Healthcare Fraud Detection System
Listing Websites about Healthcare Fraud Detection System
Healthcare Fraud Data Mining Methods: A Look Back and Look …
(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 Machine …
(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: Conceptualization and
(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 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 …
https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-020-01143-9
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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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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 Protects - CMS
(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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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 …
https://www.sas.com/en_us/insights/articles/risk-fraud/detect-health-care-claims-fraud.html
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Healthcare Fraud Prevention Partnership CMS
(Just Now) WEBReport for Congress. Read the biennial report (PDF) on the Healthcare Fraud Prevention Partnership’s efforts to identify and reduce fraud, waste, and abuse …
https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership
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Data-Centric AI for Healthcare Fraud Detection - Springer
(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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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 …
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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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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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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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How Providers Can Detect, Prevent Healthcare Fraud and Abuse
(1 days ago) WEBTo prevent an organization from participating in healthcare fraud and abuse activities, providers should understand key healthcare fraud laws, implement a …
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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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Streamline Healthcare Fraud Detection for Enhanced Industry …
(4 days ago) WEBZBrain transforms healthcare fraud detection by reducing the time and effort required to identify fraudulent activities. The traditional process, which could take up to 26 hours, is …
https://zbrain.ai/healthcare-fraud-detection-using-ai/
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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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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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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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Health Care Fraud — FBI
(8 days ago) WEBHealth care fraud can be committed by medical providers, patients, and others who intentionally deceive the health care system to receive unlawful benefits or payments. …
https://www.fbi.gov/investigate/white-collar-crime/health-care-fraud
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