Health Insurance Fraud Detection Framework
Listing Websites about Health Insurance Fraud Detection Framework
Automated Health Insurance Processing Framework with …
(Just Now) WEBInitially, the framework focuses on fraud detection to determine the legitimacy of claims. Genuine claims leverage the patient’s medical history to calculate associated risk factors and premiums. Yang W, Zhang S. Research on bootstrapping …
https://link.springer.com/article/10.1007/s42979-024-02801-9
Category: Medical Show Health
Healthcare Insurance Frauds: Taxonomy and Blockchain-Based …
(7 days ago) WEBMotivated by these facts, we propose a smart healthcare insurance framework for fraud detection and prevention (SHINFDP) that leverages the …
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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 …
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Healthcare insurance fraud detection using data mining
(2 days ago) WEBDing proposes an iForest-based anomaly detection framework under the sliding windows framework iForestASD, for streaming data. Four real-world data sets …
https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-024-02512-4
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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 …
https://ieeexplore.ieee.org/document/9843995/
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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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Healthcare Insurance Frauds: Taxonomy and Blockchain-Based …
(5 days ago) WEBMedical health insurance fraud has been a major concern for the healthcare industry and governmental institutions. In the United States, the health …
https://ieeexplore.ieee.org/document/9520214/
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A Systematic Review and Qualitative Assessment of Fraud …
(6 days ago) WEBHealth care fraud is a costly, challenging problem in health insurance. This study provides a systematic evaluation and synthesis of the methodologies and data …
https://www.tandfonline.com/doi/full/10.1080/10920277.2021.1895843
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WMTDBC: An unsupervised multivariate analysis model for fraud …
(7 days ago) WEBAn unsupervised multivariate analysis for health insurance fraud detection. The unsupervised model developed in this study has two stages: The first stage …
https://www.sciencedirect.com/science/article/pii/S0957417422022771
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Combating Health Care Fraud and Abuse: Conceptualization and
(3 days ago) WEBConclusions. The proposed framework and the initial prototype have the potential to improve the health care claims process by using blockchain technology for …
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7516680/
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Automated Health Insurance Management Framework with …
(2 days ago) WEB3.1 Dataset Specifics. Premium prediction is a regression problem, whereas fraud detection and risk prediction are classification problems. For the premium …
https://link.springer.com/chapter/10.1007/978-981-99-7862-5_21
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Blockchain as a Healthcare Insurance Fraud Detection Tool
(2 days ago) WEBThis service acts in blockchain layer and has two main functions through smart contracts. Firstly, authentication and authentication rules. Its function is to provide …
https://link.springer.com/chapter/10.1007/978-3-030-62066-0_41
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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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Smart h‐Chain: A blockchain based healthcare framework with insurance …
(2 days ago) WEBInsurance firms are prohibited by law and corporate privacy from sharing patient data, but because the data are not linked and synchronized among insurance providers, there has been a rise in healthcare fraud. A crucial component of an e-health system is safe communication between patients, healthcare providers, and insurance …
https://onlinelibrary.wiley.com/doi/10.1002/ett.4911
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Healthcare Insurance Frauds: Taxonomy and Blockchain …
(2 days ago) WEB5 Figure 2. Proposed Block-HI framework for detecting healthcare insurance fraud. The HMIC and BMICs include a Notification Manager (NM). The NM in HMIC notifies the initiator of a
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Health insurance fraud detection based on multi-channel …
(9 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://www.cell.com/heliyon/fulltext/S2405-8440(24)06076-6
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Fourteen years of manifestations and factors of health insurance …
(3 days ago) WEB‘A Process Pattern Mining Framework for the Detection of Health Care Fraud and Abuse’, Ph.D. thesis, National Sun Yat-Sen University, Taiwan. 2003. …
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8482647/
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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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Framework for Analysis and Detection of Fraud in Health Insurance
(6 days ago) WEBDownload Citation On Dec 1, 2019, Nirmal Rayan published Framework for Analysis and Detection of Fraud in Health Insurance Find, read and cite all the research you need on ResearchGate
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Healthcare Insurance Frauds: Taxonomy and Blockchain-based …
(1 days ago) WEBSome frauds are at the risk of patient health. In this work, we propose Block-HI, a blockchain-based framework for healthcare insurance fraud detection, based on our …
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SAS Payment Integrity for Health Care SAS
(3 days ago) WEBDetect, prevent and manage health care fraud with an end-to-end framework and workflow. SAS Payment Integrity for Health Care includes fraud detection, alert …
https://www.sas.com/en_us/software/payment-integrity-for-health-care.html
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Framework for Analysis and Detection of Fraud in Health Insurance
(3 days ago) WEBThe health insurance industry generates a wide range of data from patients' information to provider payment and claims report. The impact of fraud, waste, and abuse (FWA) in …
https://ieeexplore.ieee.org/abstract/document/9073700
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Health insurance fraud detection based on multi-channel …
(7 days ago) WEBRecent heterogeneous graph-based approaches to health insurance fraud detection have been limited by a number of challenges. These methods focus on …
https://www.sciencedirect.com/science/article/pii/S2405844024060766
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Fourteen years of manifestations and factors of health insurance …
(5 days ago) WEB‘A Process Pattern Mining Framework for the Detection of Health Care Fraud and Abuse’, Ph.D. thesis, National Sun Yat-Sen University, Taiwan. Google …
https://healthandjusticejournal.biomedcentral.com/articles/10.1186/s40352-021-00149-3
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Health insurance fraud detection by using an attributed …
(4 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://www.ncbi.nlm.nih.gov/pmc/articles/PMC10080767/
Category: Health Show Health
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