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RN 566/2022: care deadlines and the impact on the hospital
RN 566/2022 sets the maximum deadlines a health plan has to guarantee care, from a basic consultation to an elective admission. See the deadlines by type of procedure and why the hospital’s schedule directly affects compliance.
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- Rivio, Editorial team
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ANS (Brazil’s National Supplementary Health Agency) Normative Resolution (RN) No. 566/2022 sets the maximum deadlines a health plan has to guarantee care for a plan member, counted from the request to the actual performance of the procedure. The rule governs the relationship between health plan and plan member, not the contract between hospital and health plan, but it directly affects the hospital’s scheduling and authorization routine.
Understanding the deadlines in RN 566/2022 and where they connect to the contract between hospital and health plan helps the billing team identify responsibilities clearly and prevents delays by the hospital from being mistaken for failures by the health plan, or vice versa.
What RN 566/2022 is
RN 566/2022 governs the guarantee of care for health plan members. Published on December 29, 2022, it revoked RN 259/2011 and RN 268/2011, consolidating and updating the rules on maximum care deadlines without changing most of the deadlines already in practice.
Maximum deadlines by type of procedure
Article 3 of RN 566/2022 sets the following deadlines, counted from the date of the request for the service to its actual performance:
| Type of care | Maximum deadline |
|---|---|
| Urgent and emergency care | Immediate |
| Clinical analysis laboratory (outpatient) | 3 business days |
| Basic consultation (pediatrics, internal medicine, general surgery, gynecology and obstetrics) | 7 business days |
| Consultation and procedures with a dentist | 7 business days |
| Speech therapist, nutritionist, psychologist, occupational therapist, physical therapist, nurse‑midwife | 10 business days |
| Other outpatient diagnostic and therapy services, day hospital | 10 business days |
| Consultation in other medical specialties | 14 business days |
| High-complexity procedures (PAC) | 21 business days |
| Elective admission | 21 business days |
To meet the deadline, access to any qualified provider in the municipality where the request was made counts, not necessarily the specific provider chosen by the plan member.
What happens when the health plan misses the deadline
When no provider is available in the network (unavailability) or there is no qualified provider in the municipality (nonexistence), the health plan must guarantee care outside the contracted network, including transportation when necessary, and reimburse the plan member. Looking at how reimbursement in health plans works helps explain this obligation in detail.
Where the hospital fits into this deadline
The obligation to meet the deadlines in RN 566/2022 lies with the health plan, not the hospital. But the hospital is part of the chain that makes compliance possible: if it is slow to respond to a scheduling request or does not confirm bed availability for an elective admission, it contributes to the health plan missing a deadline that is not under the plan’s direct control.
This division of responsibility needs to be clear in the written contract between hospital and health plan, including the response time for prior authorization. This specific point is regulated by RN 503/2022, which deals with the mandatory clauses of the contract between the parties.
Elective admission deadline and the hospital schedule
The 21-business-day deadline for elective admission puts direct pressure on the hospital’s surgical schedule, especially in specialties with long waiting lists. Hospitals without clear visibility of their own scheduling capacity run the risk of contributing to missed deadlines without realizing it, creating contractual friction with the health plan.
RN 566/2022 governs the health plan, but the hospital sustains the deadline
Meeting the RN 566/2022 deadline is the health plan’s obligation, but it depends directly on the hospital’s ability to respond quickly to scheduling and authorization requests. Hospitals that do not track these deadlines internally are more exposed to contractual disputes, even without direct responsibility before the ANS.
Rivio is an artificial intelligence platform that helps hospitals monitor authorization and scheduling deadlines in real time, reducing the risk of the hospital being identified as the cause of missed deadlines that are, at their origin, the health plan’s obligation.
Frequently asked questions about RN 566/2022
What is RN 566/2022?
It is the ANS rule that sets the maximum deadlines a health plan has to guarantee care for the plan member, from a basic consultation to an elective admission.
What is the maximum deadline for an elective admission?
21 business days, counted from the date of the request to the actual performance of the procedure.
Is the hospital responsible for meeting the RN 566/2022 deadlines?
Not directly. The obligation lies with the health plan toward the plan member, but the hospital influences compliance by responding to scheduling and authorization requests.
What happens if the health plan misses the deadline?
The health plan must guarantee care outside the contracted network, including transportation when necessary, and reimburse the plan member according to the rules in force.
Has RN 566/2022 changed recently?
No. The deadlines have remained the same since 2022. RN 623/2024, in force since July 2025, deals with a different topic: the health plan’s response times to plan members’ administrative requests, not the care deadlines themselves.
