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The Health Insurance Review and Assessment Service (Korean: 건강보험심사평가원; Hanja: 健康保險審査評價院) - HIRA in short - is a government agency under Ministry of Health and Welfare responsible for claims review and quality assessment of the National Health Insurance. [1]
A web portal is a specially designed website that brings information from diverse sources, like emails, online forums and search engines, together in a uniform way.Usually, each information source gets its dedicated area on the page for displaying information (a portlet); often, the user can configure which ones to display.
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The claim is then sent out from the provider to the payer in an ANSI 837 5010 standard format. Denials can be sent back as a response to the claim from the payer stating a specific reason of why the claim cannot be adjudicated. This is where denial management processes help to ensure that there is an immediate resolution to these denials.
If the membership card makes the claim that the patron is a VIP, then the club can react accordingly, translating the authenticated VIP membership claim to a permission such as the patron being permitted to sit in the exclusive lounge area and be served free drinks. Note that not all uses of the term "authentication" include claims acquisition. [3]
Federal and state governments, insurance companies and other large medical institutions are heavily promoting the adoption of electronic health records.The US Congress included a formula of both incentives (up to $44,000 per physician under Medicare, or up to $65,000 over six years under Medicaid) and penalties (i.e. decreased Medicare and Medicaid reimbursements to doctors who fail to use ...