醫療保險 診療費請求·審査·支拂制度의 改善方案 = The study of medical insurance money claim payment and Judge and the way of payment

다국어 초록 (Multilingual 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.

목차 (Table of Contents)

• Ⅰ. 序論
• Ⅱ. 醫療保險 診斷費請求·審査·支拂制度
• Ⅲ. 診療費請求·審査·支拂現況
• Ⅳ. 診療費請求·審査·支拂에 關한 問題點 및 改善方案
• Ⅴ. 結論
• 參考文獻