Healthcare Fraud Detection System
Listing Websites about Healthcare Fraud Detection System
Healthcare Fraud Data Mining Methods: A Look Back and …
(3 days ago) WebIn this article, healthcare fraud detection systems and methods found in the literature are described and summarized. A tabulated list of peer-reviewed articles in this research domain listing the main objectives, conclusions, and data characteristics is …
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9013219/
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Medical Fraud and Abuse Detection System Based on …
(3 days ago) WebAbstract. It is estimated that approximately 10% of healthcare system expenditures are wasted due to medical fraud and abuse. In the medical area, the …
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7579458/
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How to detect healthcare fraud? “A systematic review”
(7 days ago) Webdetection. Most physicians are detected to act on Abuse and a small portion of more than 2% of doctors take part in fraud practices that harm the healthcare …
https://www.sciencedirect.com/science/article/pii/S0213911121002661
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Combating Health Care Fraud and Abuse: …
(3 days ago) WebFurthermore, by automating a larger portion of the health care fraud detection system, cumbersome and tedious tasks such as the human review of health …
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7516680/
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Data mining application to healthcare fraud detection: a …
(2 days ago) WebThe healthcare sector is an interesting target for fraudsters. The availability of a great amount of data makes it possible to tackle this issue with the adoption of data …
https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-020-01143-9
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How AI Is Playing a Role in Healthcare Fraud Prevention
(9 days ago) WebAn AI system needs to be able to tell the difference between one person's unique way of entering data and authentic fraud behavior. Additionally, these systems …
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The Health Care Fraud and Abuse Control Program …
(1 days ago) WebSince inception in 1997, the Health Care Fraud and Abuse Control (HCFAC) State-of-the-Art Fraud Detection Technology: Since June 2011, CMS uses the …
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Healthcare insurance fraud detection using data mining
(2 days ago) WebHealthcare programs and insurance initiatives play a crucial role in ensuring that people have access to medical care. There are many benefits of healthcare …
https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-024-02512-4
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Data-Centric AI for Healthcare Fraud Detection
(8 days ago) WebData‑Centric AI for Healthcare Fraud Detection Justin M. Johnson1 · Taghi M. Khoshgoftaar 1 Received: 24 December 2022 / Accepted: 20 March 2023 / Published …
https://link.springer.com/content/pdf/10.1007/s42979-023-01809-x.pdf
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Detecting health care claims fraud SAS
(1 days ago) WebAn 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 …
https://www.sas.com/en_us/insights/articles/risk-fraud/detect-health-care-claims-fraud.html
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Data-Centric AI for Healthcare Fraud Detection - PMC
(4 days ago) WebThis study presents a data-centric approach to improving healthcare fraud classification rates within the U.S. Medicare program. The U.S. Medicare program …
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10173919/
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SAS Payment Integrity for Health Care SAS
(3 days ago) WebKey Features. A single, fully integrated solution for ensuring payment integrity in health care, with components for fraud detection, alert management and case handling. Plus …
https://www.sas.com/en_us/software/payment-integrity-for-health-care.html
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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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Feature engineering to detect fraud using healthcare claims data
(1 days ago) WebTo combat this kind of societal threat, there is an intense need for healthcare fraud detection systems to evolve. Some common roadblocks in …
https://www.sciencedirect.com/science/article/abs/pii/S0957417422015330
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Graph Analysis for Detecting Fraud, Waste, and Abuse in …
(Just Now) WebAny fraud-detection system needs to be able to handle the large data volume and data diversity. Furthermore, health-care programs and perpetrators are in …
https://onlinelibrary.wiley.com/doi/10.1609/aimag.v37i2.2630
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Healthcare Fraud Data Mining Methods: A Look Back and Look …
(9 days ago) WebAbstract Healthcare fraud is an expensive, white-collar crime in the United States, and it is not a victimless crime. Costs associated with fraud are passed on to the population in …
https://perspectives.ahima.org/page/healthcare-fraud-data-mining-methods-a-look-back-and-look-ahead
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Detecting fraud in health care through emerging technologies
(7 days ago) WebIn the Republic of Korea, the National Health Insurance Service (NHIS) has developed a fraud detection system based on health care big data, which includes …
https://www.issa.int/analysis/detecting-fraud-health-care-through-emerging-technologies
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Using Data Mining to Detect Health Care Fraud and Abuse: A …
(3 days ago) Web3. Related Works. Travaille, Müller, Thornton and Hillegersberg (2011) created an overview on fraud detection within other industries, and how they can be …
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4796421/
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Federal Agencies Launch Portal for Public Reporting of …
(2 days ago) WebThat’s why we are working to tackle anticompetitive practices in the health care markets,” said HHS Secretary Xavier Becerra. “The Biden-Harris Administration and …
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Data-Centric AI for Healthcare Fraud Detection SN Computer …
(Just Now) WebAbstract. Automated methods for detecting fraudulent healthcare providers have the potential to save billions of dollars in healthcare costs and improve the overall …
https://link.springer.com/article/10.1007/s42979-023-01809-x
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Design and development of big data-based model for detecting …
(Just Now) WebAn intelligent Provider Fraud_Anomaly Detection System (PF_ADS) is introduced by the integration of big data and deep learning approaches for the …
https://link.springer.com/article/10.1007/s00500-023-08296-5
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Healthcare Fraud Wiley Online Books
(2 days ago) WebAn invaluable tool equipping healthcare professionals, auditors, and investigators to detect every kind of healthcare fraud According to private and public …
https://onlinelibrary.wiley.com/doi/book/10.1002/9781119203636
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Unveiling $5.4M Healthcare Fraud: The Case of Adarsh Gupta and …
(4 days ago) WebHealthcare fraud remains a pervasive issue, threatening the integrity of medical services and draining valuable resources from public programs. In a recent development, a …
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