DentalPin Docs

Appearance

0034 — Brazil: nothing certifies the software, so DentalPin emits NFS-e itself and speaks TISS per operadora ​

  • Status: proposed
  • Date: 2026-09-12
  • Deciders: maintainers
  • Tags: compliance, billing, interop, brazil

Context ​

Issue #139 asks seven things before any code: for NFS-e, national or municipal emission and what that means for self-hosted software, the layout, the credential, cancellation; for TISS, the current version and cadence, which guias a dental practice sends and how the rol relates to our catalog, and whether submission is per operadora or standardised. Sources are the primary texts as published by the issuing bodies: CF art. 156, LC 116/2003 and LC 214/2025 on planalto; the CGNFS-e resolutions and the technical documentation on gov.br/nfse; Receita Federal's 2026 guidance; ANS's TISS componentes (Organizacional 202607, Conteúdo e Estrutura 202511, and the Comunicação XSD/WSDL bundle, downloaded and inspected); the CFO and CFM act repositories; the SBIS certification manual; LGPD and Resolução CD/ANPD 15/2024. Every claim is quoted, with its URL in the References. Points not confirmed from those are marked open.

Brazil inverts the question that decided Portugal, France and Germany. Nobody certifies the software — not for invoicing, not for claims, not for clinical records. So the question stops being "may we?" and becomes "what must we not hard-code?", because both regimes are mid-transition and both are versioned on a calendar.

1. NFS-e: municipal tax, national standard, taxpayer's key ​

ISS is municipal (CF art. 156, III; LC 116/2003 art. 1º). Dentistry is list item 4.12 – Odontologia; art. 3º puts the tax at the provider's establishment, and dentistry is not one of its 25 exceptions. Rates run 2 %–5 % per municipality per sub-item.

The padrão nacional comes from a Convênio of 30.06.2022 (DOU 01.07.2022) governed by the CGNFS-e (5 RFB, 5 ABRASF/FNP, 5 CNM); the model is Resolução CGNFS-e nº 3/2023, whose art. 3º has the taxpayer sign and transmit a DPS either to the Emissor Público Nacional or to a municipal Emissor Local, the document reaching the ADN either way. NT 004 on the national path: the DPS "será enviada à 'Sefin Nacional', responsável pela validação das informações, cálculo dos tributos e autorização da NFS-e", returning an NFS-e XML in which "a DPS é assinada e encapsulada no interior da nota gerada". Transport is REST/JSON over mutually authenticated TLS with an XSD-validated payload (POST /nfse, GET /nfse/{chave}, and the parametros_municipais family).

All 5 571 entes federados have adhered, and LC 214/2025 art. 62 §1º made it compulsory from 01.01.2026: a municipality must either let taxpayers emit nationally or, keeping its own emitter, share into the ADN in the national layout — enforced by suspending voluntary transfers (§7º), through 31.12.2032. Adhering is not the same as emitting nationally (NT 004 §1.1). But Resolução CGSN nº 189/2026 (DOU 28.04.2026) closed that gap for our users: ME and EPP optantes pelo Simples Nacional — nearly every dental clinic — "deverão usar obrigatoriamente o Emissor Nacional a partir de 01/09/2026", and the CGNFS-e names the two compliant channels as the web portal or "software ERP com integração … API com a SEFIN Nacional". That date has passed: API integration discharges the obligation rather than evading it.

Certification — the rule, verbatim. Resolução CGNFS-e nº 3/2023 art. 3º parágrafo único:

"A transmissão dos arquivos digitais da DPS e da NFS-e […] será efetuada via internet, por meio de protocolo de segurança ou criptografia, com utilização de sistema informatizado desenvolvido ou adquirido pelo contribuinte ou disponibilizado pela administração tributária."

