• Journal of Korean society of Dental Hygiene
• /
• v.11 no.2
• /
• pp.275-289
• /
• 2011

Objectives : The recognition rate for issues and improving resolution for the recuperation income expense claim policy was examined. Methods : 1,135 copies of survey have been sent to the group of people who have claimed the dental recuperation income expense to dental recuperation institutions in Daejeon, Chungcheong Do that are registered to the health insurance evaluation and estimation office as of the May 2010 and 207 surveys that were regarded to be sincere for answering were analyzed. Results : Majority of respondence were belonged to the dentist institutions with more than 5 years of claim experiences as well as 10~50% of claim rate. The recognition of medical fee evaluation guideline was normal level, and negative recognition was higher to the health center with daily charge policy compare to the dental hospital and university affiliated dental center with treatment charge policy, Highest opinion for inappropriateness of dentist with significance was found (p<0.05). The openness of evaluation cases are regarded to be discharged through the transparent evaluation and most of the opinions for insurance claim evaluation adjustment are within the both 'Do not understand the evaluation guideline and program error of disease category, code and program' with significance(p<0.05). The reaction after the evaluation adjustment was high in reflection on the claim process after examining the reason for the evaluation adjustment through the evaluation and estimation office and university affiliated dental institution and dental center was regarded to be most active and deputy reclaimment was seemed to be most actively discharge the objection registration task (p<0.05). The claim error improving resolution recognition was highly prioritized to the accurate charting for the disease title and treatment description, improving the setting of claim program, and most highly recognized by the university affiliated dental hospital/dental center and comparably low by health center(p<0.05). and although the most of the responds of treatment description and browsing the medical fee was positive, 50% of dentists disagreed the idea so that this was creating a significant discrepancy with other groups(p<0.05). Conclusions : From this research, the recognition of medical fee evaluation guideline for dental (university) hospital and dentists were negative and high adjustment experience was examined as lacking of evaluation guideline understanding and error of disease name, code and programs and deputy reclaimment, university affiliated dental hospital/dental center were most actively handle the objection registration tasks and dentists have objection on the treatment description and browsing the treatment fee so that if these indexes can be referred to implement into the recuperation income claim process, this can be regarded to be a opportunity to create mutual credibility between recuperation institution, treatment pensioner and the evaluation institutions.

• The Journal of the Korean life insurance medical association
• /
• v.26
• /
• pp.41-53
• /
• 2007

In the course of insurance claim administration, medical experts' opinions are called medical claim reviews. They are classified into two main categories: medical verification and counsel for claim staff. Medical verification compare between product coverage and the insured's physical condition. Medical counsel for claim staff is advice for claim staff when they have a question about medical knowledge to make a claim decision. A common example of medical verification is insurance coding of pituitary apoplexy. Some clinicians have insisted that the ICD coding of pituitary apoplexy is l63 of cerebral infarction, but the exclusion criteria of I code show that neoplasm is coded as C00 to D48. Thus, pituitary apoplexy must be coded as D33. An example of medical counsel for claim staff is interpretation of some medical conditions. It is divided into UCR(usual, customary, and reasonable) assessment, assessment of causality, and so on. Disability evaluation is another subject of medical counsel for claim staff. The final claim decision must be made by claim staff because only the claim staff have the authority of claim decision. Medical claims review is only an expert's opinion.

• Journal of the Society of Disaster Information
• /
• v.11 no.2
• /
• pp.245-252
• /
• 2015

Employee's workplace satisfaction of claim adjusting company, who assesses the loss of catastrophe, have a direct influence on the loss evaluation job. Eventually their satisfaction would affect the compensation satisfaction of victims, therefore it is one of important factors for victims's compensation satisfaction. This paper analyzes empirically the determinants of employee's satisfaction to their firm for a claim adjusting company. As a result of the empirical research, it is found that the statistically significant determinant are the psychological factor, the organizational factor, and the individual factor. Among the significant factors, the psychological factor has the biggest positive factor. And the organizational factor and the individual factor is next with similar positive measurement. But the cognitive factor is not statistically significant. A claim adjusting company may use the research result for the improvement of employee's workplace satisfaction.

