Results 1 to 10 of about 248,035 (295)
Health Insurance Claim Review Using Information Technologies [PDF]
Healthcare Informatics Research, 2012 ObjectivesThe objective of this paper is to describe the Health Insurance Review and Assessment Service (HIRA)'s payment request (PARE) system that plays the role of the gateway for all health insurance claims submitted to HIRA, and the claim review ...
Young-Taek Park +4 more
doaj +6 more sources
Journal of Lipid and Atherosclerosis, 2022 Almost every Korean (97%) is enrolled in the National Health Insurance program, and most receive medical treatment at least once a year. Data are collected by the Health Insurance Review and Assessment Service (HIRA), and the results of the review are ...
Dae-Sung Kyoung, Hun-Sung Kim
doaj +4 more sources
Reporting Quality for Comorbidity Adjustment in Studies Using Korean Health Insurance Claim Data: A Scoping Review [PDF]
Journal of Preventive Medicine and Public HealthObjectives Adjustment for comorbidity is essential in observational studies using administrative data to ensure the reproducibility and transparency of research findings.
Kyoung-Hoon Kim
doaj +4 more sources
Adjusting for Confounders in Outcome Studies Using the Korea National Health Insurance Claim Database: A Review of Methods and Applications [PDF]
Journal of Preventive Medicine and Public Health, 2023 Objectives: Adjusting for potential confounders is crucial for producing valuable evidence in outcome studies. Although numerous studies have been published using the Korea National Health Insurance Claim Database, no study has critically reviewed the ...
Seung Jin Han, Kyoung Hoon Kim
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Fraud Detection in Medical Insurance Claim System using Machine Learning : A Review
International Journal of Scientific Research in Computer Science, Engineering and Information Technology, 2022 Since the beginning of the insurance industry, there has been the problem of fraudulent insurance claims. These are a broad variety of illegal activities, the most of which are never uncovered while costing the insurance industry billions of dollars annually. It is estimated that India's insurance industry is suffering losses of around 600–Rs.
null Paresh Gohil +2 more
openaire +2 more sources
Robotic process automation for identifying missing codes on insurance claims [PDF]
BMJ Health & Care InformaticsObjectives This study aimed to develop and implement robotic process automation (RPA) for identifying missing codes during insurance claim post-review at a tertiary hospital and to evaluate its feasibility and effectivenessMethods As a single-centre ...
Jiyun Lee +6 more
doaj +2 more sources
Smart contracts on blockchain for insurance and Takaful industry [PDF]
Insurance Markets and CompaniesBlockchain technology can drastically reduce the costs associated with claim verification in the insurance and Takaful industry while increasing trust among involved parties through smart contracts and a shared source of truth.
Siti Zulaikha +2 more
doaj +2 more sources
Health insurance claims management systems: Potential factors affecting their decisions [PDF]
Insurance Markets and CompaniesType of the article: Research Article AbstractThis study examines how patients’ health insurance claims were denied by different insurance providers at a Saudi Academic Medical Center (AMC), exploring the reasons for these rejections, their relationship
Nouf Khalid Al-Kahtani +6 more
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The Potential and Uptake of Remote Sensing in Insurance: A Review
Remote Sensing, 2014 Global insurance markets are vast and diverse, and may offer many opportunities for remote sensing. To date, however, few operational applications of remote sensing for insurance exist.
Jan de Leeuw +7 more
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Japanese Dental Science Review, 2022 The National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) is a database including health insurance claim and specific health checkup data.
Midori Tsuneishi +4 more
doaj +2 more sources