The Financial Commission is investigating the collective refusal of certain electronic medical record (EMR) companies to participate in the digitalization of insurance claims, in collaboration with the Fair Trade Commission. This low participation from EMR firms, which play a crucial role in connecting hospitals and the Insured24 system, is seen as a delay in the system's expansion.
At a meeting on May 11 in Jongno, Seoul, Kwon Dae-young, Vice Chairman of the Financial Commission, stated, "It is abnormal that, six months after the implementation of a system created after 14 years of discussion, the connection rate with hospitals remains at 29%, and some companies are collectively refusing to participate. The government will normalize this situation."
The digitalization of insurance claims allows patients to submit invoices, receipts, detailed billing statements, and prescriptions to insurance companies through the Insured24 app without needing paper documents from hospitals. For this to work, the EMR systems used by medical institutions must be linked with Insured24.
As of May 6, a total of 30,614 medical institutions were participating in the digital insurance claim system, including 827 hospitals, 3,573 public health centers, 12,875 clinics, and 13,339 pharmacies. The connection rate for Insured24, based on the total number of targeted medical institutions, stood at 29.0%. Approximately 3.77 million people are enrolled in the Insured24 service, with 2.41 million claims completed.
The Financial Commission plans to monitor the progress of Insured24 monthly and aims to increase the connection rate to 80-90% in the second half of the year. Initially, they will examine whether the collective refusal of some EMR companies constitutes unfair practices in collaboration with the Fair Trade Commission.
To encourage direct participation from medical institutions, the Financial Commission will introduce features such as displaying the number of claims per hospital on Insured24, allowing institutions to see the benefits of using the service. They will also launch a public campaign in collaboration with Naver and Toss, urging insurance policyholders to request connections with medical institutions.
However, the Financial Commission anticipates that the connection rate will rise to 52% next month, following a recent decision by a major EMR company to join Insured24. Vice Chairman Kwon emphasized, "For the public to fully enjoy the benefits of digital insurance claims, the connection rate must approach 100%."
* This article has been translated by AI.
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