Art. 9º, II repeats it for events. What is authorised is the taxpayer, not the program: art. 4º § único deems authorised "a pessoa jurídica regularmente inscrita no CNPJ e não desautorizada pelo ente federativo". The only gate is self-service — "Para emissão via API (sistemas próprios), é necessário credenciamento prévio no Painel do Contribuinte" — and Produção Restrita is "disponível para todas as empresas" (NT 004 §1.2), with no approval step to production documented (open). The credential is the clinic's: Manual Integrado §§6.1.3–6.1.4 requires an ICP-Brasil A1/A3 certificate carrying the emitter's CNPJ, used both as the mTLS client certificate and to sign the DPS. (The FAQ's "não preciso de certificado digital" is scoped to the web emitter; simple signature is for pessoas físicas and MEI only, art. 2º §3º.) This is the mirror image of Portugal, where the signing key had to be "de conhecimento exclusivo do produtor do programa" (ADR 0027). Here it is the taxpayer's by design.

Cancellation. Art. 7º: an issued NFS-e "não pode ser alterada, ressalvadas as hipóteses de cancelamento ou substituição", neither reversible. Art. 8º lists 16 events; there is no carta de correção — art. 9º §2º routes correction through a new NFS-e plus cancellation of the original. Deadlines are not national: art. 8º §2º subordinates "os prazos" to "os critérios parametrizados pelo ente federativo convenente no Portal Administrativo Municipal (PAM)", and Manual Integrado §13.2.4.3 enumerates them (cancellation window in days, value restrictions, unidentified tomador, already-collected taxes, substitution window). They are read at runtime, alongside ISS rates, special regimes, deductions and retentions.

2. The tax reform is a moving layout, not a future project ​

LC 214/2025 instituted IBS, CBS and IS; IS does not reach dental services. 2026 is a test year at IBS 0,1 % (art. 343) and CBS 0,9 % (art. 346), both offsettable (art. 348) — Receita Federal states that a taxpayer who issues documents correctly "estará dispensado de recolhimento do IBS e da CBS". PIS/COFINS go on 01.01.2027 (art. 542); ISS decays 10/20/30/40 % across 2029–2032 (art. 508 inserting LC 116 art. 8º-B — the 2029 rate is a function of the 31.12.2028 rate); LC 116 is repealed 01.01.2033 (art. 543, IV).

The layout already carries this: NT 004 v2.0 added the IBSCBS groups "em atendimento às alterações previstas na Emenda Constitucional nº 132", in production with legal validity from 05.01.2026, with cIndOp "baseada no art. 11 da LC nº 214". Nine months later the annexes are at Anexo VI v1.04.00 / Anexo VII v1.02.00 (NT 009), the production XSD is v1.01-20260209, and NT 008 rewrote the DANFSe. The groups are optional but fully validated when present (NT 004 §1.1) — partial data is worse than none. And the deadline has arrived: Ato Conjunto RFB/CGIBS nº 4/2026 makes destaque due from 01.10.2026 for ordinary LC 116 services (alínea "d", where 4.12 falls) and 01.01.2027 for Simples Nacional optants who elected destaque in September 2026; omission is not a rejection until 31.12.2026 but "evidenciará a desconformidade do documento fiscal".

3. TISS: one contract, N endpoints ​

RN 305/2012 is revoked; RN 501/2022 is in force (regulated by IN ANS nº 9/2022; penalties via RN 489/2022 arts. 39 and 47). Its scope article binds, with no segmentation carve-out, "Operadora …; Prestador de Serviços de Saúde; Contratante…; Beneficiário…; ANS" — so it binds the practice. Operadoras may not alter the standard (item 23) nor demand a paper duplicate of a digitally signed exchange (item 24).

Five componentes — Organizacional, Conteúdo e Estrutura, Representação de Conceitos (TUSS), Segurança e Privacidade, Comunicação — each versioned separately; there is no single "TISS version". Julho/2026 is Organizacional 202607, Conteúdo e Estrutura 202511, TUSS 202607, Segurança 202511, Comunicação 04.03.00 (01.06.00 is the separate operadora→ANS line). Cadence is roughly bi-monthly (JAN, MAR, MAI, JUL 2026), and item 323 sets the window: "não será inferior a três meses e não superior a doze meses após o início da vigência". Two rules matter more than the version number: item 209, "Sempre haverá no mínimo uma e no máximo duas versões do Componente de Comunicação vigentes"; item 210, "A versão a ser utilizada … será a acordada entre as partes". And item 211: a TUSS term is validated against the date of care, not of transmission.

