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The key to detecting fraud and abuse …
- https://cdn-aem.optum.com/content/dam/optum3/optum/en/resources/white-papers/Key_Detecting_Fraud_wp_12_2012.pdf
Health Care Fraud Detection and Investigation Software
- https://www.sas.com/en_us/software/detection-investigation-for-health-care.html
- Our health care fraud detection and investigation software enables you to detect, prevent and manage fraud, waste and abuse at every stage of the claims process. SAS …
Detecting health care claims fraud | SAS
- https://www.sas.com/en_us/insights/articles/risk-fraud/detect-health-care-claims-fraud.html
- An analytics-driven health care claims fraud platform also reduces the cost of preventing those losses, said Van den Berg. “Once you have your well-appointed detection, it takes …
A Medical Claim Fraud/Abuse Detection …
- https://www.researchgate.net/publication/220704891_A_Medical_Claim_FraudAbuse_Detection_System_based_on_Data_Mining_A_Case_Study_in_Chile
- The proposed detection system uses one committee of multilayer perceptron neural networks (MLP) for each one of the …
Health Care Fraud — FBI - Federal Bureau of Investigation
- https://www.fbi.gov/investigate/white-collar-crime/health-care-fraud
Medical Fraud and Abuse Detection System Based on …
- https://pubmed.ncbi.nlm.nih.gov/33027884/
- It is estimated that approximately 10% of healthcare system expenditures are wasted due to medical fraud and abuse. In the medical area, the combination of …
The Challenge of Health Care Fraud – NHCAA
- https://www.nhcaa.org/tools-insights/about-health-care-fraud/the-challenge-of-health-care-fraud/
- Everyone Shares the Burden of Health Care Fraud. In 2018, $3.6 trillion was spent on health care in the United States, representing billions in health insurance claims. It is an …
Decision Support System (DSS) for Fraud …
- https://www.hindawi.com/journals/je/2019/1432597/
- Fraud in health insurance claims has become a significant problem whose rampant growth has deeply affected the global delivery of health services. In addition to financial losses …
WMTDBC: An unsupervised multivariate analysis model …
- https://dl.acm.org/doi/10.1016/j.eswa.2022.119259
- , A medical claim fraud/abuse detection system based on data mining: A case study in Chile, DMIN 6 (2006) 26 – 29. Google Scholar; Ozbayoglu et al., 2020 …
A Medical Claim Fraud/Abuse Detection System based …
- https://www.academia.edu/en/10464418/A_Medical_Claim_Fraud_Abuse_Detection_System_based_on_Data_Mining_A_Case_Study_in_Chile
- This paper describes an effective medical claim fraud/abuse detection system based on data mining used by a Chilean private health insurance company. Fraud and abuse in …
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