Conceptual-driven classification for coding advise in health insurance reimbursement

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ObjectiveWith the non-stop increases in medical treatment fees, the economic survival of a hospital in Taiwan relies on the reimbursements received from the Bureau of National Health Insurance, which in turn depend on the accuracy and completeness of the content of the discharge summaries as well as the correctness of their International Classification of Diseases (ICD) codes. The purpose of this research is to enforce the entire disease classification framework by supporting disease classification specialists in the coding process.

论文关键词:Knowledge discovery,Text mining,Fuzzy formal concept analysis,Information retrieval,ICD code,Health insurance

论文评审过程:Received 27 March 2009, Revised 16 June 2010, Accepted 8 October 2010, Available online 3 December 2010.

论文官网地址:https://doi.org/10.1016/j.artmed.2010.10.003