• Title/Summary/Keyword: 단순청구

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Effect on Medical Expenses Request due to Medical Clinic Administrative Staff's Existence or Not (의원급 의료기관에서 행정인력 현황에 따른 진료비 청구에 미치는 영향)

  • Yun, Jong-Sel;Kim, Kwang-Hwan
    • Proceedings of the KAIS Fall Conference
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    • 2011.12a
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    • pp.248-250
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    • 2011
  • 2009년 1월 1일부터 3월 31일까지 신규 개원한 295개 의원급 의료기관을 대상으로 의료기관 행정인력이 있을 때와 없을 때에 따른 진료비 청구에 미치는 요인을 파악한 결과, 지역별로는 경인대권이 54.9% 가장 높은 분포를 보였으며, 진료과목별로는 일반의 29.8%로 높았으며, 행정인력이 많은 진료과도 일반의로 35.5%로 높게 나타났다. 행정인력이 있는 경우 단순청구오류건의 수정 및 이의신청횟수, 보완청구, 누락청구의 횟수도 높은 것으로 확인되며, 행정인력이 있는 경우 삭감된 부분에 대한 회수율일이 행정인력이 없는 경우보다 높은 것으로 확인되었다.이 상의 결과로 볼 때 행정인력은 병원행정 업무를 지속적인 교육과 의료인과의 소통을 통해 합리적인 청구방법 모색이 필요하다. 또한 병원행정인은 환자와 의료인과의 가교 역할을 담당하고 의료기관과 정부 등 관련기관과의 매개자로써 적절한 역할을 통해 의원급 의료기관의 경영의 도움이 될 것으로 사료된다.

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A Study on the Practices for Forfaiting in Foreign Exchange Bank in Korea and Recommendations for Improvement (국내 외국환은행의 포페이팅 취급행태와 개선점에 관한 연구)

  • Kim, Chang-Sun
    • Korea Trade Review
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    • v.42 no.3
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    • pp.25-47
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    • 2017
  • Forfaiting is a trade finance facility whereby financial institution purchases accounts receivable from exporters, on a without recourse basis. After the adoption of K-IFRS in 2011, accounting for simple borrowing as usual negotiation increases debt ratio which in turn, worsens financial soundness of a company. Hence, exporting companies have their interest in forfaiting that enables book-off in order to decrease the borrowing. Along with the execution of URF 800 at ICC and increasing the interest of exporting companies into forfaiting, foreign exchange banks in Korea expand the development of products related to forfaiting. Upon surveying all these national banks of this matter, this paper identified an appropriate solution for the forfaiting practice.

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Operational Efficiency and Value Relevance of Unbilled Revenue in the Construction Company (건설기업의 경영효율성과 미청구공사의 가치관련성)

  • Kim, Young Hoon;Cho, Seokhee
    • Journal of the Korean Data Analysis Society
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    • v.20 no.6
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    • pp.3003-3014
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    • 2018
  • This paper investigates whether the value relevance of unbilled revenue in the construction company is differentiated according to the degree of company's operational efficiency. Unbilled revenue is an item that appears in the assets of the statement of financial position based on the IFRS. It is an item that has a nature of accounts receivable, but it is calculated based on subjective judgment of management. In this paper, we hypothesized that the value relevance of unbilled revenue will be differentiated according to operational efficiency of the construction company. The results of hypothesis test are as follows. First, unbilled revenue has a significant relationship with firm's value, which is consistent with previous research results. Second, the value relevance of unbilled revenue is higher in companies with high operational efficiency. In conclusion, this paper is different from previous researches in that this paper presents not only that unbilled revenue has a value relevance but also provides evidence that it can be differentiated according to the degree of operational efficiency.

Dectection of Insurance Fraud using Visualization Data Mining Tool (Visualization Data Mining Tool을 활용한 보험사기 적발)

  • Sung, Tae-Kyung
    • Information Systems Review
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    • v.5 no.1
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    • pp.49-60
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    • 2003
  • The purpose of this study is to empirically and practically verify the applicability of visualization data mining tool in detecting real-word insurance frauds that are now emerged as one of the most serious problems socially and economically. For the verification, Analyst's Notebook by i2, which has been known as the most effective visualization data mining tool, was adopted. With Analyst's Notebook, fraud-probable insurance transactions from a very large insurance claims are selected and then substantiation for insurance frauds are attempted. The results show that Analyst's Notebook not only detects insurance fraud transactions from a vast number of insurance claims, but is also able to pinpoint organized crime group by associating one fraud transaction to another fraud transaction. Therefore, it is safe to conclude that visualization data mining is very effective in detecting false transactions and crime behaviors including insurance fraud.

