Reducing medical claims cost to Ghana’s National Health Insurance scheme: a cross-sectional comparative assessment of the paper- and electronic-based claims reviews
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- 作者：Eric Nsiah-Boateng ; Francis Asenso-Boadi ; Lydia Dsane-Selby…
- 关键词：Medical claims review ; Claims adjustment ; National Health Insurance Scheme ; Ghana
- 刊名：BMC Health Services Research
- 出版年：2017
- 出版时间：December 2017
- 年：2017
- 卷：17
- 期：1
- 全文大小：805KB
- 刊物主题：Public Health; Health Administration; Health Informatics; Nursing Research;
- 出版者：BioMed Central
- ISSN：1472-6963
- 卷排序：17
文摘
BackgroundA robust medical claims review system is crucial for addressing fraud and abuse and ensuring financial viability of health insurance organisations. This paper assesses claims adjustment rate of the paper- and electronic-based claims reviews of the National Health Insurance Scheme (NHIS) in Ghana.