Transport is per operadora. Items 133–136: operadoras "devem dispor aos prestadores … as tecnologias de webservices e de portal"; the prestador chooses between them; each operadora must publish on its own Portal TISS "o endereço dos webservices disponibilizados pela operadora" and its Coordenador TISS. The downloaded WSDLs confirm it — every <soap:address/> is empty. ANS standardises the contract, never the address. Item 139 is the licence to ship: "Qualquer solução tecnológica poderá ser utilizada desde que consiga atender na íntegra as normas de todos os componentes do Padrão TISS." No ANS registry, accreditation list or conformance seal exists for prestador software; whether individual operadoras run their own onboarding tests is open. The practice never sends to ANS — item 316 puts the monthly submission on the operadora, on the 01.06.00 schemas.

Which guias. Mandatory electronic processes (item 37): cobrança, autorização limited to the lote de anexos, internação/alta, demonstrativos de retorno, recurso de glosas; optional (item 38) elegibilidade and other authorisation — but item 41 requires any optional process done electronically to be TISS-shaped. For a dental practice that is: the Guia de Tratamento Odontológico, which does three jobs at once ("Cobrança, solicitação de autorização … e pode ser utilizada para comprovação de presença") and chains continuations through "Número da Guia Principal"; the Anexo de Situação Inicial, which may travel separately via LoteAnexo (item 50.5) — the mandatory half of authorisation; the Demonstrativo de Análise de Conta and Demonstrativo de Pagamento (dental variant, contingency guia 160); and the Recurso de Glosa Odontológica (163). The Guia de Honorários does not apply ("só pode ser vinculada à guia de Solicitação de Internação"). Whether a dental consultation may use the generic Guia de Consulta is open. Batches: LoteGuias ≤ 100 of one type, LoteAnexo and RecursoGlosa ≤ 1.

Dental fields sit per procedure line — dente (tabela 28), região da boca (42), face (32), whose String 5 width means a set of faces, not one. Header: tipo de atendimento em odontologia (51) and tipo de faturamento (55), mandatory; data de término do tratamento when there was no prior authorisation. Situação inicial is per tooth against tabela 44 plus periodontal and soft-tissue flags; the paper contingency form is an FDI odontogram legended "A - Ausente · E - Extração Indicada · H - Hígido · C - Cariado · R - Restaurado", signed by dentist and patient. There is no "situação final" — closure is a date, not a second odontogram.

TUSS is not the Rol, which is the catalog question #135 raises for Germany. Item 103: every Rol item is necessarily in TUSS 22, but TUSS "também [admite] procedimentos … que, mesmo não constando no rol, sejam praticados"; item 104 refuses any TUSS request touching coverage. ANS publishes a TUSS↔Rol correlation spreadsheet precisely because they are different lists. Dental codes originate in the CBHPO, not the CBHPM, and each term carries início/fim de vigência. Provider identity is per contract: CNES (mandatory, placeholder 9999999), CRO with UF, and a "código do contratado … junto a operadora, conforme contrato estabelecido" — N codes for N operadoras.

4. Clinical records: the decisive question, answered the other way ​

Keeping a prontuário is mandatory and may be digital — CEO (Res. CFO-118/2012, in force; amended in art. 20 only by CFO-271/2025) art. 17: "É obrigatória a elaboração e a manutenção … e a sua conservação em arquivo próprio seja de forma física ou digital", each entry carrying "data, hora, nome, assinatura e número de registro do cirurgião-dentista no Conselho Regional de Odontologia". Denying access or a copy is an infraction (art. 18, I).

Paperless operation is authorised by Res. CFO-91/2009 art. 3º, and the condition is conformity, not a certificate:

"Autorizar o uso de sistemas informatizados … eliminando a obrigatoriedade do registro em papel, desde que esses sistemas atendam integralmente aos requisitos do 'Nível de garantia de segurança 2 (NGS2)', estabelecidos no Manual de Certificação para Sistemas de Registro Eletrônico em Saúde."

