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

Sohng, Jin-Won

doi:2026.64.2.45

J Korean Dent Assoc > Volume 64(2); 2026 > Article

Special Issue

Journal of Korean Dental Association 2026;64(2):45-47.
DOI: https://doi.org/10.22974/jkda.2026.64.2.005 Published online February 28, 2026.

‘2025년 요양급여 청구 부당사례 모음집’에 수록된 치과 진료 사례 분석

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

Jin-Won Sohng

Misodream Dental Clinic, Suwon, Korea

Correspondence: Jin-Won Sohng, Tel: +82-31-295-2876,
Email: prosjin@naver.com

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.

Key Words: Insurance, Health; Insurance Claim Review; Reimbursement Mechanisms