{"id":2177,"date":"2018-03-20T10:13:53","date_gmt":"2018-03-20T09:13:53","guid":{"rendered":"http:\/\/www.prooptic-idm.com\/wiki\/wiki15\/?page_id=2177"},"modified":"2018-03-20T10:13:53","modified_gmt":"2018-03-20T09:13:53","slug":"mgen-2","status":"publish","type":"page","link":"https:\/\/prooptic.axess.fr\/?page_id=2177","title":{"rendered":"MGEN"},"content":{"rendered":"<p>\u00a0<\/p>\n<p><img decoding=\"async\" loading=\"lazy\" src=\"http:\/\/prooptic.axess.fr\/wp-content\/uploads\/2018\/03\/mgen.jpeg\" alt=\"\" width=\"335\" height=\"201\" \/><\/p>\n<p>La MGEN <strong>ne veut pas et ne sait pas<\/strong> traiter les facturations SESAM-Vitale quand il s&rsquo;agit de facturer les parts RO et RC pour un m\u00eame dossier.<\/p>\n<p>Plusieurs cas sont possibles :<\/p>\n<ul>\n<li><strong>Part RO seule : <\/strong><\/li>\n<\/ul>\n<p>S&rsquo;il ne s&rsquo;agit que de la part RO : cocher \u00ab\u00a0T\u00e9l\u00e9transmission S\u00e9curit\u00e9 Sociale et cocher \u00ab\u00a0Tiers Payant S\u00e9curit\u00e9 Sociale\u00a0\u00bb dans le dossier : la MGEN remboursera sans probl\u00e8me.<\/p>\n<ul>\n<li><strong>Part RC seule<\/strong> :<\/li>\n<\/ul>\n<p>A facturer sans t\u00e9l\u00e9transmission du dossier, puis, si vous \u00eates conventionn\u00e9s Optistya et que vous faites le tiers-payant, sur leur site pour un remboursement plus rapide et ne pas avoir \u00e0 imprimer de facture.<\/p>\n<ul>\n<li><strong>Part RO+RC :<\/strong><\/li>\n<\/ul>\n<p>Il ne faut pas t\u00e9l\u00e9transmettre du tout si vous \u00eates conventionn\u00e9s.\u00a0<br \/> Ne pas cocher \u00ab\u00a0T\u00e9l\u00e9transmissions S\u00e9curit\u00e9 Sociale\/MGEN\u00a0\u00bb dans le dossier, mais cliquer sur <strong>Modifier<\/strong>, et ajouter, dans l&rsquo;onglet \u00ab\u00a0S\u00e9curit\u00e9 Sociale\/Mutuelle\u00a0\u00bb le TP RO + l&rsquo;organisme MGEN RC que vous aurez cr\u00e9\u00e9 au pr\u00e9alable dans la <strong>partie mutuelle de la fiche identit\u00e9<\/strong>, comme indiqu\u00e9 :<\/p>\n<p><img decoding=\"async\" loading=\"lazy\" src=\"http:\/\/prooptic.axess.fr\/wp-content\/uploads\/2018\/03\/montant-amo-amc-mgen.png\" alt=\"\" width=\"800\" height=\"604\" \/><\/p>\n<p>Puis <strong>facturer le dossier sur le site Optistya<\/strong>.<br \/> C&rsquo;est le seul moyen<strong> \u00e9vitant \u00e0 la MGEN de r\u00e9gler deux fois<\/strong> la part RO et\/ou de r\u00e9gler la part RO \u00e0 vous et \u00e0 l&rsquo;assur\u00e9, r\u00e9clamant ensuite des r\u00e9gularisations.<\/p>\n<p>Si vous n&rsquo;\u00eates pas conventionn\u00e9s, vous pouvez t\u00e9l\u00e9transmettre la part RO et indiquer la part RC sans t\u00e9l\u00e9transmission, sans tiers-payant. Mais le client doit envoyer la facture mutuelle \u00e0 la MGEN.<\/p>\n<table border=\"2\">\n<tbody>\n<tr>\n<td>\n<p><strong>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong><\/p>\n<p><strong><img decoding=\"async\" src=\"https:\/\/thibautraine.files.wordpress.com\/2011\/10\/00106906-photo-panneau-attention-point-d-exclamation.jpg?w=150&amp;h=132\" alt=\"Afficher l'image d'origine\" \/><\/strong><strong>A<\/strong><strong>vec SCOR, si vous t\u00e9l\u00e9transmettez la part RO mais que vous ne faites pas le TP, que vous ajoutiez l&rsquo;ordonnance num\u00e9ris\u00e9e Scor ou non, la MGEN vous demandera quand m\u00eame les papiers !<\/strong><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u00a0 La MGEN ne veut pas et ne sait pas traiter les facturations SESAM-Vitale quand il s&rsquo;agit de facturer les parts RO et RC pour un m\u00eame dossier. Plusieurs cas sont possibles : Part RO seule : S&rsquo;il ne s&rsquo;agit que de la part RO : cocher \u00ab\u00a0T\u00e9l\u00e9transmission S\u00e9curit\u00e9 Sociale et cocher \u00ab\u00a0Tiers Payant S\u00e9curit\u00e9 &hellip; <a href=\"https:\/\/prooptic.axess.fr\/?page_id=2177\" class=\"more-link\">Continuer la lecture de <span class=\"screen-reader-text\">MGEN<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/prooptic.axess.fr\/index.php?rest_route=\/wp\/v2\/pages\/2177"}],"collection":[{"href":"https:\/\/prooptic.axess.fr\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/prooptic.axess.fr\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/prooptic.axess.fr\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/prooptic.axess.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2177"}],"version-history":[{"count":0,"href":"https:\/\/prooptic.axess.fr\/index.php?rest_route=\/wp\/v2\/pages\/2177\/revisions"}],"wp:attachment":[{"href":"https:\/\/prooptic.axess.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2177"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}