To fundamentally solve the two problems of “running errands for reimbursement” and “full prepayment by the patients”, in 2016 the Chinese government made the commitment that within two years, the direct settlements of hospitalization expenses will be fully portable across provinces. A nationwide network for basic health insurance and direct settlement network across provinces will be set up to achieve direct settlement of hospitalization expenses across provinces.

Vietnam has about 80.9 million citizen participate in Healthcare Insurance that makes the coverage of over 86% of the population. VSS now faces big challenges in HI payment inspection: how to manage the huge amount of HI participant data (hundreds of million HI payment requests need inspection annually and increasing) as well as to provide timely resolutions for all HI policies and ensure the quality of social security. It was in this situation that VSS decide to build the HI Inspection Information System to connect with over 12,000 hospitals nationwide.

The National Pension Service (NPS) developed a system that connects social insurance computer network and established the Social Insurance Information Center at the NPS in February 2003 to allow citizens to register once by visiting any office of the four social security organizations or via online to resolve inconveniences of having to make requests or submissions at each of the organizations of the four social insurances (National Pension, National Health Insurance, Employment Insurance, and Workers’ Compensation Insurance).

Following the social trend of more smart phone usage than PCs, the National Pension Service seeks to make processes effecient and innovate services by strengthening non-face to face channels, expanding remote services utilizing ICT technologies, effectively introducing the national pension scheme, strengthening communication channels with the public and improving the convenience of using e-information service to enable citizens to easily use pension-related services through their mobile phones anywhere and anytime, and pursues to continuously identify service contents to promote mobile usag

Employment and Social Development Canada (ESDC) leveraged an immersive design-thinking process to create and implement a Service Transformation Strategy that would respond to Canadians’ service expectations and a government-wide policy direction. This process allows ESDC to gather innovative ideas from employees, clients, and partners, and translate those ideas into client-centred service solutions using an agile and repeatable design methodology.

This practice has provided variety health alarms to the public before the epidemic spreads out. 2 3 It combines different data from diverse sources such as national health information from National Health Insurance Service (NHIS), social data from Twitter, climate information from National Meteorological Office (NMO), air pollution information from Environmental Science Institute (ESI) and number of food poisoning confirmed from Ministry of Food and Drug Safety (MFDS). Five infectious disease : cold, eye disease, food poisoning, dermatitis and asthma are continuously monitored.

GOSI's e-services have been introduced gradually and improved upon with the passing of time as well as branched out into more and more advanced frontiers. These services were necessary to face the following challenges: • Growth of establishments, contributors and beneficiaries • Expansion in new geographical areas to offer services for expanding businesses. • Service deterioration due to growth: lengthy lines, crowded parking lots, poor response time, process delays, cumbersome and inductive errors due to large volume.

In its efforts to enhance and facilitate the services and operations, the Social Security Corporation (SSC) has introduced a new electronic communication tool. This tool available in Arabic and English and provides various services to individuals and entreprises such as detailed information, personal profile, primary data for voluntary contributors, pensioners details, payments, transactions, and SSC numbers

Fraud incidence in healthcare is not easy to find. As a country that only started Social Health insurance (JKN program) since 2014, there are not many parties that provide fraud detection tools for INA CBG case-mix system. In addition, the law that establishes an investigation for potentially fraudulent incidents is still being drafted. On the other hand, there is a significant increase in the JKN’s participants & in the number of claims. By the end of 2017, the number of claims submissions were 80,641,271 cases.

Increasing number of Indonesia Health Insurance Program participants has greatly impacted on the increasing utilization of service and the number of claim reimbursement of BPJS Health. This change required a large number of additional resources and staff for claim administration processing. BPJS Health then launched an initiative to simplify claim processing and management so that less resources are needed. The initiative was named VEDIKA which is short for Digital Claim Verification, a digital application for the claim verification process for secondary health facility reimbursement.