIONAL AND IMPORT PROSTHESES AND INTERNAL PROSTHESES..
Coverage: 100% (corset, splints, etc), previous Medical Audit examination.

IPSICHO PATHOLOGY
Psychiatry attention will be provided the team or teams of specialist hired by APSOT, which will include a psychiatric coordinator, psychiatrists specialized in adults, teenagers and kids, psychologist and psychopedagogists; and the open system (reimbursement)

ICLOSED SYSTEM
The authorization or acknowledgement of psychotherapy treatments will be extended to a maximum of 30 (thirty) sessions per year, a maximum of 2 (two) sessions per week, and under no circumstances will exceed 4 (four) sessions per month.
To use the Psychopathology Service, you must apply for an admission interview, to determine the kind of treatment and subsequent referral to the appropriate therapist.
Said interview is free of charge for the beneficiary and can be requested by phone:

Centro ORO:
D. Güemes 4710 City of Buenos Aires (1425)
P. 4773-8289 / 4772-8851
From Monday to Friday from 8:30 a.m. to 9:30 p.m..

If unavailable to attend please cancel the appointment the day before, so it can be made available for other beneficiary.

IPSYCHOPEDAGOGY
This service shall be provide for children with insufficient school performance (dysgraphia, dyscalculia, dyslexic) and for those who require psychomotor reeducation due to a specific pathology. To have access to this service, you must apply for an interview with the team of admission for kids and teenagers:

Centro ORO:
D. Güemes 4710 City of Buenos Aires (1425)
P. 4773-8289 / 4772-8851
From Monday to Friday from 8:30 a.m. to 9:30 p.m.

IPSYCHIATRY EMERGENCIES
These emergencies may be seen outpatient or at home. In all cases you should call:

Centro ORO:
D. Güemes 4710 City of Buenos Aires (1425)
P. 4773-8289 / 4772-8851
From Monday to Friday from 8:30 a.m. a 21.30hs.

IPSYCHIATRIC HOSPITAL STAY
It will be covered for a period of up to 60 (sixty) days of hospital stay per calendar year. APSOT requires a previous consult with the psychiatric coordinator, a medical report 15 (fifteen) days later and a definitive diagnose on the 30 and the 60 day.
Psychiatric hospital stays are centralized at:

Centro ORO:
D. Güemes 4710 City of Buenos Aires (1425)
P. 4773-8289 / 4772-8851
From Monday to Friday from 8:30 a.m. to 9:30 p.m.

IPSYCHOPATHOLOGY.
Open System - Reimbursements.
Beneficiaries have 30 sessions on psychopathology every 4 years pursuant to the APSOT values at that time.

Cardiovascular Rehabilitation..
It is authorized in centers with hospital stay. It is for those severe hypertensive patients, with developed myocardial infarction, severe pulmonary emphysema and post surgical treatment. It requires previous authorization and it is authorized for a term of 6 to 12 month.

You may ask for the facilities at the APSOT Beneficiary Attention Centre:
P: 0800-122-8778
P: 011-4018-2500
From Monday to Friday from 9 a.m. to 7 p.m.

Prescribed vaccines in the PMI medicines compendium have 100% coverage. 50% coverage in pharmacies

0800-122-2776 (APSOT)
Remember, you should always have your APSOT identification card with you and your national identity document. .     

IHOW DOES THE SERVICE WORK?
1. When you dial 0-800-122-2776 you will contact APSOT Emergencies.
2. An operator will ask you for your phone number and address (to which an ambulance shall be sent), asking you to repeat it again (due to in some emergency situations information is omitted or incorrect).
3. Then, the operator will ask you 4 questions to be able to determine the kind of Emergency and the kind of service you need. It is really important to stay calm and follow the instructions the operator provides you with.

24 hours a day, 365 days of the year.

IMEDICAL EMERGENCIES (CODE RED)
An emergency is any critical situation in which life, organs and / or the patient's vital functions can be at stake if not promptly and adequately assisted by a professional. This service implies the presence of a medical professional at the requested place, with the necessary equipment, and an ambulance of the intensive care unit (UTIM). A driver and nurse are always ready in case the patient needs to be transferred to the hospital, in case the professional believes a better attention can be provided at the institution or medical facility.  

