Health insurance

Artificial intelligence could help halt health insurance fraud - The National

Artificial intelligence applied by health insurers could help save millions of dirhams a year in fraud and abuse within the UAE healthcare system, analysts claim. Swiss software company Netcetera has completed a successful trial of its latest technology within a major health insurer, spotting almost 37,000 suspicious claims made by more than 4,000 doctors between 2016-17. Those bogus claims totalled Dh21 million and would usually have gone unnoticed by insurers, who would end up paying out for unnecessary treatments given by hospitals and clinics. The system developed by Netcetera uses an AI model that runs an algorithm to detect a pattern of behaviour. The AI model built into an insurers...

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Branded vs generic drugs: Two sides of health care

Dubai: The Abu Dhabi Department of Health’s decision to have pharmacies dispense generic medicines to patients is not only going to dramatically bring down health expenditure but also boost the prospects of local and regional pharmaceutical companies that make generic drugs. The health regulation, which came into effect on September 1, directs that patients who still want to opt for branded formulations will have to pay the difference in prices which can be upto 70 per cent more. This move is being hailed by the industry as a win-win situation for all — the insurance companies reeling under huge annual bills, local pharmaceutical companies trying to establish a strong presence and end user...

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Health Insurance and Mortality in US Adults

Abstract Objectives. A 1993 study found a 25% higher risk of death among uninsured compared with privately insured adults. We analyzed the relationship between uninsurance and death with more recent data. Methods. We conducted a survival analysis with data from the Third National Health and Nutrition Examination Survey. We analyzed participants aged 17 to 64 years to determine whether uninsurance at the time of interview predicted death. Results. Among all participants, 3.1% (95% confidence interval [CI] = 2.5%, 3.7%) died. The hazard ratio for mortality among the uninsured compared with the insured, with adjustment for age and gender only, was 1.80 (95% CI = 1.44, 2.26). After additional...

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Standard health insurance, Health insurance,

Standard health insurance Standard package The government decides on the cover provided by the standard package. All insurers offer the same standard package. Healthcare insurers are obliged to accept anyone who applies for the standard insurance package and must charge all policyholders the same premium, regardless of their age or state of health. The health insurance system in the Netherlands is based on the principle of social solidarity. Together, we all pay the overall cost of health care. Everyone contributes, for example, to the cost of maternity care and geriatric care. Additional insurance Not all health care is covered by the standard package. You can opt to take out additional...

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