The Claim State of Dental Institutions forPayment from the NHIC

Background/Objectives: This study was performed to identify the causes that affect care benefits expense claim work of dental health insurance to provide basic data on efficient dental health insurance claim.

Method/Statistical Analysis: The study was conducted in the survey of Korean dental medical institution workers. The chi-square test was conducted to analyse the difference according to the health insurance claim method and the difference in health insurance reception result. A logistic regression analysis was conducted to verify the factors affecting the charge of health insurance claims.

Findings: Compared to the case of the absence of a dental hygienist, in case of 2 people, the probability of being in charge of a claim increased by 8.275 times (p = .001), and in case that the number of dental hygienists is 3 people or more, the probability of being in charge of a claim increased by 5.524 times (p = .005). Compared to the case of 1-4 employees, in case of more than 10 employees or more, the probability of being in charge of a claim is reduced by 0.119 times (p = .002). In the work experience, the probability of being in charge of a claim in case of more than 5 years and less than 10 years was 1.505 times higher than in case of less than 5 years(p = .001), and that of the case of more than 10 years was 6.440 times higher (p<.001).

Improvements/Applications: The introduction of a qualification system for the dental health insurance claim professional can reduce the burden on insurance claims by dental institutions.