That's Not Fair! Navigating the Duality of Fairness in Insurance.

Insurance serves as a social good, providing financial protection against disasters whilst operating within a profit-driven market. This dual role highlights the complex intersection of social and commercial interests, raising a fairness puzzle often portrayed as a trade-off between solidarity and actuarial fairness. Insurance organisations adhere to actuarial fairness by setting insurance premiums proportional to each individual's risk.

Achieving Robust Medical Coding in DRGs Systems: Innovative Actions Adopted in Greece.

The purpose of this study is to evaluate and illustrate the effectiveness of a specialized digital platform developed to improve the accuracy of medical coding during the full implementation of Greece's new DRG system, and to highlight innovative actions for achieving and/or improving accurate medical coding. Already grouped DRG cases recorded in the first DRG implementation year in the region of Crete were examined. A sample of 133,922 cases was analyzed and audited, through a process consisting of three stages: (i) digitalization, (ii) auditor training, and (iii) control and consultation.