Healthcare Data Fraud Detection
Listing Websites about Healthcare Data Fraud Detection
Healthcare Fraud Data Mining Methods: A Look Back …
(3 days ago) WEBFraud detection in the literature encompasses data mining (rule-based to advanced statistical methods), over-sampling, and extrapolation techniques. The literature concerning overpayment and sampling estimation are important steps in fraud detection’s business …
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9013219/
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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 provides affordable …
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10173919/
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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 industry. …
https://www.sciencedirect.com/science/article/pii/S0213911121002661
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Using Data Mining to Detect Health Care Fraud and Abuse: A …
(3 days ago) WEBData mining is the core of the KDD process. Data mining can help third-party payers such as health insurance organizations to extract useful knowledge from thousands of claims …
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4796421/
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Healthcare insurance fraud detection using data mining - PMC
(4 days ago) WEBHealthcare insurance fraud detection faces challenges from evolving and sophisticated fraud schemes that adapt to detection methods. Analyzing extensive healthcare data …
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11046758/
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Unsupervised Machine Learning for Explainable Health Care Fraud …
(4 days ago) WEBOur proposed approach for fraud detection is fully unsupervised, not relying on any labeled training data, and is explainable to end users, providing reasoning and interpretable …
https://www.nber.org/papers/w30946
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Data visualization and AI for healthcare fraud detection
(9 days ago) WEBUse AI in your healthcare fraud detection applications. Our customers have been using data visualization technology to gain insight into fraud cases for years. AI offers …
https://cambridge-intelligence.com/medical-fraud-detection/
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Data-Centric AI for Healthcare Fraud Detection - Springer
(8 days ago) WEBAutomated methods for detecting fraudulent healthcare providers have the potential to save billions of dollars in healthcare costs and improve the overall quality of patient …
https://link.springer.com/content/pdf/10.1007/s42979-023-01809-x.pdf
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Data mining application to healthcare fraud detection: a two-step
(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 mining …
https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-020-01143-9
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Artificial Intelligence Solutions to Detect Fraud in Healthcare
(1 days ago) WEBAbstract. Over the past decade, Artificial Intelligence (AI) technologies have quickly become implemented in protecting data, including detecting fraud in healthcare organizations. …
https://pubmed.ncbi.nlm.nih.gov/35773795/
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Graph Analysis for Detecting Fraud, Waste, and Abuse in …
(Just Now) WEBDetection of fraud, waste, and abuse (FWA) is an important yet challenging problem. In this article, we describe a system to detect suspicious activities in large health-care …
https://onlinelibrary.wiley.com/doi/10.1609/aimag.v37i2.2630
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An Intelligent Approach to Healthcare Fraud Prevention
(9 days ago) WEBGiven that healthcare’s most widely used technology providers, such as Epic and Cerner, serve thousands of hospitals and payers and maintain healthcare data on hundreds of …
https://guidehouse.com/insights/healthcare/2023/intelligent-approach-to-healthcare-fraud-prevention
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Healthcare Fraud Data Mining Methods: A Look Back and Look …
(1 days ago) WEBHealthcare 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 the …
https://pubmed.ncbi.nlm.nih.gov/35440932/
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Big Data fraud detection using multiple medicare data sources
(6 days ago) WEBA survey on the state of healthcare upcoding fraud analysis and detection. Health Serv Outcomes Res Methodol. 2017;17(1):31–55. Article Google Scholar Rashidian A, …
https://journalofbigdata.springeropen.com/articles/10.1186/s40537-018-0138-3
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How AI Is Playing a Role in Healthcare Fraud Prevention
(9 days ago) WEBJan. 22, 2020. AI will be a valuable tool for preventing healthcare fraud as more data makes its way into the industry, but it isn't foolproof. Kayla Matthews, Industry Voice. …
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Fraud Detection in Healthcare - Towards Data Science
(3 days ago) WEBFraud Detection in Healthcare. Identifying Suspicious Healthcare Providers Using Tableau Viz. In summary, view 1 of the dashboard aims at educating an analyst or …
https://towardsdatascience.com/fraud-detection-in-healthcare-1801bf19d36c
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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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Healthcare insurance fraud detection using data mining
(2 days ago) WEBHealthcare insurance fraud detection faces challenges from evolving and sophisticated fraud schemes that adapt to detection methods. Analyzing extensive healthcare data …
https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-024-02512-4
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Unsupervised Machine Learning for Explainable Health Care Fraud …
(2 days ago) WEBOur proposed approach for Medicare fraud detection is fully unsupervised, not relying on any labeled training data, and is explainable to end users, providing reasoning and …
https://arxiv.org/abs/2211.02927
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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 quality of …
https://link.springer.com/article/10.1007/s42979-023-01809-x
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Detecting fraud in health care through emerging technologies
(7 days ago) WEBThe traditional health care fraud detection methods, often limited to ex-post detection rather than fraud prevention, seem not to be efficient and effective, until now. Health …
https://www.issa.int/analysis/detecting-fraud-health-care-through-emerging-technologies
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FTC Finalizes Changes to the Health Breach Notification Rule
(3 days ago) WEBThe Federal Trade Commission today announced it has finalized changes to the Health Breach Notification Rule (HBNR) that will strengthen and modernize the rule by clarifying …
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The Data Dilemma: Navigating Fraud Detection In AI With - Forbes
(2 days ago) WEBOne example is the healthcare sector, where AI models are used to diagnose diseases from medical images. By prioritizing fraud detection and data integrity, we can …
Category: Medical Show Health
Change Healthcare Finally Admits It Paid Ransomware Hackers
(Just Now) WEBChange Healthcare's post to its website, however, warns that 22 screenshots of its data had been posted to the dark web by an unnamed hacker group, and that they included …
https://www.wired.com/story/change-healthcare-admits-it-paid-ransomware-hackers/
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Unveiling Insurance Fraud: Legal Risks, Detection Strategies, and …
(5 days ago) WEBHealthcare Fraud: Billing for medical services or treatments that were never provided, forging medical records, or engaging in kickback schemes with healthcare providers.
Category: Medical Show Health
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