Art. 4º refuses the same for NGS1; CFM 1.821/2007 art. 3º is worded identically. Three facts settle the certification question:

  • The seal was abolished. Res. CFM 2.218/2018 (DOU 29.11.2018) art. 1º: "Revogar o artigo 10º da Resolução CFM nº 1.821/2007" — the article creating the joint selo — "CONSIDERANDO o término do Convênio CFM/SBIS".
  • Federal law makes certification optional. Lei 13.787/2018 art. 5º §2º: "Poderão ser implementados sistemas de certificação…". Requirements are delegated to a regulamento never issued (open); CFO's 2026 Manual reads it as the rules "de cada unidade de saúde ou definidos por Cirurgião-dentista".
  • SBIS says so itself. Manual v5.0 §1: "A Certificação de S-RES SBIS é um processo voluntário que resulta em uma opinião técnica qualificada e imparcial". No CFO act requires it.

Where certification exists it attaches to "o nome do produto … a versão do produto" assessed as a complete component stack, with recertification on "adição de novas funcionalidades ou módulos fora do escopo" — hostile to a rolling-release, self-hosted product, but an architectural argument, not a legal bar.

Retention: CFO-91/2009 sets 10 years (paper) / permanent (electronic), but Lei 13.787/2018 art. 6º sets a 20-year federal floor from the last entry and §5º extends it expressly to records "gerados e mantidos originalmente de forma eletrônica". CFO's 2026 Manual adds Parecer 125/92 minor-tolling (10 years from the patient's 18th birthday) and recommends indefinite retention. Signature: NGS2 needs one and ICP-Brasil is authorised (CFO-91/2009 art. 5º), but MP 2.200-2/2001 art. 10 §2º does not bar "outro meio de comprovação da autoria e integridade". Images: CFO-196/2019 allows publishing diagnosis and conclusion images by the treating dentist under a TCLE (art. 2º), with name and CRO on every publication and no third-party cases (art. 4º), and categorically forbids intra-procedure images and video outside scientific publication (art. 3º); CEO art. 44 I/XII still treats "antes e depois" as abusive. Teleodontologia: CFO-278/2025 (25.11.2025, revoking CFO-226/2020) permits teleconsulta with prescription, makes storing session A/V optional, accepts electronic consent that "assegure a autenticidade, integridade e rastreabilidade", and gives the patient a right to "cópia em mídia digital".

5. LGPD ​

Health data is sensitive (art. 5º, II) and the basis for clinical care is not consent: art. 11, II opens "sem fornecimento de consentimento do titular", with "f" covering "tutela da saúde, exclusivamente, em procedimento realizado por profissionais de saúde", "a" carrying the retention duty and "d" the defence of rights. A TISS claim is lawful sharing — art. 11 §4º permits it "para permitir … II - as transações financeiras e administrativas resultantes do uso e da prestação dos serviços", bounded by "em benefício dos interesses dos titulares" and by §5º. Erasure does not reach the prontuário: art. 18, VI covers only consent-based data and is subject to art. 16, I ("cumprimento de obrigação legal ou regulatória"); a refusal must state reasons (art. 18 §4º, II), and the patient may demand the list of recipients (art. 18, VII). Security is owed "desde a fase de concepção" (art. 46 §2º). Breach notification to ANPD and patients is three working days (Res. CD/ANPD 15/2024 arts. 6º, 9º), and a dental breach trips two relevance triggers at once: sensitive data and professional secrecy.

