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KMID : 0896219910120010509
Journal of Daegu Health College
1991 Volume.12 No. 1 p.509 ~ p.523
The study of medical insurance money claim payment and Judge and the way of payment
Lee Eun-Hee

Abstract
There are many problems in Medical insurance Among therm. I studied about claim payment and Judge and the way of payment. Current Medical insurance choose the "The 3rd person Payment" as the way of payment and also choose "The Fee-for-service" as assessment of the payment of insurance money. The problem is that insurance company pay the money instead the patient, under the name of the protection of insurance finances, It is paid after a course of Judgement. As a result, Insursnce company adjust the price because of over claim and over treatment. Medical institution insists that a course of judgement invade the doctors rights. So I suggest the Reform First, The way of judgement should be opened to the Public, Second, Simplifying the claim payment affair and expention overlooking jugement Make use of Medical recorder, by public claimer program. Because there are so much complication of claim payment it delays the payment.
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