Healthcare Fraud Detection Techniques

Listing Websites about Healthcare Fraud Detection Techniques

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Healthcare Fraud Data Mining Methods: A Look Back and Look …

(3 days ago) WEBThe fraud literature regarding the applications of advanced statistical techniques in various healthcare domains (medical, dental etc.) covers three main aspects of the business process: fraud detection, statistical sampling, and oversampling …

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9013219/

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AI and machine learning – an intelligent approach to healthcare …

(9 days ago) WEBAI and ML can be used to detect and prevent healthcare fraud in the following ways. Analyzing large volumes of healthcare data to identify patterns of …

https://www.hfma.org/cost-effectiveness-of-health/ai-and-machine-learning-an-intelligent-approach-to-healthcare-fraud-prevention/

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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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A Systematic Review and Qualitative Assessment of Fraud …

(6 days ago) WEBApplying a previously validated approach that has not been taken by prior health care fraud reviews, our qualitative method showed high validity in terms of …

https://www.tandfonline.com/doi/full/10.1080/10920277.2021.1895843

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Healthcare Fraud Data Mining Methods: A Look Back …

(4 days ago) WEBSome of the healthcare fraud schemes that are frequently discussed in the literature and used to develop fraud detection algorithms or analytics within regulatory entities are as follows

https://www.researchgate.net/publication/360086958_Healthcare_Fraud_Data_Mining_Methods_A_Look_Back_and_Look_Ahead

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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 care. …

https://link.springer.com/content/pdf/10.1007/s42979-023-01809-x.pdf

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Artificial Intelligence Solutions to Detect Fraud in Healthcare

(1 days ago) WEBOut of 183 retrieved studies, 31 met all inclusion criteria. This review found that AI has been used to detect different types of fraud such as identify theft and …

https://pubmed.ncbi.nlm.nih.gov/35773795/

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Healthcare Fraud Data Mining Methods: A Look Back and Look …

(9 days ago) WEBIn this article, healthcare fraud detection systems and methods found in the literature are described and summarized and several research topics are proposed to fill the potential …

https://www.semanticscholar.org/paper/Healthcare-Fraud-Data-Mining-Methods%3A-A-Look-Back-Kumaraswamy-Markey/fbbf5844b1fd242908a4a0aa65c59a8f5f2d4472

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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. …

https://www.issa.int/analysis/detecting-fraud-health-care-through-emerging-technologies

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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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Heath care fraud detection methods and new approaches

(4 days ago) WEBFraud and abuse have caused significant cost in the health care systems of many countries. This paper aims to provide a review on health care fraud detection, …

https://ieeexplore.ieee.org/document/8093544

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Predicting Healthcare Fraud in Medicaid: A - ScienceDirect

(7 days ago) WEBThe research addresses a relevant and important problem in Medicaid healthcare fraud detection. This paper offers artifacts including a set of …

https://www.sciencedirect.com/science/article/pii/S2212017313002946

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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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Healthcare Fraud Data Mining Methods: A Look Back and Look …

(9 days ago) WEBThe fraud literature regarding the applications of advanced statistical techniques in various healthcare domains (medical, dental etc.) covers three main aspects of the business …

https://perspectives.ahima.org/page/healthcare-fraud-data-mining-methods-a-look-back-and-look-ahead

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Data mining application to healthcare fraud detection: a two-step

(3 days ago) WEBMethods. We propose a two-step algorithm: the first step entails kmeans clustering of providers to identify locally consistent and locally similar groups of …

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7362640/

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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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A novel fraud detection and prevention method for healthcare …

(7 days ago) WEBMany of these authors used machine learning techniques to identify, monitor, and detect the vulnerabilities found in Ethereum and other platform smart …

https://www.sciencedirect.com/science/article/pii/S2772662222000534

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