IMEDICAL EMERGENCIES (CODE YELLOW)
We call emergency to every situation where there is no imminent risk to the patient's life, but it must be treated fast enough, to avoid a progressive deterioration and serious complications. This category includes all profiles in which the symptoms are not life threatening, but require prompt attention.  

IHOME CARE (CODE GREEN)
Home Care are those situations in which, due to the characteristics of the symptoms and/or condition, immediate assistance is not required, but the patient cannot go to a clinic or medical centre. We provide this service for Clinical analysis, Pediatrics and Cardiology.  

IAMBULANCE SCHEDULED TRANSFERS
Available for patients who must seek care at diagnose or treatment centre, and because of their condition are unable to move by other means.

IREGIONAL COVERAGE
Uruguay: Contracted centers for emergencies.

IRESTRICTIONS ON THE NATIONAL AND INTERNATIONAL COVERAGE
Consultation abroad: subject to APSOT evaluation.
APSOT shall not cover the following treatments, practices or surgeries:

_On experimental stage.
_Not scientifically attested.
_Againts the legal rules in force.
_Against the life natural process of the individual.
_Blood provision.
_Chronic psychiatric hospital stay.
_Geriatric hospital stay.
_Cosmetology.
_Injuries suffered as a consequence of taking part in professional competitions, test or demonstration of skills and/or speed races of any kind, (motorcycling, motor racing, parachuting, etc.).
_Cases in which the Work Risk Insurer should respond.

IREQUIREMENTS
All receipts for the request of reimbursement must be the ORIGINAL ones.

ICONSULTATION
The diagnose must appear.
Test and practices: Submit the medical order and invoice.
Drugs: Prescription, invoice and cut-out bar codes.
Surgeries: Surgical procedure plus the invoice.

IMODULE TO DETERMINE REIMBURSEMENTS ON OUTPATIENT SERVICES
Complementary diagnose test and auxiliary treatments.
APSOT's values.

IHOSPITAL STAY SERVICES
Fees and surgical expenses
In all cases you choose a clinic from the directory, an authorization for hospitalization will be issued (clinic expenses) 100% a covered by APSOT, surgical expenses shall be reimbursed taking into account the module consisting of all the members of the surgical team that took part in the surgical procedure. Said value will be set to APSOT's value.**

When using a clinic and private physician, we will reimbursed the value of the module (from clinical expenses and surgical fees) adjusted to values APSOT .**

** In both cases it will only be reimbursed, those surgical services that have been previously authorized by the Medical Audit of APSOT. To obtain this authorization you must submit (before surgery) the budget of the professional involved so that APSOT can report you the estimated amount of the refund, which may vary according to surgical procedure.

Important:
Reimbursement requests for services shall be submitted no later than 90 (ninety) days from payment date. Afterwards, no recognition shall be made, other than cases of force majeure duly substantiated.
For this purpose, the Affiliate shall fill out a form of Reimbursement Request for Medical Expenses for each of the beneficiaries subject to reimbursement request. APSOT reserves the right to request for: additional information, test results, reports on the progress and end of the treatment and consults, etc.

INON-COVERED SERVICES
_ Pain treatment.
_ Every services excluded by APSOT in its closed plans.
_ Chronic drugs, oncologic, high cost and poor incidence, diabetes.
_ Professional fees for personalized care.
_ Home care.
_ Orthopedic: shoes and elastic element.
_ Patient companion (if the patient is under the age of 15)
_ Transplants

IREIMBURSMENTS FOR MEDIAL SERVICES (PRESTACIONES MEDICAS)

