Health Insurance Fraud Research Paper
Listing Websites about Health Insurance Fraud Research Paper
Fourteen years of manifestations and factors of health …
(3 days ago) WEB“Health insurance fraud is an act based on deceit or intentional misrepresentation to obtain illegal benefits concerning the coverage provided by health …
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8482647/
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A study on the path of governance in health insurance …
(4 days ago) WEBCombating health insurance fraud is of utmost importance to physicians, patients, and health insurers. To delve into the mechanisms of health insurance fraud …
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10543491/
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Risks Free Full-Text Fraud Detection in Healthcare …
(9 days ago) WEBHealthcare fraud is intentionally submitting false claims or producing misinterpretation of facts to obtain entitlement payments. Thus, it wastes healthcare …
https://www.mdpi.com/2227-9091/11/9/160
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How to detect healthcare fraud? “A systematic review”
(7 days ago) WEBHolmberg and Rothstein (2011); Kirlidog and Asuk (2012); Bauder et al. (2016) state, that vulnerable fraud is found in various types of insurance including health …
https://www.sciencedirect.com/science/article/pii/S0213911121002661
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UPCODING MEDICARE: IS HEALTHCARE FRAUD AND …
(3 days ago) WEBIntroduction. Medicare fraud has been defined by the Centers for Medicare and Medicaid Services (CMS) as submitted or caused to have been submitted, false …
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649706/
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Fourteen years of manifestations and factors of health …
(5 days ago) WEBHealthcare fraud entails great financial and human losses; however, there is no consensus regarding its definition, nor is there an inventory of its manifestations and …
https://healthandjusticejournal.biomedcentral.com/articles/10.1186/s40352-021-00149-3
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A Systematic Review and Qualitative Assessment of Fraud …
(6 days ago) WEBHealth care fraud is a costly, challenging problem in health insurance. This study provides a systematic evaluation and synthesis of the methodologies and data …
https://www.tandfonline.com/doi/full/10.1080/10920277.2021.1895843
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A Review of Fraudulent Practices in Healthcare Insurance …
(6 days ago) WEBHealthcare insurance fraud is a complex and costly problem that has become a concern globally. Traditional methods of detecting fraudulent claims and requests are time …
https://ieeexplore.ieee.org/document/10345969/
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Categorizing and Describing the Types of Fraud in …
(7 days ago) WEBConclusions and Future Research This paper provides a systematic literature review of health insurance fraud types in published works. Much work has been done in …
https://www.sciencedirect.com/science/article/pii/S1877050915027295
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Analyses and Detection of Health Insurance Fraud Using …
(1 days ago) WEBFraud can be witnessed in all insurance types including health insurance. In health insurance industry, fraud is committed by intentional dissimulation or …
https://link.springer.com/chapter/10.1007/978-981-10-5699-4_5
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Multi-stage methodology to detect health insurance claim fraud
(9 days ago) WEBThe research methodology was able to detect fraudulent claims with accuracy rates of 86, 85, 87, and 84 % respectively for otolaryngologists, general …
https://link.springer.com/article/10.1007/s10729-015-9317-3
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Models for Detecting Frauds in Medical Insurance SpringerLink
(1 days ago) WEBIn this paper a thorough investigation is done over the health insurance fraud detection problem, solved by building several Machine Learning models. Our goal was …
https://link.springer.com/chapter/10.1007/978-3-031-04206-5_5
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(PDF) Fraud Detection in Healthcare Insurance Claims
(Just Now) WEBa health model that automatically detects fraud from health insurance claims in Saudi Arabia. The model indicates the greatest contributing factor to fraud with …
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Recommendations to protect patients and health care practices …
(3 days ago) WEBTypes of fraud. There is no standard in how fraud is classified. 17 CMS describes 10 different types of Medicaid fraud, whereas Thornton et al 17 describe 18 …
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7323645/
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(PDF) Fraud Detection and Analysis for Insurance Claim
(2 days ago) WEBFraud Detection and Analysis for Insurance Claim using Machine Learning. March 2022. DOI: 10.1109/SPICES52834.2022.9774071. Conference: 2022 IEEE …
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The Challenge of Health Care Fraud – NHCAA
(6 days ago) WEBThe National Health Care Anti-Fraud Association (NHCAA) estimates that the financial losses due to health care fraud are in the tens of billions of dollars each year. A …
https://www.nhcaa.org/tools-insights/about-health-care-fraud/the-challenge-of-health-care-fraud/
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A Study of Health Insurance Fraud in China and - ResearchGate
(8 days ago) WEBIn this paper, a theoretical model of medical insurance fraud identification is proposed, which characterizes the judgment variables of fraud from the three …
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Fraudulent Detection in Healthcare Insurance SpringerLink
(1 days ago) WEBThis paper compares the performance of five unsupervised algorithms in health insurance fraud detection. The five algorithms are “isolation forest (IF), …
https://link.springer.com/chapter/10.1007/978-981-15-9019-1_1
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Combating Health Care Fraud and Abuse: Conceptualization and
(3 days ago) WEBConclusions. The proposed framework and the initial prototype have the potential to improve the health care claims process by using blockchain technology for …
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7516680/
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A Review on Health Insurance Claim Fraud Detection
(4 days ago) WEBThe major use of anomaly or outlier detection is fraud detection. Health care fraud leads to substantial losses of money each year in many countries. Effective fraud detection is important for reducing the cost of Health care …
https://www.academia.edu/12745728/A_Review_on_Health_Insurance_Claim_Fraud_Detection
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Editorial: Fraud and Corruption in Healthcare - PMC
(3 days ago) WEBThe scale of losses due to fraud and corruption in healthcare is impressive as it accounts for approximately $455 billion of the $7.35 trillion spent on healthcare …
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9204141/
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Healthcare Fraud Data Mining Methods: A Look Back and Look …
(3 days ago) WEBFraud Actors, Types, and Facts. Healthcare fraud takes many forms. Some of the more prevalent forms 12, 13 are traditional fraud schemes implemented by shell …
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9013219/
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