淡江大學機構典藏:Item 987654321/72572
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    Title: Application of single sampling plan for auditing medical claimed payments of Taiwan national health insurance
    Authors: Fu, Hwai-hui;Tsai, Hsien-tang;Lin, Ching-wei;Wei, Duan
    Contributors: 淡江大學財務金融學系
    Date: 2004
    Issue Date: 2011-10-24 10:34:07 (UTC+8)
    Abstract: National Health Insurance (NHI) has been implemented in Taiwan for nearly a decade. Owing to growing demand for medical-care, effective sampling auditing is a key factor in obtaining reasonably priced medical-care services. This investigation proposes a conceptual framework “medical-claim payment auditing (MCPA) procedure” based on the “Military Standard 105E (MIL-STD-105E) single sampling plan” for establishing an objective criterion for making medical-claim payments fairly. The MCPA procedure contributes to the following: (1) meeting international standards of sampling technology; (2) reducing the sampling ratio and consequently auditing costs; and (3) encouraging healthcare providers to honestly apply their medical-claim payments thus avoid wasting medical resources.
    Relation: Health policy 70(2), pp.185-195
    DOI: 10.1016/j.healthpol.2004.02.006
    Appears in Collections:[Graduate Institute & Department of Banking and Finance] Journal Article

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