Health Insurance Fraud Detection Dataset

Listing Websites about Health Insurance Fraud Detection Dataset

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GitHub - suhitasva/Capstone_Project: Healthcare Fraud Detection

(5 days ago) Before we proceed, let us look at who our patients are. If we look at the graphs above, we see that majority of our patients belong to race encoded as 0 and gender encoded as 1. Most … See more

https://github.com/suhitasva/Capstone_Project

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Healthcare insurance fraud detection using data mining

(2 days ago) WEBIn this study, a fraud detection methodology is presented that utilizes association rule mining augmented with unsupervised learning techniques to detect …

https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-024-02512-4

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HEALTHCARE PROVIDER FRAUD DETECTION ANALYSIS Kaggle

(5 days ago) WEBHEALTHCARE PROVIDER FRAUD DETECTION ANALYSIS. code. New Notebook. table_chart. New Dataset. tenancy. New Model. emoji_events. New Competition. …

https://www.kaggle.com/datasets/rohitrox/healthcare-provider-fraud-detection-analysis

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Big Data fraud detection using multiple medicare data sources

(6 days ago) WEBThe Combined dataset had the best overall fraud detection performance with an AUC of 0.816 using LR, indicating better performance than each of its individual …

https://journalofbigdata.springeropen.com/articles/10.1186/s40537-018-0138-3

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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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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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Health insurance fraud detection based on multi-channel …

(7 days ago) WEBThe aim of health insurance fraud detection is to identify abnormal samples from large and complex health insurance datasets, and numerous fraud detection …

https://www.sciencedirect.com/science/article/pii/S2405844024060766

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Health insurance fraud detection by using an attributed …

(2 days ago) WEBHealth insurance fraud detection problem with an AHIN. The health insurance fraud detection problem can be defined by modelling different objects and …

https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-023-02152-0

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Healthcare insurance fraud detection using data mining

(8 days ago) WEBMethodolgy In this study, a fraud detection methodology is presented that utilizes association rule mining aug-mented with unsupervised learning techniques to detect …

https://link.springer.com/content/pdf/10.1186/s12911-024-02512-4.pdf

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

(3 days ago) WEBOne such avenue of saving potentially billions of dollars is to avoid and detect healthcare fraud. The National Health Care Anti-Fraud Association 1 conservatively …

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

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Health Insurance Fraud Detection Using Feature Selection and

(2 days ago) WEBIn the literature, various methodologies have been proposed to detect fraud in the health insurance domain. Richard A. Bauder and Taghi M. Khoshgoftaar …

https://link.springer.com/chapter/10.1007/978-981-99-1203-2_17

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Fraud Detection in Health Insurance Claims A Machine …

(6 days ago) WEBwww.actuariesindia.org Machine Learning vs. Rule-Based Systems in Fraud Detection There are two types of ML approachesthat are commonly used –both independently or …

https://actuariesindia.org/sites/default/files/2022-07/25062021_IAI_Fraud%20Detection-in-Health-Insurance-Claims.pdf

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Implementation of Correlation and Regression Models for …

(4 days ago) WEBchallenges of increased potential fraud to health insurance business. This work describes implementation of existing and enhanced fraud detection methods in the pre-COVID-19 …

https://arxiv.org/pdf/2102.04210v1

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How to detect healthcare fraud? “A systematic review”

(7 days ago) WEBA claims detection system and the incorporation of a health insurance/Medicare service DataSet. 16 Perform comparative data tiers and a detailed …

https://www.sciencedirect.com/science/article/pii/S0213911121002661

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Insurance Fraud - Detection Solutions: Health Insurance, 2022 …

(2 days ago) WEBHealth insurance fraud is defined as providing false or misleading information to a health insurance provider to unlawfully obtain benefits. It can be perpetrated by the …

https://www.sas.com/content/dam/SAS/documents/analyst-reports-papers/en/celent-insurance-fraud-detection-solutions-health-113186.pdf

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Health insurance fraud detection based on multi-channel …

(2 days ago) WEBHealth insurance fraud is becoming more common and impacting the fairness and sustainability of the health insurance system. Traditional health insurance fraud …

https://ui.adsabs.harvard.edu/abs/2024Heliy..1030045H/abstract

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Medical Insurance Fraud Detection using Graph Neural …

(6 days ago) WEBHence, this study proposes a medical insurance fraud detection method called StGNN that relies on a spatiotemporal constraint graph neural network. Our method includes …

https://bit.kuas.edu.tw/~jni/2022/vol7/s2/14.JNI0311.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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Markov model with machine learning integration for fraud …

(2 days ago) WEBFraud has led to a huge addition of expenses in health insurance sector in India. The work is aimed to provide methods applied to health insurance fraud …

https://arxiv.org/abs/2102.10978

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Fraud, Waste and Abuse (FWA) - HCP

(8 days ago) WEBFalse Claims Act. The False Claims Act (FCA) is a federal statute that is intended to prevent healthcare fraud and recover losses involving any federally funded contract or program, …

https://www.healthcarepartnersny.com/wp-content/uploads/2020/08/FWA-Provider-Training_Aug-2020.pdf

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Corporate Fraud Handbook - Wiley Online Library

(9 days ago) WEBFor general information on our other products and services or for technical support, please contact our Customer Care Department within the United States at (800) 762-2974, …

https://onlinelibrary.wiley.com/doi/pdf/10.1002/9781119351962.fmatter

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Financial Statement Fraud - Wiley Online Library

(9 days ago) WEBFor general information on our other products and services or for technical support, please contact our Customer Care Department within the United States at (800) 762-2974, …

https://onlinelibrary.wiley.com/doi/pdf/10.1002/9781118527436.fmatter

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DA Dan Donovan announces the takedown of an insurance fraud …

(8 days ago) WEBInsurance companies would then be billed for procedures that took 25, 40, or 60 minutes. BHATT and DINARDO decided which patients were too risky to see because of possible …

https://www.wcnyh.gov/newspage145.html

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