A Study on the Payment Mechanism of Independent Guarantee -focusing on matters that the relevant parties involved should know- (청구보증상 지급메커니즘에 따른 실무상 유의점)

  • Oh, Won-Suk;Kim, Pil-Joon;Lee, Woon-Chang
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.46
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    • pp.133-158
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    • 2010
  • Independent guarantee is a creation of the need from the both sides, i.e. the applicant (principal debtor) and the beneficiary (creditor). The former used to have to deposit cash in favor of the beneficiary in case of his default, which laid a burden on his liquidity while the latter still wanted to have the equivalent to cash. Independent guarantee satisfied the both parties by freeing the applicant of a deposit and maintaining the beneficiary's right at the same time. The fact that independent guarantee has three payment mechanisms is not widely known to the public. They are (i) payment on first demand, (ii) payment upon submission of third-party documents, (iii) payment upon submission of an arbitral or court decision. From the applicant's point of view, the order in his favor is (iii), followed by (ii) and (i). As there shouldn't be a case where one party is at a disadvantage against the other, useful insight is being sought for the benefit of the applicant. First, the applicant can offer his intention to provide a payment mechanism (ii) or (iii) rather than (i) if he must deliver it. Second, if the beneficiary still wants to have (i) and the applicant is in a position not to reject it, the latter should thoroughly check any provisions that may work against him later. Third, the applicant could use counterbalancing provisions in underlying contract to cope with protective clauses in the guarantees. Forth, the applicant should review the beneficiary's sincerity to prevent unfair calling risks. The applicant may use an ECA(Export Credit Agency) in his country to which he can transfer not only unfair calling risks, but also political risks. On the other hand, a bank needs to keep the following advice in mind. The foremost important thing for the bank not to forget is that it provides a guarantee as a service provider, not as a responsible party for the feasibility of the project, etc. Credit risk of the applicant should require the greatest attention when issuing a guarantee: the bank should look into the possibility that it can procure immediate reimbursement from its customers after payment to the beneficiary. Second, the applicant's ability to complete the project should be reviewed by checking its track records, techniques and reputation, etc. Third, the bank may also use an ECA to cover the beneficiary's unfair calling risks as well as political risks. In the case of Korea, as Korea Export Insurance Corporation(KEIC) can cover all the risks mentioned above, the bank could use its service called 'Export Bond Insurance.' What's better for the bank is that ECA cover can enhance the bank's asset quality by putting it zero on its risk weighted asset.

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Financial Structure, Ownership, and Corporate Control (기업의 소유구조 및 지배력과 재무구조)

  • Rhieu, Sang-Yup;Cheong, Ki-Moon
    • Korean Business Review
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    • v.11
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    • pp.195-216
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    • 1998
  • Ownership of an asset can be identified with the right to exercise "residual control" where the contract is silent about decision rights, or with the right to receive any "residual returns" that remain after contractual. obligations are fulfilled. Although the concept of "ownership" seems reasonably clear in many of the cases, the concepts of residual control and the residual returns that define ownership are actually quite elusive. For large corporations, there is really no single individual who owns both the residual returns and the residual control. Despite the limited qualifications, ownership is clearly. the most common and effective meas to motivate people to create, maintain, and improve the value of assets. In this paper, we try to clarify the relationships among financial structure, ownership, and corporate control with the concept of ownership defined as the residual control and the residual returns, Financial securities are not just claims to part of a firm's net income. They give the security holder certain rights. A careful matching of rights of control and returns can create incentives that increase total value of the firms. In the corporate firms, managers, lenders, and shareholders have different interests. And the financial structure affects how different those interests are and what decisions management will make. Managers are, in general, better informed than investors about the firm's prospects. The financial decisions by managers may affect investors' beliefs and, therefore, the price of shares and the value of the firm.

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Government 3.0 Era, Issues on Freedom of Information System (정부3.0 시대, 정보공개시스템의 개선 과제)

  • Jung, Zin-Im;Kim, You-Seung
    • The Korean Journal of Archival Studies
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    • no.39
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    • pp.45-72
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    • 2014
  • In the recent years, Gov.2.0, which strengthens not only a claim for freedom of information but also sharing public information, became a new paradigm of government operations. In line with the paradigm the Korean government promotes the Gov.3.0 policy. This study exams the freedom of information system, which expends its roles and responsibilities for enhancing the usage of public information in the Gov.3.0 era. Furthermore, it analyzes the system's usability from the perspective of users. The freedom of information system is the fundamental portal for all the public information's disclosure and usage. Without providing the solution for problems of the system, the Korean government's Gov3.0 policy cannot succeed. Also, Park Geun-hye Government's Gov.3.0 initiatives which consists of tasks, such as reinforcing freedom of information, immediate releasing original documents, and expending public access to information, should be done through the freedom of information system. The importance of the system is increasingly heavy. It is not only the simple online contact point for public information, but also a public sphere for sharing public raw data and for implementing the Gov.3.0 vision. However, the current system still does not slove it problems. This study analyzes the system's problems in terms of usability and sustainability. As a result, it provides three alternative strategies for the freedom of information system, including 'personnel and financial support expansion', 'strengthening user-friendly operating' and 'establishing long-term strategies for system improvement.