Decision ​

  1. Both halves are feasible for an open-source, self-hosted, modifiable product, and we say so plainly. No Brazilian instrument certifies invoicing software (Res. CGNFS-e 3/2023 art. 3º § único), TISS software (RN 501/2022, CO item 139) or clinical-record software (CFM 2.218/2018; Lei 13.787 art. 5º §2º; SBIS Manual v5.0). Brazil is the first market in this series where DentalPin can be a practice's only system. This ADR exists mainly so that finding is not quietly re-litigated.
  2. Two BR-gated modules, br_nfse and br_tiss, in the verifactu shape: own br_nfse_* / br_tiss_* tables, own Alembic branch, own Nuxt layer and settings page, auto_install=False, uninstall leaves nothing behind. A practice that bills only particulares installs the first. billing and catalog learn nothing about Brazil.
  3. br_nfse registers a BillingComplianceHook for BR and targets the national path: build and sign a DPS, POST /nfse to SEFIN Nacional, store the returned NFS-e, chave de acesso and DANFSe reference, mirror state into Invoice.compliance_data['BR']. Municipal emissores próprios are not a v1 target — after Res. CGSN 189/2026 the Simples Nacional majority is on the Emissor Nacional. GET /parametros_municipais/{codigoMunicipio}/convenio decides at runtime whether a clinic is reachable this way; if not, the module says so and issues nothing.
  4. The clinic holds the credential; DentalPin never does — an ICP-Brasil A1 e-CNPJ uploaded per clinic like verifactu's FNMT certificate, plus the practice's own Painel do Contribuinte credenciamento. No DentalPin-operated signing service, no producer key: the Portuguese failure mode cannot arise here.
  5. Nothing calendar-dependent is hard-coded. ISS rates, regimes, deductions, retentions and cancellation/substitution windows come from parametros_municipais at runtime. CBS/IBS rates, the 2029–2032 ISS decay and the 2033 LC 116 repeal are configuration with effective dates. XSD/leiaute versions, cIndOp and NBS tables and the DANFSe spec are versioned seeds replaceable without a code change, with homologation and production sets separable.
  6. The IBSCBS groups are a launch requirement, not a roadmap item — destaque has been due since 01.10.2026 and NT 004 §1.1 validates the groups fully whenever present. br_nfse emits them completely or does not emit; it never sends partial IBS/CBS data. Correction follows the law: immutable document, cancelamento / cancelamento por substituição / solicitação de análise fiscal as events, and no carta de correção.
  7. br_tiss is N connections, not one integration. A per-operadora connection profile holds the endpoint (from that operadora's Portal TISS), credentials, the practice's código de contratado for that contract, and the Comunicação version agreed with that operadora. There is no global TISS version setting.
  8. br_tiss v1 covers exactly the mandatory dental processes: Guia de Tratamento Odontológico (cobrança and autorização), Anexo de Situação Inicial via LoteAnexo, the demonstrativos de retorno, and Recurso de Glosa Odontológica. Elegibilidade and non-anexo authorisation come later and, if built, are TISS-shaped (item 41). DentalPin never talks to ANS; no code touches the 01.06.00 monitoramento line.
  9. TUSS is seeded read-only in br_tiss, with vigência dates, and mapped to the treatment catalog by a module-owned mapping table — the answer ADR 0031 gave for the BEMA. catalog gains no TUSS column. Codes validate against the date of care; the dental line is (tabela, código, dente?, região?, faces[]) with faces multi-valued. The Rol is not modelled as a coverage engine — a wrong "this is covered" is worse for the practice than silence. No "situação final" odontogram is built as a TISS obligation; br_tiss reads the existing odontogram to fill the situação inicial anexo and nothing more.
  10. We do not seek SBIS S-RES certification and do not claim it. The seal that mattered died in 2018; the survivor is voluntary and scoped to a product version and its stack. Instead the NGS2 requirements are adopted as an engineering target for the Brazilian edition: per-entry author binding with CRO and timestamp, append-only notes, access control and audit, and an optional ICP-Brasil signing capability over a hash-chained audit trail as the non-ICP baseline (MP 2.200-2 art. 10 §2º). Our pages say "meets the NGS2 requirements", never "certified".
  11. Retention defaults to 20 years from the last entry (Lei 13.787 art. 6º §5º), configurable upward, with minor-tolling from the patient's 18th birthday. An LGPD erasure request is honoured for marketing and consent-based data and refused with a recorded, reasoned response for the prontuário (art. 16, I). Consent is not the clinical basis (art. 11, II "f"/"a"); consent records are per-item, revocable and versioned, and gate images per CFO-196/2019 — a procedure-in-progress class that is never exportable, publication only of diagnosis/conclusion images by the treating professional, name and CRO stamped on export, no before/after composer. TISS payloads carry only the guia's fields, every disclosure is logged (art. 18, VII), and breach tooling targets the three-working-day deadlines.
  12. Until both modules exist, DentalPin's position in Brazil is "clinical record, schedule and patient invoicing; NFS-e and TISS pending, both feasible" — on the Brazilian pages and in the readiness matrix. Unlike Germany and Portugal, this is temporary: nothing external blocks it.

