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eClaim System based on IHE XDR

Published:09 September 2015Publication History

ABSTRACT

The Korean national health insurance program provides reimbursements to hospitals. This process is computerized by the form of EDI(Electronic Data Interchange) standard-based system. However, the claiming process of private health insurance program has to be done in person by submitting necessary documents to the private insurance company. In this paper, we have proposed an eClaim system for the private health insurance system using international standards such as ISO/HL7 CDA, IHE PDQ, IHE XDR for health information exchange.

References

  1. Kwon S. 2009. Thirty years of national health insurance in South Korea: lessons for achieving universal health care coverage. Health Policy and Planning. 24: 63--71.Google ScholarGoogle Scholar
  2. Dias et al. Modeling healthcare authorization and claim submissions using the openEHR dual-model approach, BMC Medical Informatics and Decision Making (2011), 11:60Google ScholarGoogle ScholarCross RefCross Ref
  3. Robert H. Dolin, Liora Alschuler, Sandy Boyer, Calvin Beebe, Fred M. Behlen, Paul V. Biron, Amnon Shabo, HL7 Clinical Document Architecture, Release 2, JAMIA Vol. 13, No 1, Jan/Feb 2006, 30--39Google ScholarGoogle Scholar
  4. IHE IT Infrastructure Technical Framework Supplement Patient Identifier Cross-Reference HL7 V3 (PIXV3) and Patient Demographic Query HL7 V3 15 (PDQV3). {http://www.ihe.net/Technical_Framework/upload/IHE_ITI_Suppl_PIX_PDQ_HL7v3_Rev2-1_TI_2010-08-10.pdf}Google ScholarGoogle Scholar
  5. IHE IT Infrastructure Technical Framework Volume 1 Cross-Enterprise Document Reliable Interchange {http://www.ihe.net/uploadedFiles/Documents/ITI/IHE_ITI_TF_Vol1.pdf}Google ScholarGoogle Scholar

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  1. eClaim System based on IHE XDR

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      • Published in

        cover image ACM Conferences
        BCB '15: Proceedings of the 6th ACM Conference on Bioinformatics, Computational Biology and Health Informatics
        September 2015
        683 pages
        ISBN:9781450338530
        DOI:10.1145/2808719

        Copyright © 2015 Owner/Author

        Permission to make digital or hard copies of part or all of this work for personal or classroom use is granted without fee provided that copies are not made or distributed for profit or commercial advantage and that copies bear this notice and the full citation on the first page. Copyrights for third-party components of this work must be honored. For all other uses, contact the Owner/Author.

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        Association for Computing Machinery

        New York, NY, United States

        Publication History

        • Published: 9 September 2015

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        Acceptance Rates

        BCB '15 Paper Acceptance Rate48of141submissions,34%Overall Acceptance Rate254of885submissions,29%
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