Chapter 1 Payment Methods of National Health Insurance
   1.1 FSS (Fee-For-Service)
   1.2 DRG (Diagnostic Related Group)
   1.3 Fixed Pricing
   1.4 New DRG
   1.5 DRG vs. New DRG

Chapter 2 Background on Introduction of New DRG
   2.1 New DRG Expasion History
   2.2 Medical Billing Formula for New DRG

Chapter 3 New DRG Management
   3.1 New DRG Applications
   3.2 New DRG Classification Criteria
   3.3 Inclusive and Non-Inclusive New DRG Products
   3.4 Issues with New DRG Criteria Changes

Chapter 4 Actual Cases Affected by New DRG Product Changes
   4.1 Anti-Adhesion Products
   4.2 Disposible Aspirators (Radio Wave/Ultrasonic)
   4.3 Circular Staplers
   4.4 Intraocular Lenses

Appendix 1 History of National Health Insurance
Appendix 2 New DRG Participating Institutions (as of April 2023)
Appendix 3 Product Group Exceptions of New DRG Reimbursement Products

References

[Tabel 1] Payment Methods of National Health Insurance
[Tabel 2] Summary of 7 Diagnostic Related Grops
[Tabel 3] DRG vs. New DRG
[Tabel 4] Medical Billing Formula for DRG
[Tabel 5] Non-Reimbursement Therapeutic Materials
[Tabel 6] Product Group Code Criteria for Non-Inclusive Therapeutic Materials
[Tabel 7] New DRG Expansion History
[Tabel 8] New DRG Pilot Program Additional Incentive Items and Rates - Hospital / General Hospital
[Tabel 9] New DRG Pilot Program Additional Incentive Items and Rates - Tertiary Referral Hospital
[Tabel 10] Inclusive Products vs. Non-Inclusive Products after 2022 Guidance Revision
[Tabel 11] Changes in Numbers of Reimbursement Products
[Tabel 12] Number of Inclusive Products of Reimbursement Product Group
[Tabel 13] Number of Inclusive Products of Non-Reimbursement Product Group
[Tabel 14] B1 Suture Group: Automatic Suture Devices Before Revision
[Tabel 15] B1 Suture Group: Automatic Suture Devices After Revision
[Tabel 16] Absorbable Internal Hemostasis Products Before Revision
[Tabel 17] Absorbable Internal Hemostasis Products After Revision
[Tabel 18] Pre-Revision Hemostatic Agents vs. Post-Revision Hemostatic Agents
[Tabel 19] Major Changes in Systems on Anti-Adhesion Products
[Tabel 20] Manufacture, Export, and Import Volume of Anti-Adhesion Products 2018-2022
[Tabel 21] Major Changes in Systems on Circular Staplers
[Tabel 22] Comparison of Claims Before and After the Introduction of G105 Group
[Tabel 23] Disease Groups and Intraocular Lens Exceptions
[Tabel 24] Development History of the National Health Insurance
[Tabel 25] Comparison of Medical Procedures, Therapeutic Materials, and Pharmaceuticals

[Fig 1] Reimbursement System for Long-Term Care Hospital
[Fig 2] New DRG (Diagnosis Related Group)
[Fig 3] Medical Billing for New DRG
[Fig 4] Guardix, Gel-Type Anti-Adhesion Product
[Fig 5] Ultrasonic Aspirator by Ethicon
[Fig 6] YoY Comparison of Radio Wave Aspirator Claims 2019-2020
[Fig 7] YoY Comparison of Ultrasonic Aspirator Claims 2019-2020
[Fig 8] Utilization of Circular Staplers
[Fig 9] TECNIS Symfony IOL (Intraocular Lens)
[Fig 10] The First Medical Insurance Act in Korea - Chapter 1 Article 1
[Fig 11] Chairman Joo-young Chung of Hyundai attending the Medical Insurance Committee Board Meeting in 1979
[Fig 12] Banner Celebrating Universal Medical Insurance Nationwide
[Fig 13] Poster Informing the Launch of National Health Insurance Service
[Fig 14] Paradigm Shift from Medical Insurance to Health Insurance