Healthcare Fraud Detection Research Paper
Listing Websites about Healthcare Fraud Detection Research Paper
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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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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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/
Category: Medical Show Health
Data-Centric AI for Healthcare Fraud Detection SN …
(Just Now) WEBData-Centric AI for Healthcare Fraud Detection. Original Research; there is a great opportunity to automate healthcare fraud detection. However, there are …
https://link.springer.com/article/10.1007/s42979-023-01809-x
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A Systematic Review and Qualitative Assessment of Fraud …
(6 days ago) WEBThe main gaps we identified are the need to validate existing methods, lack of proof of intent to commit fraud, absence of a fraud rate estimate in the studies …
https://www.tandfonline.com/doi/full/10.1080/10920277.2021.1895843
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A Systematic Review and Qualitative Assessment of Fraud …
(5 days ago) WEBThis paper is specific to reviewing upcoding fraud analysis and detection research providing an overview of healthcare, upcoding, and a review of the current …
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Unsupervised Machine Learning for Explainable Health …
(4 days ago) WEBUnsupervised Machine Learning for Explainable Health Care Fraud Detection. Shubhranshu Shekhar, Jetson Leder-Luis & Leman Akoglu. Working Paper 30946. DOI …
https://www.nber.org/papers/w30946
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Unsupervised Machine Learning for Explainable Health …
(2 days ago) WEBThe US federal government spends more than a trillion dollars per year on health care, largely provided by private third parties and reimbursed by the government. …
https://arxiv.org/abs/2211.02927
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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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(PDF) Fraud Detection for Healthcare - ResearchGate
(1 days ago) WEBMedicine (IOM) estimates the annual loss to due to fraud. in the healthcare domain to b e $75Billion [3]. The magni-. tude of the fraud problem has attracted many …
https://www.researchgate.net/publication/264622353_Fraud_Detection_for_Healthcare
Category: Medicine Show Health
Machine Learning Based Approaches for Healthcare Fraud …
(Just Now) WEBThis health care fraud detection can be done using many automation methods like machine learning approach using available claim data[1][21][22], rule based system[2] …
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Medical professionals and health care fraud: Do they aid or check …
(7 days ago) WEBThis paper examines the role of health care professionals in combating health care fraud. It is not overall clear whether the share of the health professionals …
https://onlinelibrary.wiley.com/doi/full/10.1002/mde.3117
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Combating Health Care Fraud and Abuse: Conceptualization and
(3 days ago) WEBAlthough several companies are exploring blockchain to enhance health care reimbursement and revenue cycle management, few have explicitly assessed …
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7516680/
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[PDF] A Comprehensive Study of Healthcare Fraud Detection …
(8 days ago) WEBThis paper aims to provide a comprehensive survey of the statistical methods applied to health care fraud detection, with focuses on classifying fraudulent behaviors, identifying …
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Risks Free Full-Text Fraud Detection in Healthcare Insurance …
(9 days ago) WEBFeature papers represent the most advanced research with significant potential for high impact in the field. A Feature Paper should be a substantial original …
https://www.mdpi.com/2227-9091/11/9/160
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Explainable machine learning models for Medicare fraud detection
(7 days ago) WEBAs a means of building explainable machine learning models for Big Data, we apply a novel ensemble supervised feature selection technique. The technique is …
https://journalofbigdata.springeropen.com/articles/10.1186/s40537-023-00821-5
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Healthcare Fraud Detection Using Machine Learning
(1 days ago) WEBThis paper presents a comprehensive review of machine learning techniques for healthcare fraud detection, focusing on the application of IEEE standards in developing and …
https://ijcrt.org/papers/IJCRT2404517.pdf
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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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Using Big Data Analytics to Detect Fraud in Healthcare Provision
(4 days ago) WEBBig Data technologies can contribute to medical fraud detection. The aim of this paper is to present by an example, the methodological approach of the Hellenic National …
https://ieeexplore.ieee.org/document/9265118
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Blockchain and AI-Empowered Healthcare Insurance Fraud …
(5 days ago) WEBMotivated by these facts, we present a systematic survey for Artificial Intelligence (AI) and blockchain-enabled secure health insurance fraud detection in this …
https://ieeexplore.ieee.org/document/9843995/
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Network analytics for insurance fraud detection: a critical
(Just Now) WEBHowever, the literature on fraud detection using NA in insurance is still scarce. This paper adds to that literature in four ways: 1. Multiple state-of-the-art NA …
https://link.springer.com/article/10.1007/s13385-024-00384-6
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Healthcare Insurance Fraud Detection Using AI and Blockchain
(8 days ago) WEBThis research paper explores the fusion of AI algorithms and blockchain's secure ledger system, particularly utilizing SHA-256 encryption and Proof of Work consensus …
https://www.ijirmps.org/papers/2024/2/230595.pdf
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