• Proceedings of the Korean Institute Of Construction Engineering and Management
• /
• 2006.11a
• /
• pp.301-304
• /
• 2006

The insistence of rights and interests in contract is being generalized by opening in construction market which is following F.T.A, internationally. Conditions of contract in construction have different specialities compared with other industries. Different conditions of contract should be established because of a specific character that is different from each construction, such as work, environment, circumference conditions. Although the order of Turn-key is being expanded by increasing construction scale and demanding hybrid function, the suitable regulations of contract are not settled. As a result, various factors of claim is occurring in Change Order-Claim, because they just obey a part of guide-line. This study suggests useful solutions in detail concerned with the main factor of Change Order-Claim by each D/B phases through practical sorting and analysis of the causes of Change Order-Claim.

• Korea Journal of Hospital Management
• /
• v.10 no.2
• /
• pp.45-63
• /
• 2005

The purposes of this study are to understand the doctors' attitude and satisfaction about the review system of national health insurance claim in Korea and to suggest the way to improve this system This study conducted a survey of the doctors registered in the medical association in Seoul city. The survey was performed as a form of self-administered questionnaire from January 2004 to February 2004. The contents of questionnaire dealt with doctors' attitude and satisfaction about the review system of medical service claim. Totally, 1,037 members replied to our survey and we analysed 981 doctors' data, excluding incomplete responses. As a result, 89.7% of repliers showed a negative attitude about the influences of the review system on improvement of medical service quality, 98.0% of repliers have had experiences that they have given distorted insufficient medical services in order to evade the curtailment of service claim. Also, 91.6% of repliers stated that they have had experiences of intentional modification or alteration of diagnostic code to shun the curtailment. Most of the doctors showed negative attitude to the curtailment procedure and the review system of service claim originally intended to be one of the quality control methods of medical service in Korea also, the development of both scientific and reasonable parameters and criteria for claim is needed. 'Through the improvement of review system for appropriate medical service, there is a need of a way to increase the satisfaction of medical service providers, and to encourage the motivation for quality control. Also, education is strongly needed to provide doctors with sufficient information about review criteria and curtailment cases.

• Journal of the Korean Operations Research and Management Science Society
• /
• v.15 no.1
• /
• pp.83-97
• /
• 1990

We consider an insured who wishes to determine his optimal reporting strategy over a given planning horizon, when he has option of reporting of not reporting his at-fault accidents. Assuming that the premium in future period is continually adjusted by the insured's loss experience, the insured would not report every loss incurred. Rather, considering the benefits and costs of each decision, the insured may want to seek a way of optimizing his interests over the planning horizon. The situation is modeled as a dynamic programming problem. We consider an insured's discounted expected cost minimization problem, where the premium increase in future period is affected by the size of the current claim. More specifically, we examine two cases ; (1) the premium increase in the next is a linear function (a constant fraction) of the current claim size; (2) the premium increase in the next period is a concave function of the current claim size. In each case, we derive the insured's optimal reporting strategy.

• Proceedings of the Korean Institute of Building Construction Conference
• /
• 2017.05a
• /
• pp.278-279
• /
• 2017

Result from Amendment of Apartment Houses Decree Customer Service, Recently, the starting point of Defects Liability changed "Criteria of Completion date" to "Delivery date to Divided property". Through the Law amended, There are some inconsistency between "Claim for repairing defects" and "Period of security deposit for repairing defects claim". If someone bought a house after Completion date, Purchasing period of "Claim to security deposit for repairing defects" lapsed without renewal. This research is to identify problems and solutions for improving the system.

• Journal of Korean Society for Quality Management
• /
• v.21 no.1
• /
• pp.22-34
• /
• 1993

In claiming for the purchased products, two types of errors can occur from the consumer's point of view. One is to accept defective products and the other one is to reject good products. Due to such errors, Claim rate for the products is expected to be different from that the producer has originally anticipated. In this paper, the probability distribution of the number of claimed products when such consumer's inspection errors are involved is derived. Then, a simple model is provided to estimate the claim rate when such errors are present.