REIMBURSMENT FOR OUTPATIENT SERVICES _Medical consult at the Doctor's OFFICE $100.- _Home Care Consult $100.- Maximum per year, per person: NONE Important: when 3 or more consults with the same physician are done, the medical file must be attached. _Nutrition Consult $ 25.-c/u Maximum per year per person: 24 sessions (two per month) COMPLEMENTARY TEST COMPLEMENTARIOS DE DIAGNOSTICO Y TRATAMIENTOS AUXILIARES   _Lab, images (high complexity with authorization and low complexity without authorization) Maximum per year and person: NONE / APSOT's Values. _Contrast Material Reintegro 100% _Radioactive Material Radio-cobalto therapy Maximum per year and person: NONE / with authorization / APSOT's Values. _For auxiliary treatments: Physiokinesiology (laser and imam-therapy): NONE $24.- Physiokinesiology - Home care (previous authorization) $31.- Maximum per year and person: 25 sessions per year and person _Speech-language pathology $ 20c/u Maximum per year and person: NONE/ APSOT's value. _Phebology $65.- 100% coverage without maximum nor limits / APSOT's (with previous authorization) MATERNITY   _Clinic from medical card with particular physician. In this case the authorization for admission in the clinic will be issued ( clinic expenses, including Neonatology) covered 100% by APSOT. al 100% a cargo de APSOT. _Psychoprophylaxis of birth (course) $250.- For all acting team (includes medical fees, midwife, anesthetist, scrub nurse, monitor) hasta, $1890.- In case of Cesarean intervention (includes medical fees, midwife, anesthetist, scrub nurse, monitor) hasta, monitorista), hasta $2024.- REIMBURSEMENTS FOR SERVICES DURING ADMISSION _Clinical Admission _Surgical Admission _Admission Fees Maximum per year and person : none / APSOT’s Values Patient Companion (for patients under 15 years old) Maximum per year and person : none / APSOT's Values _Clinical Fees Maximum per year and person : none / APSOT's Values MEDICINE   _Not in contracted pharmacies 60% _Abroad 50% off according to APSOT's Values DISPOSABLE MATERIALS   _During admission 100% APSOT _During ambulatory treartments 50% INTENSIVE CARE UNIT AND CORONARY UNIT   _Maximum per year and person : none / APSOT's Values MENTAL HEALTH   _Individual Therapy (per session) $40.- _Group Therapy (per session) $40.- _Family Therapy (per session) $40.- _Bonding Therapy $40.- 30 sessions every 4 calendar years will be acknowledged according to APSOT values ALERGIES   _Consults (includes desensitization treatment) _Tests Maximum per year and person : none / APSOT's Values REHABILITATION   _Cerebrovascular Accident _Serious Accidents - Kinesiology - Physiatry - Speech-Language Pathology _Orthopedics postoperatives Maximum per year and person : none / APSOT's Values FOREING CONSULTATION   _Foreign consultation service subject to Medical Audit APSOT. Maximum per year and person : NONE / NO CHARGE AMBULANCE TRANSPORTATION   _Transportation service (requested by Physitian) Maximum per year and person : none / APSOT's Values OPHTHALMOLOGY   _Frames $ 100.- _Gradation lenses _White lenses $ 52 c/par _Bifocal lenses $146 c/par _Trifocal lenses $ 266 c/par Maximum per year and person: one pair every 2 years, one for short-sightedness and the other for presbyopsia, except gradation modification) _Soft Contact Lenses $240.- c/par _Flexible Contact lenses $300.-c/par _Toric Lens $432- c/par Maximun per year and person: 1 pair a year, except a modification in gradation. INSOLES   _Leather insoles $25.- c/ par _Silicone insoles $75.-c/ par _Valente Valente insoles $25.-c/par REIMBURSEMENTS FOR SPECIAL COVERAGE _Burial expenses. Upon death of the holder, spouse or sons - APSOT's values. $1200.-

IREIMBURSMENT FOR DENTAL SERVICES

The affiliate cannot seek treatment through the closed system if he or she have already started the treatment with a dentist not listed by APSOT or the other way around.
Reimbursement shall be obtained by submitting the "Reimbursement Form".
You must submit the pre operation X-Rays for reimbursement of endodontic and dental surgery provisions. For periodontal services, a subsequent audit may be carried out within 30 days.
All X-rays (except for endodontic and dental surgery purposes) must be submitted by the patient within 30 days. By submitting the refund form, in cases of endodontic, must also be submitted preoperative and postoperative radiographs.
After the treatment, the reimbursement forms may be submitted directly by the patient or by the person designated in the Custom Care Centers APSOT. Refunds will be effective within 10 (ten) working days, or by accreditation in the salary receipt or automatic registration in banks, as requested by the beneficiary, reserving the right to make APSOT dental audits with a patient when necessary.
After the treatment, the reimbursement forms may be submitted directly by the patient or by the person designated in the Custom Care Centers APSOT. Refunds will be effective within 10 (ten) working days, or by accreditation in the salary receipt or automatic registration in banks, as requested by the beneficiary, reserving the right to make APSOT dental audits with a patient when necessary.
It should be noted that no provision not covered by APSOT may be submitted for reimbursement..
Treatments within the country will be channeled through the APSOT Custom Care Centers according to the place.