• Korean Journal of Community Nutrition
• /
• v.7 no.4
• /
• pp.585-594
• /
• 2002

This study examined the status of current nutrition labelling and claims for the processed foods that were purchased in the supermarket. They were assessed in the aspects of frequency and content of nutrition labelling and claims. The results are summarized as follows; The percentage of products contain the nutrition labelling or claims of processed foods of investigation were 18.7% and 18.8% respectively. In the nutrition labelling method, the format separated by expression contents with 'only liability indication nutrient'or 'liability indication nutrients plus discretion indication nutrients' were 44.7% and 43.4% respectively. In the case of type and title, 'table' and 'nutrition composition'were used most frequently, 83.9% and 83.2% respectively. And in the case of expression unit, 'per 100 g or 100 ml'was higher (56.8%) than others. Nutrition claims were divided into 'nutrition content claim'and 'comparative claim', in the former the most claim was 'containing'and in the other'more or plus'used most frequently.'Nutrient function claim'was 13.4% and 'Implied nutrient claim'was 7.3% of all the claims. Results of the evaluation of current nutrition labeling system, nutrition labelling was less advanced and variable in content and format and also the information was not easy for consumers to understand and use them. To support achievement of the nutrition label, there must be program and initiatives for better understanding and communication and guidances on food labelling and nutrition for food manufactures.

• Journal of the Society of Cosmetic Scientists of Korea
• /
• v.29 no.2 s.43
• /
• pp.67-77
• /
• 2003

Two categories of cosmetic products, cosmetics and quasi-drugs, have been established by the Ministry of Health, Labor and Welfare (MHLW) in Japan. Japanese pharmaceutical law has defined that products categorized as cosmetics do not exhibit any effects on human skin. In fact, cosmetic products are not permitted to claim any efficacy. On the other hand, products in the quasi-drug category can claim several efficacies such as anti-inflammatory effects, whitening/lightning effects, hair growth effects and so on. Unfortunately, the Japanese MHLW has not yet approved the efficacy of anti-aging/anti-wrinkle effects as a claim point. However, the population is aging, and the demand for anti-aging/anti-wrinkle products is increasing year by year. Japanese cosmetic companies have proposed to the MHLW that anti-aging/anti-wrinkle agents be approved as a claim concept of a quasi-drug. However, unified evaluation methods for anti-aging/anti-wrinkle effects have not been established. Currently, each company evaluates the efficacy of products/materials using their own original methods. Thus, to request approval of the MHLW, the establishment of a unified evaluation method is needed. Consequently, the Japan Cosmetic Industry Association (JCIA) has established a task force to develop guidelines for evaluating anti-wrinkle effects in 1998. In conclusion, the JCIA would like to adopt visual and image analysis scales to evaluate the anti-wrinkle effects objectively. Generally, wrinkles are roughly classified into three groups as fine wrinkles, linear deep wrinkles and crow's feet. However, academic societies of dermatology or cosmetics have not yet established a definition of wrinkles in Japan. Thus, in advance of setting up an evaluation method, the definition of wrinkles f3r evaluation must be decided. Wrinkles are defined by the task force of the JCIA as follows; furrows that people can recognize visually and that appear on the forehead, the corners of the eyes and the backs of the neck with aging. In addition, furrows are emphasized by exposure to solar light and by dry conditions. Visual evaluation is the most sensitive method and can be applied to most types of wrinkles. However, visual evaluation is hard to express digitally as results. Besides, in the case of image analysis, comparisons of data obtained from distinct examinations can not be done, because data from image analysis are relative values. Thus, to enhance the reliability of the evaluations, the adoption of an objective scale was required. The principle of the evaluation method is to analyze images taken from silicone replicas of wrinkle areas using several parameters, such as the proportion of the wrinkle $area({\%})$, the mean depth of the wrinkles (mm), the mean depth of the deepest wrinkle (m) and the deepest point on the deepest wrinkle. Lights are shown on the skin replica from an orthogonal direction of the main orientation of the wrinkle, and the resulting shadow images are quantified by the image analysis method. To increase the precision of the data or to allow comparisons of independent examinations, a scale with furrows of several depths, 200, 400, 600, 800, and $1000{\mu}m$, is adapted in the evaluation system. I will explain the guidelines established by the JCIA in the presentation.

