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February 28, 2026The Journal of The Korean Dental Association0 citations

A review of dental-related cases in the 2025 compilation of improper health insurance claims

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JSJin-Won Sohng

Key Points

  • This review aims to identify and analyze common errors in dental-related health insurance claims.
  • Analyzed cases from the 2025 Compilation of Improper Health Insurance Claims.
  • Examined patterns of claims errors in dental practices.
  • Identified structural vulnerabilities in clinic workflows.
  • Highlighted frequent patterns of claim errors in dental practices.
  • Demonstrated that errors are linked to workflow issues in clinics.
  • Suggested that enhancing internal review processes may reduce improper claims.

Abstract

In dental practice, claims for National Health Insurance reimbursement are an essential extension of clinical care, and dentists ultimately bear responsibility for the accuracy of insurance claims. This study analyzed dental-related cases included in the 2025 Compilation of Improper Health Insurance Claims published by the Health Insurance Review and Assessment Service and the Ministry of Health and Welfare of Korea to examine patterns of claim errors frequently occurring in routine dental practice. The findings suggest that these errors reflect structural vulnerabilities within dental clinic workflows, and that strengthening basic internal review systems may contribute to the prevention of improper insurance claims.

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Cite This Study

Jin-Won Sohng (2026) studied this question.

synapsesocial.com/papers/69a288170a974eb0d3c0421fhttps://doi.org/10.22974/jkda.2026.64.2.005
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