A Study on the Improvement of Accessibility to Public Records: Based on the Construction of Subject Thesaurus for Presidential Archives (공공기록에 대한 접근성 제고 방안에 관한 연구 - 대통령기록관 주제시소러스 개발 사례를 중심으로 -)

  • Rieh, Hae-Young;Kwon, Yongchan;Seong, Hyojoo;Yoo, Byonghoo
    • Journal of Korean Society of Archives and Records Management
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    • v.14 no.4
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    • pp.127-151
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    • 2014
  • To search based on the functional classification or provenance is not easy for users, and the key word-based information retrieval presents only simple words matching with the title of the records. The Presidential Archive of Korea developed a subject classification scheme to improve the convenience of searching for various records and came up with a subject thesaurus based on the scheme that utilizes the terms appearing on the title of the records and the terms used by the users who searched the portal or requested information disclosure. This research presents the development process of subject thesaurus. It also presents the utilization methods for records management work and services.

Right of disposition of cargo and Air waybill (송하인의 운송물 처분청구권과 항공화물운송장)

  • Nam, Hyun-Sook;Choi, June-Sun
    • The Korean Journal of Air & Space Law and Policy
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    • v.30 no.2
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    • pp.177-199
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    • 2015
  • Commerce enriches human life enriched and within commerce, transportation of cargo is arguably the most important in business transactions. Traditionally, marine transport has been major commercial transaction, but carriage cargo by air is on the increase. While the fare for freight in comparison with that of ocean is higher, air freight has many benefits that justify the higher shipping fee; lower insurance premium, packing charges, inventory control, cost management and especially speed. Therefore, air freight transport is accumulating gradually. An air waybill(AWB) is needed in the air transport flow. It is a nonnegotiable security, so the holder cannot transfer of a right to a third party. Some scholars suggest that a negotiable AWB is needed. However, it seems nearly impossible to do so; an e-AWB use shows a gain in numbers, even if it has not met expectations. Going forward, it would appear reasonable to conduct a follow-up study on the utility and legal problem for e-AWB. After sending goods, the consignor has the right of disposition of cargo in some cases, and more research is necessary, because it is related to change of ownership and a trade settlement. According to WATS (World Airlines Transport Statistics), the Korean Air took third place in international freight in 2014, and fifth in total, domestic and international to great acclaim. However, there is a lack of research supporting the business showing. It is hope that more studies on e-AWB, stoppage in transit, and a risk of outstanding amount, etc. connect to develop Korean air freight industry.

A proposal for advanced underwriting method of heavy drinker (알코올 남용자에 대한 Underwriting 선진화 방안)

  • Lee, Bum-Soo;Lee, Kyoung-Mo
    • The Journal of the Korean life insurance medical association
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    • v.25
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    • pp.103-118
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    • 2006
  • 근래에 한국의 생명보험 시장에는 주요 질병의 보장을 위한 상품들이 연일 쏟아져 나오고 있다. 그러나 이와 함께 증가될 수 있는 리스크에 대한 대비는 상대적으로 부족한 실정이다. 특히 간질환에 의한 급부발생이 타질환에 비하여 현격하게 높은 국내 실정에 맞게 언더라이팅 초점이 맞추어져야 할 필요가 있다. 간질환 유발인자로 대표적인 것은 B형 간염이지만, 과다한 알코올 섭취에 의한 간질환 역시 매해 빠른 속도로 증가하는 추세이다. 따라서 본 논문에서는 알코올에 의한 질환의 종류와 이와 관련된 보험금 청구 통계, 그리고 음주로 인한 교통사고의 폐해에 대해 살펴보고, 알코올 남용자를 사전에 판별할 방법을 찾아보고자 한다. 일반적으로 알려져 있는 알코올 관련 질환으로는 지방간, 알코올성 간염, 알코올성 간경변이 있으며, 이로 인한 급부발생율은 급격히 증가하고 있다. 음주로 인한 폐해는 단순히 간질환에 그치지 않고 있으며, 교통사고의 상당수가 음주와 관련이 되어있다. 이러한 리스크에 대해 국내의 상당수 보험사들은 혈액검사를 통하여 간기능에 대한 기준을 설정하여 언더라이팅을 하고 있다. 현재 주로 시행되고 있는 간기능 검사들에 대한 정확도에 대해서는 논란이 있을 수 있다. 따라서 보다 정밀한 검사법들에 대한 연구가 필요할 것이다. 외국의 경우, 보험을 가입하고자 하는 보험 대상자들은 직업이나 흡연, 위험 취미뿐만 아니라 알코올과 관련된 일정한 양식의 질문표에 대하여 성실하게 고지하도록 하고 있다. 국내에도 알코올과 관련된 자세한 고지항목을 첨부하여, 일정 기준에 미치지 못하는 가입자에 대하여 표준미달체로 분류하여 보다 정밀한 검진을 통해 세밀한 언더라이팅이 이루어져야 하겠다. 이와 아울러, 알코올로 인한 사회적 폐해의 심각성에 대한 인식 확대를 위한 각 보험사 및 유관기관의 노력이 전개된다면, 음주에 대한 진사 절차가 수월해질 것으로 기대된다.

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