Chile

Healthcare System

Mandatory health insurance system where workers choose annually between FONASA (public) or an ISAPRE (private). The GES/AUGE framework guarantees access, quality, timeliness, and financial protection for 85 prioritized health conditions. Chronic disease management programs (GES) create unique insurance eligibility documentation not found in most other countries.

System Type: Dual public/private mandatory-choice
Regulatory Body: ISP (Instituto de Salud Pública de Chile) — drug regulatory agency; Superintendencia de Salud — FONASA/ISAPRE oversight; MINSAL (Ministerio de Salud) — healthcare policy
Data Protection: Ley 19.628 sobre Protección de la Vida Privada (currently being updated with GDPR-aligned Ley 21.719, phased into force 2026)
Currency: CLP
Emergency Number: 131 (SAMU — ambulance), 132 (bomberos/fire), 133 (Carabineros/police)
Languages: es

Coding Systems

diagnosis

CIE-10 (Spanish ICD-10)

Clasificación Internacional de Enfermedades, Décima Revisión — Spanish translation of WHO ICD-10 base. MINSAL (Ministerio de Salud) mandates CIE-10. Codes are identical to WHO ICD-10; only descriptions are in Spanish. No national extensions or modifications.

procedures

MAI (Manual de Aranceles de Isapres / FONASA MAI)

Arancel FONASA-MAI — Chilean procedure fee schedule. Non-standardized descriptive numeric codes used for billing; no international mapping. FONASA publishes the MAI arancel annually. ISAPREs use the same MAI base with modifications. Codes take the form XX.XX.XXX (section.subsection.procedure). No CPT or ICHI equivalent adopted.

drg

GRD (Grupos Relacionados por el Diagnóstico)

IR-DRG (International Refined DRG) system recently adopted by FONASA for hospital funding. Limited adoption in 2025; public hospitals transitioning.

dental

FDI (ISO 3950)

Federation Dentaire Internationale two-digit notation — universal standard in Chile

drugs

ISP Registro Sanitario

Instituto de Salud Pública de Chile — national drug regulatory agency. All approved medications carry Registro Sanitario ISP number (RS-XXXXX). ISP regulates drug scheduling, bioequivalence, and pharmacovigilance. CENABAST manages public procurement of generic medicines for public sector.

Translation Corridors

CL→US (Chilean-Americans, former political refugees, diaspora with US insurance) CL→ES (Chilean community in Spain) VE→CL (Venezuelan patients with FONASA accessing Chilean healthcare — CIE-10 same but Venezuelan public system very different) PE→CL (Peruvian workers — both use CIE-10, minimal code crosswalk needed but insurance context differs) BO→CL (Bolivian migrant workers) HT→CL (Haitian community — French/Creole → Spanish + Chilean system navigation)

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