The Potential and Uptake of Remote Sensing in Insurance: A Review [PDF]
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
doaj +5 more sources
Analysis of characteristics of patients whose sugammadex claims were denied by the Auto Insurance Claims Review Department of Korean Health Insurance Review & Assessment Service: a retrospective single-center review [PDF]
Anesthesia and Pain MedicineBackground: Recently, there have been many cases where sugammadex used in traffic accident patients has been deducted from auto insurance claims. This study aims to investigate the characteristics of sugammadex deductions through retrospective analysis.Methods: We included patients who underwent general anesthesia after traffic accidents at our ...
Hwa Song Jong, Ki Tae Jung
openalex +3 more sources
Epidemiologic Study on Kawasaki Disease in Korea, 2007-2014: Based on Health Insurance Review & Assessment Service Claims [PDF]
Journal of Korean Medical Science, 2016 The aim of this study is to assess the actual epidemiologic features of Kawasaki disease (KD) in Korea using the data from Health Insurance Review & Assessment Service (HIRA) claims from 2007 to 2014. We investigated HIRA claims of patients who had KD (International Classification of Diseases-10, M30.3) as a major diagnosis and were given intravenous ...
Sangmi Ha +3 more
openalex +4 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 sent to the National Health Insurance Service (NHIS).
Dae‐Sung Kyoung, Hun‐Sung Kim
openalex +3 more sources
Transfigurations of Healthcare Insurance (Payers) Claims with Artificial Intelligence: An Extensive Literature Review [PDF]
Journal of Advances in Developmental Research: Health Insurance (HI) pays for medical as well as surgical expenditures incurred by the insured person, thereby rendering financial safety against the expensive costs related to Healthcare (HC) services. HC costs are effectively managed via the process of Healthcare Insurance Claims (HICs), where insured individuals submit claims to their insurance ...
Vaishnavi Mishra +2 more
openalex +2 more sources
Transforming Claims and Care: A Comprehensive Review of the U.S. Health Insurance TPA Market
The U.S. Health Insurance Third-Party Administrator (TPA) Market is experiencing steady growth, valued at USD 100.55 billion in 2024 and projected to reach USD 129.08 billion by 2030 at a CAGR of 3.9% from 2025–2030. This manuscript examines the driving forces, challenges, and opportunities shaping the market.
next move strategy consulting
+4 more sources
A review of the Ghana National Health Insurance Scheme claims database: possibilities and limits for drug utilization research [PDF]
Basic & Clinical Pharmacology & Toxicology, 2018 AbstractBackgroundThere are inadequate data on prescribed drug utilization in Sub‐Saharan Africa (SSA). Drug utilization research (DUR) in this region is hampered by lack of access to databases that capture prescribed drug utilization such as health insurance claims, electronic medical records and disease registries.
Daniel Ankrah +5 more
openalex +4 more sources
Forensic Audit in Fraud Detection and Prevention for General Insurance Claims: A Literature Review
International Journal of Integrative ResearchThis paper presents a comprehensive literature review on the application of forensic audit techniques to detect and prevent fraud in general insurance claims. The review encompasses studies published between 2020 and 2025, focusing on the evolving role of forensic auditing within the insurance industry.
Pristiwanto Bani, Nurhayati Siregar
openalex +3 more sources
JOURNAL OF BUSINESS STUDIES AND MANGEMENT REVIEWThis study aims to map the effect of claim and underwriting expenses on insurance company profits. In a study using the Systematic Literature Review method, 16 articles out of 200 articles were found that fit the criteria, with search strings from 2018 to 2022.
Deka Veronica +3 more
openalex +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 HealthObjectives: 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
doaj +2 more sources