When the medical institution submits the medical care fee claim in the form of either EDI(Electronic Data Interchange), electronic media (diskette, CD), or in writing in accordance with the appropriate details, the request for medical care fee for tertiary hospitals, dental hospitals, and oriental hospitals is conducted at the Headquarters. The review for hospitals, doctors' offices and pharmacies are handled at their respective branches.

The cost request details received by EDI are automatically reviewed by applying a computerized program to catch missing required fields such as base costs including drug costs, and physician fees as well as to check for discrepancies in the application of standards. The purpose of medical service fee review is to maintain quality standard as well as an adequate level of medical fees.

This is achieved by determining whether the payment claimed by the service providers is clinically valid and formulated in a cost-efficient manner and calculated according to the Benefit Coverage Standards stipulated in the National Health Insurance Acts.