Consequences ​

Good ​

  • The feasibility question gating #139 closes with a sourced "yes" on both halves — the first market here whose answer is not "a third party issues, DentalPin mirrors".
  • br_nfse gives the hook a REST/JSON reference implementation alongside verifactu's SOAP/mTLS; the certificate handling is an already-solved shape.
  • Targeting SEFIN Nacional collapses what looked like 5 571 integrations into one, and Res. CGSN 189/2026 makes that the right bet for our users.
  • br_tiss's mandatory surface is small: one guia, one anexo, two demonstrativos, one appeal.
  • TUSS-in-module keeps catalog country-agnostic and reuses the answer already given for the BEMA, so #135 and #139 do not diverge.

Bad / accepted trade-offs ​

  • Both regimes are calendar-versioned and mid-reform. br_nfse tracks NT/XSD releases that moved four times in nine months; br_tiss tracks a bi-monthly cadence with a 3–12 month window. Someone owns that, or these rot faster than anything else here.
  • br_tiss must speak two Comunicação versions simultaneously, selected per operadora. That complexity cannot be designed away.
  • Onboarding is per operadora — endpoint, credentials, contract code, possibly the operadora's own tests (open).
  • Adopting NGS2 without certification means we carry the requirements and the argument; a practice that wants a seal goes elsewhere.
  • The destaque deadline has passed, so br_nfse v1 is larger than a pre-reform NFS-e module would have been.
  • One pt.json serves Portugal and Brazil today; the issue asks for a separate issue with specific keys, so that stays out of scope.

Alternatives considered ​

  • One br_compliance module. — A practice can need the invoice without the convênio side; the two have different dependencies, cadences and owners.
  • Integrate a commercial NFS-e gateway (the ADR 0027 pattern). — That pattern exists to borrow a certification we cannot hold. No such rule here, so a gateway buys a subscription and a dependency for nothing. Kept as a fallback if a clinic's municipality proves unreachable through SEFIN Nacional.
  • Target per-municipality web services first. — The obvious reading before Res. CGSN 189/2026; now the wrong bet for the Simples Nacional majority, and LC 214 art. 62 is pushing the remaining emissores próprios into the national layout anyway.
  • Route TISS through a broker. — Nothing in RN 501 contemplates one and item 134 gives the prestador the transport choice. A commercial convenience, not a standard; revisit only if per-operadora onboarding proves unworkable.
  • Model the Rol as a coverage engine. — Different list from TUSS, and coverage is the operadora's determination.
  • Seek SBIS S-RES certification. — Voluntary, product- and stack-scoped, required by nothing. Revisit if a regulamento under Lei 13.787 makes it mandatory.
  • Ship br_nfse without the IBSCBS groups. — Destaque is already due and partial data is fully validated; this ships a known desconformidade.