• Journal of Korean Society for Quality Management
• /
• v.40 no.1
• /
• pp.39-48
• /
• 2012

An early detection system for warranty issues periodically collects customers' claim data and automatically reports alarms about emerging issues based on statistical algorithms. It helps companies to reduce an issue definition time and save the handling cost of warranty claims. This paper provides an evaluation framework to validate the economic effect of an early detection system project. For this purpose, we present economical index of a project with explicit formulas such as ROI(return on investment), PP(payback period), NPV(net present value), PI(profitability index) and IRR(internal rate of return) and analyze the sensitivities of the index according to the variation of project input parameters. The proposed analysis framework is expected to be used for evaluating economic values of various system integration projects.

• Korean Journal of Construction Engineering and Management
• /
• v.17 no.5
• /
• pp.35-44
• /
• 2016

Various risk factors are known to be the nature of construction project execution process. These factors lead to potential claims, dispute mediation, arbitration, and litigation which can result in huge loss of money and time. Therefore, it is necessary for construction companies in Korea to improve overall project management capability through the evaluation before entering into the overseas construction market. Also, after examination of the claim and dispute caused by construction project risks, a substantial degree of influence and active preparation for the claim and dispute management should be confirmed via the effect analysis of the each factors. Main claim causes were derived through claim and dispute cases involved with domestic construction projects. As a prediction result of the main claim, 16.1% of the construction change claim, 5.7% of the bad faith claim and 2.7% for the construction delay claim were found to be the portion of the total construction cost. As a result of this analysis, risk management methodology was suggested to improve a project management capability for domestic construction companies through analysis result of the main factors of construction claims.

• Journal of the Korean housing association
• /
• v.27 no.5
• /
• pp.65-72
• /
• 2016

The purpose of the study was to investigate defect cases in residential interior design, to identify the state of defects, and to categorize types of defect and disputes. In addition, consumer appraisal to residential interior design service were analyzed. The results of this study could provide fundamental information regarding the defects and claims in residential interior design. First, we did literature review for defect disputes in architectural design and interior design. We identify the definition of defects by building life cycle, by state of construction, by activity, and by design performance. Second, we analysed interior design defects cases reported in Korea Consumer Agency & Ministry of Land, Infrastructure and Transport. A total of 49 cases of defect disputes in residential interior design from 2000 to 2015 were investigated. As a result, many defects appeared during the construction stage. A majority of defects cases fall into insulation, water-proofing/leakage work. In terms of design aspects claim, functional and aesthetic defects were claimed. Third, from Consumer Market Evaluation Indicators, raw data from 500 respondents were investigated for the housing repair and interior design. It is found that information comparability, responsiveness to consumer claim, price, and safety are important factors for consumer satisfaction in interior design.

• Journal of Korean Society of Industrial and Systems Engineering
• /
• v.34 no.3
• /
• pp.115-122
• /
• 2011

The critical role played by manufacturing performance measurement systems in achieving competitive success is increasingly recognized. Developing an integrated performance measurement model is significant for strategic management. This study consist of several principal steps. Performance criteria from the literature and an questionnaire were utilized prior to building the performance model. The AHP(Analytic Hierarchy Process) is utilized to evaluate the weight of each criterion when generating the performance measurement model for Korea automobile parts manufacturing company. AHP analysis showed clear difference in the priority between 5 criteria and 24 sub-criteria in terms of manufacturing performance of Korean automobile parts manufacturing company. The result of priority evaluation in the 5 criteria of 2nd level was ranked quality, cost, delivery, employee, flexibility. And the critical sub-criteria in the 24 sub-criteria of 3rd level was ranked claim rate, process defect rate, outsourcing parts defect rate, ability to quality management innovation, claim cost, etc.

• Phonetics and Speech Sciences
• /
• v.4 no.4
• /
• pp.37-43
• /
• 2012

This study investigates an independent evaluation of prosody and segmentals with reference to the difference in the foreign accent of Korean, Chinese, and Japanese learners of English. For this study, a set of stimuli were made of English sentences read by male and female Korean, Chinese, and Japanese learners of English by prosody swapping technique. Two groups of American and Korean subjects evaluated the difference in the prosody and segmentals of the stimuli by pairwise difference rating. The results showed that there was no significant difference in the evaluation scores of prosody and segmentals across accents for either subject group. The results also showed that both subject groups indicated a greater score with segmentals than with prosody. The results of the present study are significant in that they are opposite to the claim of some previous studies that prosodic factors could have a greater influence on the foreign accent and intelligibility than segmentals.