Data on Health and Medical Informatics Reported by Byoung-Kee Yi and Colleagues (Development of eClaim system for private indemnity health insurance in South Korea: Compatibility and interoperability): Information Technology – Health and Medical Informatics

2022 FEB 02 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- New research on Information Technology - Health and Medical Informatics is the subject of a report. According to news reporting out of Seoul, South Korea, by NewsRx editors, research stated, “South Korea has the mandatory National Health Insurance (NHI) and supplemental Private Indemnity Health Insurance (PIHI). According to the Financial Supervisory Service, the share of the population with PIHI increased to 66% in 2018 due to the financial burden.”

Our news journalists obtained a quote from the research, “However, since the traditional PIHI claim workflow is based on the paper attachment method, it is a big burden to every stakeholder and limits the usability and accessibility of the claims data. To improve the traditional PIHI claim workflow, we developed the electronic claim (eClaim) service for the PIHI in Korea. We also applied the HL7 (Health Level Seven) FHIR (Fast Healthcare Interoperability Resources) standard to ensure interoperability of the claims data. The proposed eClaim Service has been launched in 2017. It has been increased from 8155 in the first half of 2018 to 114,087 in the second half of 2020. Currently, 60 healthcare providers and 22 payers participated in this service. In this study, we proposed an eClaim workflow and service to improve the legacy system.”

According to the news editors, the research concluded: “The proposed method can be helpful to other entities planning for their own health insurance system and also applied to various practical purposes including value-based care, automated claim review, and clinical research.”

This research has been peer-reviewed.

For more information on this research see: Development of eClaim system for private indemnity health insurance in South Korea: Compatibility and interoperability. Health Informatics Journal, 2022;28(1):14604582211071019. Health Informatics Journal can be contacted at: Sage Publications Inc, 2455 Teller Rd, Thousand Oaks, CA 91320, USA. (Sage Publications - http://www.sagepub.com/; Health Informatics Journal - jhi.sagepub.com)

Our news journalists report that additional information may be obtained by contacting Byoung-Kee Yi, Data Science Research Institute, 36626Samsung Medical Center, Seoul, South Korea.

Publisher contact information for the Health Informatics Journal is: Sage Publications Inc, 2455 Teller Rd, Thousand Oaks, CA 91320, USA.

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