How to verify the rule still holds ​

  • docs/technical/country-readiness.md and the Brazilian landing page state Decision 12 and never imply any Brazilian body certifies DentalPin.
  • No module grep-matches a hard-coded ISS rate, a cancellation deadline in days, or a CBS/IBS percentage; each resolves through parametros_municipais or a dated configuration row.
  • Backend test: a BR clinic issuing through br_nfse against a SEFIN Nacional stub produces a DPS that validates against the pinned XSD with IBSCBS populated, and is refused at issue time if those groups are incomplete.
  • Backend test: two operadora profiles pinned to different Comunicação versions each produce a LoteGuias in their own namespace; a TUSS code whose vigência ended before the date of care is accepted, one that began after it is refused.
  • grep -r monitoramento backend/app/modules/br_tiss is empty, and br_tiss contains no ANS endpoint.
  • catalog has no TUSS, CBHPO or Rol column; the mapping lives in br_tiss_*.
  • Backend test: an LGPD erasure request for a BR patient deletes marketing and consent-based records and returns a reasoned refusal for the prontuário; an image classified procedure-in-progress has no reachable export path.

Answers to the issue ​

  1. National or municipal, and self-hosted software — Context §1. Both paths exist; all 5 571 entes have adhered and LC 214 art. 62 forces the national layout from 01.01.2026; Simples Nacional ME/EPP must use the Emissor Nacional since 01.09.2026, with API integration one of the two official channels. A practice may emit from software it developed or bought — no certification of the software exists. Decision 3.
  2. Current layout and dental fields — Context §1–2: production XSD v1.01-20260209 plus the NT 004/007/008/009 IBSCBS groups; service item 4.12; cIndOp from Anexo VII v1.02.00. Decisions 5–6.
  3. Authentication and where the credential lives — Context §1: an ICP-Brasil A1/A3 e-CNPJ held by the clinic, for mTLS and the DPS signature, plus self-service Painel do Contribuinte credenciamento. Decision 4.
  4. Cancellation and correction — Context §1: immutable document, 16 events, no carta de correção, correction by substitution, deadlines as per-municipality PAM parameters. Decision 6.
  5. TISS version and cadence — Context §3: five separately versioned componentes, Comunicação 04.03.00, roughly bi-monthly releases, a 3–12 month implementation window, one or two live versions chosen bilaterally. Decision 7 answers "the part that will age this module fastest".
  6. Which guias, and rol ↔ catalog — Context §3: Guia de Tratamento Odontológico, Anexo de Situação Inicial, demonstrativos, Recurso de Glosa Odontológica. TUSS (CBHPO for dentistry) is the coding terminology; the Rol is a coverage instrument and a different list. Decisions 8–9.
  7. Per operadora or standardised — Context §3: standardised contract, per-operadora endpoint. Each operadora publishes its own address and TISS Coordinator; the shipped WSDLs carry an empty <soap:address/>. One protocol, N connections. Decision 7.

Open questions ​

  • Any approval step between Produção Restrita and Produção for a taxpayer's own NFS-e software? Nothing documented; the FAQ's "solicitar acesso" is municipality-scoped.
  • Do municipalities running emissores próprios impose their own web-service credenciamento? Outside the national rule.
  • Do individual operadoras homologate a prestador's software before opening their webservice? ANS neither mandates nor forbids it.
  • May a dental consultation be billed on the Guia de Consulta?
  • Has any regulamento under Lei 13.787/2018 ever been issued? None found — which is what leaves S-RES certification voluntary.
  • Verbatim text of RN 501/2022 and IN ANS 9/2022 (hosts unreachable; operative content taken from ANS's own documentation, which tags each rule with its source).
  • Whether ANPD's planned health-data guia orientativo narrows art. 11 §4º in a way that touches TISS payload scope.

Readiness matrix row ​

| Brazil | ✅ pt (pt-BR overlay on pt #509) | ✅ | ❌ NFS-e: feasible, no software certification exists — the practice emits from its own software with an ICP-Brasil e-CNPJ (Res. CGNFS-e 3/2023 art. 3º § único); br_nfse pending, targeting the SEFIN Nacional API with the IBSCBS groups (ADR 0034) | ❌ TISS: feasible — "qualquer solução tecnológica poderá ser utilizada" (RN 501/2022, CO item 139); br_tiss pending, one protocol and N per-operadora connections, Comunicação 04.03.00; DentalPin never talks to ANS (ADR 0034) | #139 (answered) |

References ​