The effects of health insurance on the choice of medical procedures: Evidence from heart attacks and childbirths

2021 ◽  
Author(s):  
Marco A. Castaneda ◽  
Meryem Saygili
Keyword(s):  
Health Insurance ◽  
Medical Procedures ◽  
Heart Attacks

scholarly journals Private health insurance coverage-related lawsuits

2020 ◽  
Vol 73 (3) ◽  
Author(s):  
Ana Beatriz Perez Afonso ◽  
Mayra Gonçalves Menegueti ◽  
Thamiris Ricci de Araújo ◽  
Lucieli Dias Pedreschi Chaves ◽  
Ana Maria Laus
Keyword(s):  
Health Insurance ◽  
Private Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Medical Procedures ◽  
Cross Sectional ◽  
Positron Emission ◽  
Percutaneous Rhizotomy ◽  
Using Data ◽  
National Regulatory Agency

ABSTRACT Objectives: to analyze lawsuits brought by beneficiaries of health insurance operators. Methods: this was a cross-sectional descriptive study carried out in a large-capacity private health insurance operator using data collected by the company from 2012 to 2015. Results: ninety-six lawsuits were brought by 86 beneficiaries regarding medical procedures (38.5%), treatments (26.1%), examinations (14.6%), medications (9.4%), home care (6.2%), and other types of hospitalization (5.2%). The procedures with the highest number of lawsuits were percutaneous rhizotomy; chemotherapy; treatment-related positron-emission tomography scans; and for medications relative to antineoplastic and Hepatitis C treatment. Conclusions: the lawsuits were filed because of the operators’ refusal to comply with items not established in contracts or not regulated and authorized by the Brazilian National Regulatory Agency for Private Health Insurance and Plans, refusals considered unfounded.

Application of Text Mining Methodologies to Health Insurance Schedules

2011 ◽  
pp. 944-963
Author(s):  
Ah Chung Tsoi ◽  
Phuong Kim To ◽  
Markus Hagenbuchner
Keyword(s):  
Health Insurance ◽  
Text Mining ◽  
Health Insurer ◽  
Medical Procedures ◽  
Bag Of Words ◽  
Text Data ◽  
Health Insurers

This chapter describes the application of a number of text mining techniques to discover patterns in the health insurance schedule with an aim to uncover any inconsistency or ambiguity in the schedule. In particular, we will apply first a simple “bag of words” technique to study the text data, and to evaluate the hypothesis: Is there any inconsistency in the text description of the medical procedures used? It is found that the hypothesis is not valid, and hence the investigation is continued on how best to cluster the text. This work would have significance to health insurers to assist them to differentiate descriptions of the medical procedures. Secondly, it would also assist the health insurer to describe medical procedures in an unambiguous manner.

Application of Text Mining Methodologies to Health Insurance Schedules

2006 ◽  
pp. 29-51
Author(s):  
Ah Chung Tsoi ◽  
Phuong Kim To ◽  
Markus Hagenbuchner
Keyword(s):  
Health Insurance ◽  
Text Mining ◽  
Health Insurer ◽  
Medical Procedures ◽  
Bag Of Words ◽  
Text Data ◽  
Health Insurers

This chapter describes the application of a number of text mining techniques to discover patterns in the health insurance schedule with an aim to uncover any inconsistency or ambiguity in the schedule. In particular, we will apply first a simple “bag of words” technique to study the text data, and to evaluate the hypothesis: Is there any inconsistency in the text description of the medical procedures used? It is found that the hypothesis is not valid, and hence the investigation is continued on how best to cluster the text. This work would have significance to health insurers to assist them to differentiate descriptions of the medical procedures. Secondly, it would also assist the health insurer to describe medical procedures in an unambiguous manner.

Application of Text Mining Methodologies to Health Insurance Schedules

2010 ◽  
pp. 785-806
Author(s):  
Ah Chung Tsoi ◽  
Phuong Kim To ◽  
Markus Hagenbuchner
Keyword(s):  
Health Insurance ◽  
Text Mining ◽  
Health Insurer ◽  
Medical Procedures ◽  
Bag Of Words ◽  
Text Data ◽  
Health Insurers

This chapter describes the application of a number of text mining techniques to discover patterns in the health insurance schedule with an aim to uncover any inconsistency or ambiguity in the schedule. In particular, we will apply first a simple “bag of words” technique to study the text data, and to evaluate the hypothesis: Is there any inconsistency in the text description of the medical procedures used? It is found that the hypothesis is not valid, and hence the investigation is continued on how best to cluster the text. This work would have significance to health insurers to assist them to differentiate descriptions of the medical procedures. Secondly, it would also assist the health insurer to describe medical procedures in an unambiguous manner.

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