REIMBURSMENT FOR DENTAL SERVICES
610100	Consult, test, diagnose and pl./trat.	18
610400	Emergency consult	20
610600	Dentistry consult (specialists only)	30
_Chapter II: Dental Sugery (62)
620100	Amalgam Simple	40
620200	Amalgam Compound	45
620900	Anlge reconstruction (send X-ray pre-operation)	60
621500	Composite Simple	48
621600	Composite Compound	48
_Chaper III: Endodontic (63)
630100	Single rooted Root Canal	110
630200	Multi rooted Root canal	140
630500	Parcial Biopulpectomy	48
630700	Canal unblocking	40
630800	Bolt preparation procedure	20
_Prótesis Parcial Removible(64)
640201	Acrylic up to 4 teeth	400
640202	Acrylic 5 or + teeth	450
640206	Flexible protheses	150
640203	Chrome cobalt die cast up to 4 teeth	600
640204	Chrome cobalt die cast 5 or + teeth	680
	Complete Protheses (64)
640301	Superior Complete	550
640302	Inferior Complete	550
640411	Individual Impression tray	70
640401	Simple fixture	90
640402	Fixture addition of 1 tooth	90
640403	Fixture adding 1 retainer	90
640404	Fixture adding 1 tooth and 1 retainer	120
640405	Subsequent teeth	26
640406	Subsequent retainer	35
640407	Weld retainer adding 1 tooth	130
640410	Reline of prostheses partial or complete	120
_Chapter V: Prevention
650100	Prophylaxis (ultrasound cleaning y mechanical toothbrush)	33
650200	Prevention module	36
650500	Sealer of point and fissures (up to 15 years)	20
_Chapter VI: Orthodontics
660100	Test consults	46
660200	Treatment of primary or mixed dentition	1400
660300	Treatment of permanent dentition (**)	2400
660400	Simple treatment - to be determined( AUDIT)	750
_Capitulo VII: Odontopediatría
670100	Motivation (up to 3 session and up to 13 years)	30
670200	Fixed space retainer (up to 8 years)	120
670300	Removable space retainer (up to 8 years)	160
670400	Formocresol treatment in temporary teeth	45
670500	Metalic Crown	110
670604	Amelodentary Fracture	100
670601	Reduction luxation dental unmovable	100
_Chapter VIII: Periodontics
680100	Periodontal consult	35
680200	Chronic Gingivitis	43
680300	Simple and moderate gum disease	42
680400	Severe gum desease	54
	Gum disease treatment maintenance every 6 meses	45
680500	Dental attrition	60
680700	Splint	80
_Chapter IX: Radiology
690101	Rx. Periapical	12
690102	Rx. Bite- wing	12
690103	Rx. Oclusal 6x8	23
690104	Rx. serial measure 7 x-rays	50
690105	Rx. Serial 14 x-rays	80
690201	Tracing 1 take	49
690202	Tracing subsequente takes	26
690203	Rx. temporomandibular articulation	40
690204	Rx. Panoramic	40
690205	Telerx. Cephalometric	50
690206	Sialography	50
_Chapter X: Surgery
700100	Dental surgery - extraction	42
700200	Plastic, mouth and sinus communication	120
700300	Biopsy by puncture or aspiration	35
700400	Alveolectomy by area	40
700500	Immediate dental implant replacement	100
700600	Abscess drainage	48
700700	Biopsy by removal	48
700800	Surgical extension of a clinical crown	40
700900	Extraction of an impacted tooth	140
701000	Germectomy	180
701100	Eruption Impacted tooth	60
701200	Apicectomy	120
701300	Osteomyelitis Treatment	80
701400	Removal of a foreign body	72
701500	Corrective Alveolectomy in 6 areas
_Chapter XI: Implant/Fixed protheses
777777	Implants (*)	2200
788888	Fixed Protheses (bolt, stump, crown) muscle relaxant x-ray (*)	1400

REMOVABLE PROTHESES ARE RENEWED EVERY THREE YEARS
(*) FIXED PROTHES AND IMPLANTS/ PER AFFILIATE PER YEAR.
(**) DENTAL BRACES WITHOUT AGE LIMIT, ONLY ONE TIME.
CLEANING: 1 / YEAR
FLUOR (UP TO 13 YEARS OF AGE) EVERY 6 MONTH
DENTAL SURGERY EVERY 2 YEARS each piece.