• Health Policy and Management
• /
• v.26 no.1
• /
• pp.71-78
• /
• 2016

The value of using health insurance claim database is continuously rising in healthcare research. In studies where comorbidities act as a confounder, comorbidity adjustment holds importance. Yet researchers are faced with a myriad of options without sufficient information on how to appropriately adjust comorbidity. The purpose of this study is to assist in selecting an appropriate index, look back period, and data range for comorbidity adjustment. No consensus has been formed regarding the appropriate index, look back period and data range in comorbidity adjustment. This study recommends the Charlson comorbidity index be selected when predicting the outcome such as mortality, and the Elixhauser's comorbidity measures be selected when analyzing the relations between various comorbidities and outcomes. A longer look back period and inclusion of all diagnoses of both inpatient and outpatient data led to increased prevalence of comorbidities, but contributed little to model performance. Limited data range, such as the inclusion of primary diagnoses only, may complement limitations of the health insurance claim database, but could miss important comorbidities. This study suggests that all diagnoses of both inpatients and outpatients data, excluding rule-out diagnosis, be observed for at least 1 year look back period prior to the index date. The comorbidity index, look back period, and data range must be considered for comorbidity adjustment. To provide better guidance to researchers, follow-up studies should be conducted using the three factors based on specific diseases and surgeries.

• International conference on construction engineering and project management
• /
• 2011.02a
• /
• pp.526-533
• /
• 2011

Contracting is said to be a high-risk business, and a common cause of business failure is related to cash management. A contractor's financial viability depends heavily on how actual payments from an owner deviate from those defined in the contract. The paper presents a method for contractors to evaluate the punctuality and fullness of owner payments based on historical behaviour. It does this by classifying owners according to their late and incomplete payment practices. A payment profile of an owner, in the form of aging claims submitted by the contractor, is used as a basis for the method's development. Regression trees are constructed based on three predictor variables, namely, the average time to payment following a claim, the total amount ending up being paid within a certain period and the level of variability in claim response times. The Tree package in the publicly available R program is used for building the trees. The analysis is particularly useful for contractors at the pre-tendering stage, when contractors predict the likely payment scenario in an upcoming project. Based on the method, the contractor can decide whether to tender or not tender, or adjust its financial preparations accordingly. The paper is a contribution in risk management applied to claim and dispute resolution practice. It is argued that by contractors having a better understanding of owner payment behaviour, fewer disputes and contractor business failures will occur.

• Journal of Information Management
• /
• v.20 no.1
• /
• pp.117-138
• /
• 1989

In this article, the organizational structures of check- in and claim function are examined. The procedure and function of serials control system(CLASSMATE, EBSCONET, LINX, NOTIS, INNOVACQ) are analyzed, particularly in check- in and claim system. A check-in and claim system is suggested through analysis of above serials control systems.

• Proceedings of the Korean Institute Of Construction Engineering and Management
• /
• autumn
• /
• pp.341-344
• /
• 2002

Claims are on an increasing trend in the domestic construction field with changes of negative thought about them. But there are still many factors of causing disputes Potentially due to old customs that an owner is predominant over a contractor. Unless these factors are solved, it is obvious that many disputes will occur henceforward. This study derives claim factors that must be solved first of all through analyzing how claim factors influence construction management factors such as time, cost, quality, and presents countermeasures that may prevent these claims.

• Health Policy and Management
• /
• v.14 no.4
• /
• pp.88-113
• /
• 2004

Starting from April, 2003, new pre-review system has been introduced and implemented to reduce unnecessary conflict with medical care organizations caused by current retrospective claim review system and to enhance efficiency of review system. The main purpose of pre-review system is to educate doctors to contrive adequacy of medical services. This research mainly focuses on effectiveness of pre-review system's influence on physicians' behavior changes. The analysis-participants were drawn from 1,449 clinics which implemented pre-review system, since April of 2003. The research results are as followings. First, the amount per claim has reduced by $\\3,154$, days of visit per claim by 0.1 day, and amount per visit by $\\412$, which were statistically significant. Second, anesthesiologists have decreased in three indicators the most, and the internists had least of changes. Third, the amount per claim and days of visit per claims has dropped significantly on physicians with less periods of practice and physicians with more ages. Fourth, the clinics without the expensive medical equipments, the city clinics showed significant decrease on days of visit per claim. Fifth, in intervention methods, the one-to-one education showed more significant decrease on amount per visit rather than information feedback by paper. In conclusion, the pre-review system have an impact on self-imposed physician behavioral change. The outcome of this research may be utilized for future extension implementation of pre-review system. Furthermore, it is showed that ability of transitions in medical services review system according to the future transition of payment system and context of health service policy.