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KMID : 0362520140160020089
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Journal of The Korean Academy of Dental Hygiene
2014 Volume.16 No. 2 p.89 ~ p.98
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Introduction to the Public Dental Insurance Claim Professionals System
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Ahn Se-Youn
Oh Byung-Kyung
Hwang Sun-Hee
Yoo Eun-Mi
Han Ji-Youn
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Abstract
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The purpose of this study is capable of dental insurance claims for the views of experts investigating the qualifications, curriculum development, dental insurance plan to provide basic information as is necessary. A total of 600 dental clinics in South Korea, including in the Seoul and Gyunggi areas, which provide their clients with or without public dental insurance claim services were randomly screened and surveyed door-to-door using a questionnaire between April 20 and June 20, 2010. Of the 600 clinics, 511(85.1%) were finally selected for this study to exclude from the analysis the unreliable data from the other 89 clinics First, regarding the qualifications of the public dental insurance claim professionals, 47.6% of them agreed to the requirement for a minimum of three years of clinical experience for efficient insurance claims, and 40.4%, to a five-year clinical experience. Second, the older the subjects were, the more they desired the introduction of the public dental insurance claim professionals system. Both dental hygienists and dentists showed a high level of agreement to the system, with a statistically significant difference(p<0.05). Third, regarding the educational requirement for the system, 60.4% of the subjects who had 11 years’ or longer clinical experience, 58.8% of the subjects with five years’ or shorter experience, and 56.1% of the subjects with six to 10 years of experience agreed, with a statistically significant difference (p<0.05), to the need for professional education. Fourth, in the case of general claims, the subjects were highly positive about the introduction of the system, for which they showed a statistically significant difference(p<0.05). With the introduction of the system, the time and space needed for the administrative procedures for the individual claims may be reduced. Considering the increasing numbers of disputes and criminal suits on individual claims processed by health care providers, public dental insurance claim manpower may need to be hired for the administrative efficiency of dental clinics, and to reduce the workload of dental hygienists and other professionals.
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KEYWORD
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Dental Health Insurance, Public Dental Insurance Claim Professionals System
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