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.
- 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 Scholar
- Dias et al. Modeling healthcare authorization and claim submissions using the openEHR dual-model approach, BMC Medical Informatics and Decision Making (2011), 11:60Google ScholarCross Ref
- 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 Scholar
- 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 Scholar
- 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 Scholar
Index Terms
- eClaim System based on IHE XDR
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